针刺及针刺配合埋线缓解椎体压缩性骨折疼痛的对比研究

发布时间：2018-03-22 03:36

本文选题：骨质疏松　切入点：椎体压缩性骨折　出处：《广州中医药大学》2010年硕士论文　论文类型：学位论文

【摘要】： 研究背景随着老年人口的不断增加,作为中老年退行性疾病之一的骨质疏松症及其所引起的骨折己成为一个严重的社会问题而备受关注。骨折是骨质疏松症最常见和最严重的并发症,它不仅增加病人的痛苦,而且严重限制患者的活动,甚至缩短寿命。而骨质疏松症引起的骨折则以脊柱椎体压缩性骨折最为常见,临床症状主要表现为腰背部疼痛及活动受限。研究目的通过比较单纯针刺和针刺结合埋线的治疗方法缓解由骨质疏松性椎体压缩性骨折引起的疼痛的疗效,探讨针刺疗法和埋线疗法协同增效的可能性,寻求切合临床实际的提高针刺疗效的方法。研究方法以广州中医药大学第三附属医院(骨伤科医院)住院部的年龄在60岁以上的骨质疏松性椎体压缩性骨折患者为研究对象,采用随机分组的方法,将60例患者分为单纯针刺(A组)和针刺结合埋线组(B组),每组各30例。针刺和埋线选穴：肾俞(双)、脾俞(双)、大肠俞(双)、夹脊穴(双)、委中(双)、足三里(双)、太冲(双)、腰痛点(双)、关元、气海、阿是穴。单纯针刺组治疗方法：上述穴位针刺得气后留针二十五分钟。每隔5分钟行针一次,用捻转弹动,行平补平泻法。隔天一次,三次为一个疗程。针刺结合埋线组治疗方法：肾俞、脾俞、大肠俞、夹脊穴采用埋线疗法,其它同针刺组。治疗前后分别检测一次下列疼痛指标：1.自发性疼痛2.翻身痛3.前后屈痛4.步行痛5.椎体压痛6.完成翻身动作所需时间。治疗前后两组分别在治疗前后采用“疼痛分数”进行疗效评价。研究结果 1.A组与B组治疗前后比较,患者完成翻身动作所需时间均明显缩短,差别有显著性意义(P0.01),说明二组治疗后疼痛减轻,活动能力改善。 2.A组与B组治疗后,患者完成翻身动作所需时间变化比较,两组间差别无显著性意义(P0.05)。 3.A组与B组治疗前后比较,临床观察的五项疼痛分数均改善,差别有显著性意义(P0.01),说明二组在治疗后均有效。 4.A组与B组在治疗后临床有效率比较,两组间差别无显著性意义(P0.05),说明二组疗效无明显差异。研究结论单纯针刺和针刺结合埋线均能明显缓解骨质疏松性椎体压缩性骨折引起的疼痛；但比较二组疗效,针刺结合埋线组未见明显提高。
[Abstract]:Research background. With the continuous increase of the elderly population, osteoporosis, one of the degenerative diseases of the middle-aged and elderly, and its associated fractures have become a serious social problem. Fracture is the most common and serious complication of osteoporosis. It not only increases the patient's pain, but also severely restricts the patient's activity and even shortens the life span. The fracture caused by osteoporosis is the most common fracture of vertebral body compression, and the clinical symptoms are mainly pain in the back and waist and limited movement. Research purpose. By comparing the curative effect of simple acupuncture and acupuncture combined with embedding thread to relieve the pain caused by osteoporotic vertebral compression fracture, the possibility of synergistic effect between acupuncture therapy and catgut embedding therapy was discussed. To find a method to improve the therapeutic effect of acupuncture in accordance with clinical practice. Research method. The patients with osteoporotic vertebral compression fracture, aged over 60 years, in the hospital of the third affiliated Hospital of Guangzhou University of traditional Chinese Medicine (Orthopedics and Trauma Hospital) were studied. 60 patients were divided into simple acupuncture group A (group A) and acupuncture combined with catgut embedding group (group B), 30 cases in each group. Acupuncture and catgut embedding selection points: Shenshu (Shuangzhu, Pi Yu (Shuangli), Dachang Yu (Shuangli), Jiaji points (Shuangli, Huazhong, Zusanli, Zusanli). Shuangzao, Taichung (Shuangli, Kuanyuan), Qihai, Ashi. Treatment method of simple Acupuncture Group: keep the needle for 25 minutes after the acupuncture at the above mentioned acupoints. Once every 5 minutes, move with twist and spring, take the method of leveling and tonifying and reducing. Once every other day, Three times as a course of treatment. Acupuncture combined with catgut embedding group treatment methods: Shenshu, spleen Yu, Dachang Yu, Jiaji point embedding therapy, Other same acupuncture group. Before and after treatment, the following pain indexes: 1: 1. Spontaneous pain 2. Turn over pain 3. Front and back flexion pain 4. Walking pain 5. Vertebral tenderness 6. Time required to complete the turn over. Before and after treatment, the two groups were treated separately. Pain score was used to evaluate the curative effect before and after treatment. Research results. 1.Compared with group B before and after treatment, the time required to complete the turning over was significantly shorter in group A than in group B, and the difference was significant (P 0.01), indicating that the pain and activity ability of the two groups were alleviated after treatment. 2.After the treatment of group A and group B, there was no significant difference between the two groups in the time required to complete the turning over. 3.Compared with group B before and after treatment, the scores of five items of pain in group A were improved, and the difference was significant (P 0.01), which indicated that the two groups were effective after treatment. 4. There was no significant difference in the clinical effective rate between group A and group B after treatment, indicating that there was no significant difference in curative effect between the two groups. Research conclusion. The pain caused by osteoporotic vertebral compression fracture was significantly alleviated by simple acupuncture and acupuncture combined with embedding thread, but compared with the two groups, the acupuncture combined with thread embedding group was not significantly improved.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R246

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