阿是穴火针配合针刺治疗寒凝瘀滞型阳明经肘劳临床研究

发布时间：2018-03-24 03:34

本文选题：寒凝瘀滞型阳明经肘劳　切入点：火针疗法　出处：《广州中医药大学》2013年硕士论文

【摘要】：肘劳属于“伤筋”、“痹症”范畴,是日常生活只要反复用力活动前臂的人都有可能引起的疾病。急性发作的患者疼痛难耐,伸腕和前臂旋转供能障碍,严重影响生活质量和患肢的功能。推拿手法、中药外敷、局部封闭、针灸等方法治疗是临床上较常用的方法。近些年来,针灸被运用到缓解疼痛和消除炎症方面取得较好的疗效。针灸疗法的功效有通调气血、激发经气、通络止痛、温阳养血等,这种疗法源远流长,患者较容易接受。不少研究说明与西药相比,针灸有着相似甚至更好的消炎止痛的效果且基本无副作用。本着进一步提供更多有效的针灸治疗方法的宗旨,根据中医学对肘劳的病因病机、辨证辩经的认识,探讨火针疗法对改善肘劳的合理性和有效性。作为一种具有针刺和灸双重作用,火针疗法的作用原理包括局部刺激、经络传导、整体调节三个方面,通过将针烧至通红,快速刺入阿是穴,可达到瞬间强刺激穴位,增加刺激量,增加人体阳气激发经气、调节脏腑机能,使经络通气血行,临床常有事半功倍之效,并且简便易行,价格低廉等优点。研究目的：火针具有针刺和灸双重疗效,具有强刺激的特点,这种手法在古代已被运用在紧急寒凝痹症和内外各科中治疗疾病。通过文献及临床实践发现火针治疗寒凝淤滞型阳明经肘劳有一定疗效,从而,进一步运用科学临床试验研究,探讨火针对于改善寒凝淤滞型肘劳的临床疗效和安全性,为肘劳的辨证治疗和分经论治提供研究思路和方法。研究方法：在广州中医药大学体育健康学院和广州体育学院纳入合格受试者60例,随机分为火针治疗组和空白对照组。其中火针治疗组30例,空白对照组30例。空白对照组不予任何治疗,火针治疗组以手阳明大肠经为主,选取明显压痛点作为阿是穴进行火针治疗,配合曲池、合谷行针刺治疗,得气后采用写法,留针20分钟。隔日1次,治疗6次为一疗程,治疗1个疗程后观察疼痛指数及疗效指标的变化。将所得数据资料输入计算机,运用SPSS13.0统计软件进行统计分析,通过比较两组间的病程时间、治疗前后疼痛指数(VAS评分)及疗效是否具有统计学意义。研究成果： 1、治疗前受试者性别、年龄、病程、身高、体重、疼痛指数(VAS评分)无显著性差异(P0.05),具有可比性；2、治疗后,治疗组受试者VAS评分较治疗前显著下降,经t检验,治疗前后有显著性差异(P0.05)；3、治疗后,治疗组疗效明显优于对照组,治疗组受试者VAS评分较对照组受试者VAS评分显著下降；4、治疗后,治疗组好转所需时间较对照组明显缩短；5、治疗后,火针组几乎无出现不良反应,火针疗法较为安全。研究结论：火针治疗寒凝瘀滞型阳明经肘劳是一种新型、有效、较安全的临床治疗方法,治疗组患者VAS评分较对照组显著下降,疗效分析中,治疗组疗效明显优于对照组,而且火针疗法较为安全。
[Abstract]:Elbow strain belongs to the category of "injured tendons" and "arthralgia". It is a disease that can be caused by people who work hard and repeatedly in daily life. Massage manipulation, external application of traditional Chinese medicine, local blocking, acupuncture and other methods are more commonly used in clinical treatment. In recent years, acupuncture and moxibustion have been used to relieve pain and eliminate inflammation. The effects of acupuncture and moxibustion include regulating qi and blood, arousing meridian qi, unblocking collaterals and relieving pain, warming yang and nourishing blood, and so on. This therapy has a long history. Patients are more receptive. Many studies have shown that acupuncture has similar or even better anti-inflammatory and analgesic effects than western medicine, and basically has no side effects, in line with the purpose of further providing more effective acupuncture and moxibustion treatment. According to the understanding of the etiology and pathogenesis of elbow strain and differentiation of symptoms and signs in traditional Chinese medicine, the rationality and effectiveness of fire acupuncture therapy in improving elbow strain were discussed. As a dual action of acupuncture and moxibustion, the principle of fire acupuncture therapy includes three aspects: local stimulation, meridian conduction and global regulation. By burning the acupuncture to the red point and rapidly pricking into the Ashi point, the instant strong stimulation of acupoints can be achieved. Increasing the amount of stimulation, increasing the body yang qi to stimulate meridian qi, regulating the function of viscera, making meridian ventilation and blood flow, clinical often double the effect with half the effort, and simple and easy, low price and other advantages. Objectives of the study:. Fire needle has the dual curative effect of acupuncture and moxibustion, and has the characteristic of strong stimulation. This technique has been used in ancient times to treat the disease in emergency cold and coagulation syndrome and in internal and external departments. Through literature and clinical practice, it has been found that fire acupuncture has a certain curative effect on cold and coagulated stagnation of Yangming meridian elbow strain. To explore the clinical efficacy and safety of fire aimed at improving the clinical efficacy and safety of cubital strain due to cold coagulation and stasis, and to provide research ideas and methods for the treatment of cubital strain based on syndrome differentiation and meridian differentiation. Research methods:. Sixty eligible subjects were randomly divided into fire acupuncture treatment group and blank control group, including 30 cases in fire needle treatment group, in which 30 cases were treated with fire needle. 30 cases in blank control group. No treatment was given in the blank control group. In the fire acupuncture treatment group, the main treatment group was hand Yangming large intestine meridian, and the obvious tenderness point was selected as the point of fire acupuncture treatment, combined with qu Chi and Hegu acupuncture treatment, and after getting qi, the treatment method was used. The needle was kept for 20 minutes. Once every other day, 6 times were treated as a course of treatment. After one course of treatment, the changes of pain index and curative effect index were observed. The data were input into the computer and analyzed by SPSS13.0 statistical software. By comparing the course of disease, pain index and VAS score before and after treatment, and the curative effect were statistically significant. Research findings:. 1. There was no significant difference in sex, age, course of disease, height, weight and pain index (P 0.05) before treatment. The VAS scores of the subjects in the treatment group were significantly lower than those before treatment, and were significantly lower than those before treatment (t test). There was significant difference before and after treatment. After treatment, the curative effect of the treatment group was significantly better than that of the control group. The VAS score of the treatment group was significantly lower than that of the control group, and the VAS score of the treatment group was significantly lower than that of the control group. The time required for improvement in the treatment group was significantly shorter than that in the control group. After treatment, there were almost no adverse reactions in the fire acupuncture group, and the fire needle therapy was more safe. The study concluded that:. Fire acupuncture is a new, effective and safe clinical treatment method for the cold and coagulant stagnation of Yangming meridian elbow strain. The VAS score of the patients in the treatment group is significantly lower than that in the control group. In the analysis of curative effect, the curative effect of the treatment group is obviously better than that of the control group. And fire needle therapy is safer.
【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】：2013
【分类号】：R246.9

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