三重穴麦粒灸结合针刺治疗气虚型慢性功能性便秘临床研究

发布时间：2018-01-07 20:27

本文关键词：三重穴麦粒灸结合针刺治疗气虚型慢性功能性便秘临床研究　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察比较三重穴麦粒灸结合针刺与单纯针刺对于治疗气虚型慢性功能性便秘患者的临床疗效差异,以气虚型慢性便秘中医证候评分、Knowles-Eccersley-Scott症状评分(KESS)及便秘患者生活质量(PAC-QOL)作为观察指标,通过比较两组病例治疗前和治疗后的各量表积分,评估三重穴麦粒灸结合针刺的临床有效性及实用性,分析其相对于单纯针刺法的临床优越性,为临床三重穴麦粒灸结合针刺治疗气虚型慢性功能性便秘的诊疗方案提供实践依据。方法：采用临床随机对照试验的前瞻性研究观察方法,收集自2015年5月至2016年3月期间,来源于台湾黄耆中医诊所门诊,年龄为18~80岁确诊为气虚型慢性功能性便秘,并符合规定诊断标准及纳入标准的的患者60例,将患者随机分为麦粒灸结合针刺组的实验组30例,以及单纯针刺组的对照组30例,实验组予针刺后施麦粒灸,对照组仅予单纯针刺治疗,每日一次,每次留针30分钟,疗程长为4周。治疗后,对患者的气虚型慢性便秘中医证候评分、Knowles-Eccersley-Scott症状评分、便秘患者生活质量问卷(PAC-QOL)总分三个观察指标以及总体疗效进行评量。应用SPSS19.0软件包进行各项统计分析,并对两组的各项指标与整体疗效进行评估对照观察。结果：纳入本临床观察研究的60例病例中,实际完成临床治疗病例数,麦粒灸结合针刺组30例,单纯针刺组30例。基线情况分析：两组病例分别在性别、年龄、年龄分布、病程、治疗前气虚型便秘中医证候观察表评分、Knowles-Eccersley-Scott症状评分(KESS)、便秘患者生活质量问卷(PAC-QOL)总分的差异上,均无统计学意义(P0.05),显示两组具有可比性。疗效评价方面：麦粒灸结合针刺组与单纯针刺组均能明显且有效改善患者便秘症状,实验组痊愈3人,显效13人,有效10人,无效9人,总有效率为86.67%,显愈率为53.33%;对照组痊愈2人,显效9人,有效12人,无效7人,总有效率为76.67%,显愈率为36.67%,两组临床总有效率经检验后,得P0.05,差异具有统计学意义,说明实验组的临床疗效优于对照组。两组在气虚型便秘中医证候观察表、KESS评分及便秘患者生活质量问卷(PAC-QOL)总分三个方面,治疗前后的P值皆等于0(P0.001),差异均有极显着统计学意义,显示两组的总积分皆明显降低,表示两种治疗方式皆可有效改善气虚型慢性功能性便秘之症状。比较上述提及之三个量表中两组治疗后的总积分P0.05,差异有统计学意义,说明实验组总积分改善幅度优于对照组,表示三重穴麦粒灸结合针刺治疗对于改善气虚型慢性功能性便秘比单纯针刺治疗更为有效。结论：应用三重穴麦粒灸结合针刺治疗气虚型慢性功能性便秘除了安全有效,其整体疗效在本研究中更是明显优于单纯针刺治疗。
[Abstract]:Objective: to observe and compare the clinical curative effect of Sandun acupoint moxibustion combined with acupuncture and simple acupuncture in treating chronic functional constipation with deficiency of qi, and to evaluate the TCM syndromes of chronic constipation with deficiency of qi. Knowles-Eccersley-Scott symptom score (KESS) and quality of life (QOL) of constipation patients were used as the observation index. By comparing the scores of the two groups before and after treatment, the clinical effectiveness and practicability of triple acupoint moxibustion combined with acupuncture were evaluated, and the clinical superiority of Sandun acupoint moxibustion combined with acupuncture was analyzed. Objective: to provide practical basis for clinical diagnosis and treatment of chronic functional constipation with triple point moxibustion combined with acupuncture in chronic functional constipation with deficiency of qi. Methods: prospective study and observation method of clinical randomized controlled trial were used. Collected from May 2015 to March 2016, from the Huangqi clinic clinic, the age of 1880 years old diagnosed as chronic functional constipation of Qi deficiency type. 60 patients who met the standard of diagnosis and inclusion were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). The experimental group was treated with grain moxibustion after acupuncture, while the control group was treated with simple acupuncture once a day for 30 minutes each time. The course of treatment was 4 weeks. After treatment, the TCM syndrome score of chronic constipation of Qi deficiency type was evaluated. Knowles-Eccersley-Scott symptom score. The quality of life questionnaire (QOL) of constipation patients was divided into three observation indexes and the total curative effect. The statistical analysis was carried out with SPSS19.0 software package. Results: among the 60 cases included in the clinical observation study, the actual number of cases completed clinical treatment, grain moxibustion combined with acupuncture group of 30 cases. Baseline analysis: two groups of cases in gender, age, age distribution, course of disease, Qi-deficiency type of constipation before the treatment of TCM syndrome observation table score. The scores of Knowles-Eccersley-Scott symptom and quality of life (QOL) of constipation patients were different. There was no statistical significance (P 0.05), which showed that the two groups were comparable. In the evaluation of curative effect, the treatment group and the simple acupuncture group could obviously and effectively improve the constipation symptoms of the patients, and 3 patients were cured in the experimental group. The total effective rate was 86.67 and the apparent recovery rate was 53.33; In the control group, 2 patients were cured, 9 were significantly effective, 12 were effective, 7 were ineffective, the total effective rate was 76.67 and the apparent recovery rate was 36.67. The total effective rate of the two groups was tested and obtained P0.05. The difference is statistically significant, indicating that the clinical efficacy of the experimental group is better than that of the control group. The KESS score and the total score of quality of life questionnaire (PAC-QOL) of constipation patients were all equal to 0 P 0.001g before and after treatment. The difference was statistically significant. The results showed that the total scores of the two groups were significantly decreased, indicating that the two treatment methods can effectively improve the symptoms of chronic functional constipation of Qi-deficiency type. Compared with the above mentioned three scales, the total scores of the two groups after treatment were compared (P0.05). The difference was statistically significant, indicating that the improvement of the total score in the experimental group was better than that in the control group. It is indicated that the treatment of triple point moxibustion combined with acupuncture is more effective in improving chronic functional constipation with deficiency of qi than in acupuncture alone. The treatment of chronic functional constipation with triple point moxibustion combined with acupuncture is safe and effective. The overall curative effect is better than acupuncture alone in this study.
【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】：2016
【分类号】：R246.1

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