邱氏穴治疗肾绞痛的机理探讨

发布时间：2017-12-27 16:50

本文关键词：邱氏穴治疗肾绞痛的机理探讨　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:肾绞痛为泌尿外科常见病之一,疾病发生时患者疼痛剧烈,并伴有恶心呕吐,大汗淋漓、面色苍白等症状,老年患者或合并其他疾病等体弱患者可能有休克的风险,西医药物治疗是目前主要的治疗手段,但有时效果并不满意,且不良反应较多。邱氏穴是邱云桥教授发现并应用于治疗肾绞痛常用的穴位,在治疗肾绞痛有许多优势。但比较缺乏对其止痛机理的研究。本研究通过观察不同组别患者血浆中6-酮前列腺素Fla(6-KetoPGF1a),血栓素B2(TXB2)值,由此来评价前列环素(PGI2)、血栓素A2(TXA2)水平,从而初步探讨邱氏穴治疗肾绞痛的机理。方法:1.按纳入标准和排除标准分别选取20例正常人、40例急性肾绞痛患者。2.根据随机数字表法简单随机将40例肾绞痛患者分为治疗组(邱氏穴组)、对照组(肌肉注射曲马多组)各20例。两组分别按要求行指压邱氏穴、肌肉注射曲马多100mg治疗。3.观察并统计治疗组与对照组治疗前与治疗后患者VAS疼痛量表评分。4.检测正常人组,治疗组治疗前与治疗后,对照组治疗前与治疗后研究对象血浆中6-KetoPGF1a,TXB2值,由此来评价PGI2、TXA2水平。5.采用统计软件SPSS21.0对所收集资料进行分析,探讨邱氏穴治疗肾绞痛的机理。结果:1.所有患者在试验过程中无脱落。患者的性别、年龄、发病到就诊时间在统计学上无差异(P0.05),资料具有可比性。2.治疗前治疗组与对照组两组VAS疼痛评分差异无统计学意义(P0.05);治疗后两组的VAS疼痛评分差异有统计学意义(P0.05);同组治疗前后VAS疼痛评分差异有均统计学意义(P0.05);两组患者治疗前后疼痛积分的下降程度△P差异无统计学意义(P0.05)。3.治疗前治疗组与对照组两组6-KetoPGF1a、TXB2水平组间比较,差异无统计学意义,但两组均较正常人组升高,差异具有统计学意义(P0.05);治疗组与对照组治疗后的6-KetoPGF1a、TXB2的水平均较治疗前下降,组间差异具有统计学意义(P0.05);而治疗组治疗前后6-KetoPGF1a、TXB2水平下降幅度较对照组大,差异具有统计学意义(P0.05)。结论:指压邱氏穴与肌肉注射曲马多相比,在疗效基本相同的情况下,前者在降低肾绞痛患者血浆中炎性递质如TXA2、PGI2方面具有优势。表明邱氏穴治疗肾绞痛的机理可能与降低肾绞痛患者血浆中炎症递质有关。
[Abstract]:Objective: renal colic is one of the common disease in Department of Urology, disease in patients with severe pain and nausea, vomiting, sweating, pale complexion and other symptoms, the risk of elderly patients or with other disease patients may have a weak shock, western medicine is the main means of treatment, but sometimes the effect is not satisfactory, and the bad the reaction is more. Qiu Shixue is Professor Qiu Yunqiao found and applied to the acupoints commonly used in the treatment of renal colic, there are many advantages in the treatment of renal colic. But there is a lack of research on the mechanism of pain relief. This study through the observation group with different plasma 6- keto prostaglandin Fla (6-KetoPGF1a), thromboxane B2 (TXB2), thereby to evaluate the prostacyclin (PGI2), thromboxane A2 (TXA2) level, so as to explore the mechanism of Qiu Shixue in the treatment of renal colic. Methods: 1. according to the inclusion criteria and exclusion criteria, 20 cases of normal and 40 patients with acute renal colic were selected respectively. 2. according to the random digital table method, 40 patients with renal colic were divided into treatment group (Qiu Shixuezu) and control group (20 cases of intramuscular tramadol group). The two groups respectively according to the requirements for high Shixue, shiatsu intramuscular injection of tramadol 100mg treatment. 3. the score of VAS pain scale was observed between the treatment group and the control group before and after the treatment. 4. detect the normal group. Before treatment and after treatment, the plasma 6-KetoPGF1a and TXB2 values in the control group before and after the treatment were evaluated, so as to evaluate the level of PGI2 and TXA2. 5. by using the statistical software SPSS21.0 to collect data for analysis, to explore the mechanism of Qiu Shixue in the treatment of renal colic. Results: 1. all patients did not fall off during the test. There was no difference in sex, age, onset and time of treatment (P0.05), and the data were comparable. 2. before treatment between the two groups VAS pain score difference was statistically significant (P0.05); VAS was statistically significant differences in pain scores between the two groups after treatment (P0.05); there were significant differences in VAS pain score before and after treatment in the same group (P0.05); no statistical significance in two groups of patients before and after treatment of pain points decrease of delta P difference (P0.05). 3. before treatment between the treatment group and the control group two 6-KetoPGF1a group, TXB2 group, the difference was not statistically significant, but the two groups were lower than normal group increased, the difference was statistically significant (P0.05); the treatment group and control group after treatment 6-KetoPGF1a, TXB2 levels were lower than that before treatment, the two groups were significant the difference between the treatment group (P0.05); and 6-KetoPGF1a and TXB2 levels before and after treatment decreased significantly than the control group, the difference was statistically significant (P0.05). Conclusion: compared with intramuscular injection of tramadol Shixue acupressure Qiu, is basically the same in effect under the condition of the former in reducing inflammatory mediators in plasma of patients with renal colic such as TXA2, PGI2 has the advantage. That may Shixue Qiu mechanism in the treatment of renal colic and reduce inflammatory mediators in the plasma of patients with renal colic.
【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】：2017
【分类号】：R246.9

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