针刺肌肉起止点治疗桡骨茎突狭窄性腱鞘炎的临床研究

发布时间：2017-12-27 11:45

本文关键词：针刺肌肉起止点治疗桡骨茎突狭窄性腱鞘炎的临床研究　出处：《广州中医药大学》2016年博士论文　论文类型：学位论文

【摘要】：目的：探索疗效好、副作用小、有效提高生活质量的桡骨茎突狭窄性腱鞘炎的针灸治疗方法。通过针刺肌肉起止点、针刺阿是穴的方法,比较两者之间的疗效,并观察其远期疗效,为针刺肌肉起止点治疗桡骨茎突狭窄性腱鞘炎提供依据。方法：于台北市士林区崇生中医诊所,收集临床桡骨茎突狭窄性腱鞘炎患者共60例,随机分为肌肉起止点组(治疗组)30例及阿是穴组(对照组)30例,两组均每周治疗3次,二周为一疗程,共治疗1个疗程。1个疗程后观察两组患者的临床症状、体征变化,并对两组进行疗效评定。对以上数据建立数据库,运用spss 22.0进行统计分析。结果：经统计学分析,治疗前针刺肌肉起止点组(治疗组)和针刺阿是穴组(对照组)两组患者性别、年龄、病程、治疗前周发作天数及主症体征评分均无明显差异(P0.05),具有可比性。1个疗程后,针刺肌肉起止点组愈显率为50.00%,总有效率为86.66%,针刺阿是穴组愈显率为16.77%,总有效率为73.33%,经检验后两组疗效比较具有统计学意义(P0.05),说明针刺肌肉起止点组疗效优于针刺阿是穴组;两组组内治疗前后症状及体征之评分结果比较,有统计学意义(P0.05),提示两种疗法治疗前后症状及体征皆有明显改善；两组治疗后之症状及体征评分比较,结果有统计学意义(P0.05),提示治疗后针刺肌肉起止点组症状及体征之评分较针刺阿是穴组下降显着。治疗停止3个月后疗效评定,针刺肌肉起止点组组愈显率为46.66%,总有效率为90.00%,针刺阿是穴组愈显率为10.34%,总有效率为48.28%,针刺肌肉起止点组总有效率优于针刺阿是穴组,经统计学分析,两组疗效具有统计学意义(P0.05),说明治疗后3个月针刺肌肉起止点组之疗效优于针刺阿是穴组；组内治疗前及治疗后3个月评分比较,结果有统计学意义(P0.05),提示治疗后3个月较治疗前之主症及体征皆有改善；组内治疗后及治疗后3个月评分比较,结果有统计学意义(P0.05),提示治疗后3个月较治疗1个月后之主症及体征皆有复发情形；治疗后3个月两组评分进行比较,结果有统计学意义(P0.05),提示治疗3个月后针刺肌肉起止点组疗效优于针刺阿是穴组。结论：本课题经临床研究后,桡骨茎突狭窄性腱鞘炎经肌肉起止点及阿是穴治疗后皆有临床疗效,也都有一定的复发率,但肌肉起止点疗法近期及远期疗效皆优于阿是穴疗法,复发率也较低。肌肉起止点治疗桡骨茎突狭窄性腱鞘炎值得推广。
[Abstract]:Objective: To explore the method of acupuncture treatment of stenosing tenosynovitis of the radial styloid process has good curative effect, little side effect, effectively improve the quality of life. Through the method of acupuncture, acupuncture Ashi muscle starting and ending point, compare the effect between the two, and observe the long-term curative effect, provide the basis for acupuncture treatment of muscle enthesis radial styloid stenosing tenosynovitis. Methods: in the Shihlin District of Taipei city Chong students of Chinese medicine clinics, collect clinical de Quervain disease patients with a total of 60 cases were randomly divided into muscle enthesitis group (treatment group) 30 cases and Ashi group (control group) 30 cases, two groups were treated 3 times a week, two weeks for a course of treatment 1 course of treatment. After 1 courses of treatment, the clinical symptoms and signs of the two groups were observed, and the efficacy of the two groups was evaluated. A database is set up for the above data, and SPSS 22 is used for statistical analysis. Results: by statistical analysis, the treatment of acupuncture before the start points of the muscles group (treatment group) and acupuncture point group (control group) two groups of patients with gender, age, course of disease, treatment of the previous week there were no significant difference between the days of onset and main symptom score (P0.05), comparable. After 1 courses of acupuncture, muscle enthesis grouprevealing rate is 50%, the total effective rate was 86.66%, the acupuncture point grouprevealing rate is 16.77%, the total effective rate was 73.33%, after testing the efficacy of the two groups was statistically significant (P0.05), acupuncture muscle starting and ending point group is better than acupuncture Ashi group; in the two groups before and after treatment the score of symptoms and signs compared with statistical significance (P0.05), suggesting that the two therapy before and after treatment of symptoms and signs improved evidently; compared the symptoms and signs of the two groups after treatment the score, the results were statistically significant (P0.05), suggesting that after treatment the scores of acupuncture muscle starting and ending point the symptoms and signs of a group of acupuncture point group decreased significantly. Stop the treatment efficacy evaluation after 3 months, the starting and ending points of muscular acupuncture group group markedly effective rate was 46.66%, the total effective rate was 90%, the acupuncture point grouprevealing rate is 10.34%, the total effective rate was 48.28%, the starting and ending points of muscular acupuncture group total effectiveness is better than that of Acupuncture point group, by statistical analysis, with statistical significance the efficacy of the two groups (P0.05), that 3 months after the treatment of acupuncture point treatment group muscle starting and ending acupuncture Ashi group treatment group; 3 months score before and after treatment. The results were statistically significant (P0.05), suggesting that before 3 months after treatment compared with the main symptoms and signs are improved 3 months after the score; and in the treatment group after treatment, the results were statistically significant (P0.05), suggesting that after 3 month treatment compared with the treatment of the primary disease after 1 months and have signs of recurrence 3 months; compare the scores of the two groups after treatment, the results were statistically significant (P0.05), prompt After 3 months of treatment with acupuncture muscle starting and ending point group is better than acupuncture point group. Conclusion: the clinical study, radial styloid stenosing tenosynovitis by muscle starting and ending points and Ashi points after treatment has clinical curative effect, also have a certain recurrence rate, but the muscle from the short-term and long-term effect of therapy is better than acupuncture, and low recurrence rate. Muscle enthesis treatment of radial styloid stenosing tenosynovitis is worthy of promotion.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.9

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