中风偏瘫的分期治疗研究

发布时间：2018-01-14 00:04

本文关键词：中风偏瘫的分期治疗研究　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：针灸治疗中风偏瘫的方法众多,在临床上,不同的针灸方法取效的快慢和效果大小各不相同,功能恢复的速度快慢及针灸效果的大小对患者健康的恢复具有重要意义。分期针刺治疗中风偏瘫是临床上常用的治疗方法,然而,分期之后如何合理的运用不同针刺方法或者结合推拿方法,则是治疗的关键所在。本课题根据针灸经络理论及Signe Brunnstrom提出的中风偏瘫后机体运动功能恢复的六个阶段的特殊病理过程,将中风偏瘫分为四个分期,灵活采用针刺、放血、点穴推拿以及火针等治疗方法对不同分期的中风偏瘫患者进行治疗。一、目的:观察在分期的前提下,综合运用针刺、放血、点穴推拿以及火针等治疗方法对不同分期的中风偏瘫患者的治疗效果。二、方法:选择80例中风偏瘫患者,随机分成两组,分期治疗组40例,传统针刺组40例。治疗组根据不同分期,结合不同的针刺手法及选穴,综合运用毫针、火针以及刺络放血等方法进行治疗,10次为一疗程,疗程间隔7天,连续治疗6个疗程。(1)第一期(中风软瘫期):采用以“醒脑开窍法”结合张氏“手三针”(穴位:后溪、中渚、间谷(奇穴,为合谷穴与三间穴连线中点))和张氏“足三针”(穴位:足临泣、太冲、内庭)为主,针刺关节处穴位为辅进行治疗;(2)第二期(中风痉挛期):以“靳三针”(脑三针、颞三针、舌三针、手三针、足三针)和张氏“手、足三针”为主,辅以火针点刺穴位、肌肉、关节痉挛处穴位及阿是穴,针后拔罐;(3)第三期(中风恢复期):以张显臣老师的“手三针”“足三针”进行动针治疗,辅以点穴推拿松解痉挛的肌肉,十宣、气端放血以调血运;(4)第四期(中风后遗症期):以“井穴大接经”针刺疗法为指导(阴证从阴引阳,即从手太阴肺经少商穴开始,至足厥阴肝经大敦穴结束;阳证从阳引阴,即从足太阳膀胱经至阴穴开始,至手太阳小肠经结束),放血与针刺并举,辅以常规体针治疗。对照组不对患者进行中风分期,均采用“醒脑开窍法”结合“靳三针”(脑三针、颞三针、舌三针、手三针、足三针)为主进行治疗。10次为一疗程,疗程间隔7天,连续治疗6个疗程。三、结果:从中风肢体偏瘫改善情况看,传统针刺组及分期治疗组均能取得明显进步,治疗前后均有明显差异。而从传统针刺与分期治疗对于改善肢体偏瘫功能的对比来看,对中风患者进行运动功能FMA评分、临床神经功能缺损程度评分显示分期治疗组均优于传统针刺组,两者比较有明显差异。四、结论:分期治疗法及传统针刺法均能有效的提高中风患者的运动功能及日常生活能力,但分期治疗法优于传统针刺法。
[Abstract]:There are many methods of acupuncture and moxibustion to treat apoplectic hemiplegia. In clinic, the speed and effect of different acupuncture and moxibustion methods are different. The speed of functional recovery and the size of acupuncture and moxibustion are of great significance to the recovery of patients' health. Acupuncture by stages is a common clinical treatment for stroke hemiplegia, however. After stages, how to use different acupuncture methods or massage methods reasonably. According to the theory of acupuncture and meridian and Signe Brunnstrom's six stages of recovery of motor function after apoplectic hemiplegia. Apoplectic hemiplegia is divided into four stages, flexible use of acupuncture, bloodletting, point massage and fire acupuncture treatment for different stages of stroke hemiplegia patients. 1, objective: to observe the premise of staging. Comprehensive use of acupuncture, bloodletting, point massage and fire acupuncture treatment for different stages of stroke hemiplegia patients. Second, 80 patients with apoplectic hemiplegia were randomly divided into two groups. Treatment group 40 cases, traditional acupuncture group 40 cases. The treatment group according to different stages, combined with different acupuncture techniques and points selection, comprehensive use of milliacupuncture, fire acupuncture and puncture collateral bleeding and other methods for treatment. 10 times as a course of treatment, the course of treatment interval of 7 days, continuous treatment of 6 courses of treatment. 1) the first stage (stroke palsy stage: by "refreshing the brain to open the orifices" combined with Zhang's "hand three acupuncture" (acupoint: Houxi, Zhongzhu). Jianyu (Qiqi point, which is the midpoint of Hegu point and three points) and Zhang's "foot three acupuncture points" (acupoint: foot sobbing, Taichong, inner atrium) is the main point, acupuncture at the acupoint of the joint is auxiliary for treatment; Second stage (stroke spasm stage: Jin three needles (brain three needles, temporal three needles, tongue three needles, hand three needles, foot three needles) and Zhang's "hand, foot three acupuncture", supplemented with fire acupuncture acupoints, muscles. Acupoints and Ashi points at joint spasm, cupping after acupuncture; Stage 3 (convalescence of apoplexy: treatment with "three needles of hand" and "three needles of foot" by teacher Zhang Xianchen, supplemented by point massage to relieve spasmodic muscles, 10 exuberance, bleeding at the end of Qi to regulate blood delivery; Stage 4th (sequelae of apoplexy): according to acupuncture therapy of "Jing acupoint great connection with meridian" (Yin syndrome from Yin to Yang, that is, from hand Taiyin Lung Meridian Shaoshang point, to foot Jueyin liver Meridian Dadong point end; Yang syndrome from Yang to Yin, that is, from foot sun bladder meridian to Yin point, to the end of the hand sun small intestine meridian, blood and acupuncture, combined with routine body acupuncture treatment. The control group does not stage stroke. All patients were treated with "refreshing brain and opening resuscitation method" combined with "Jin three needles" (brain three needles, temporal three needles, tongue three needles, hand three needles, foot three needles) for a course of treatment, with an interval of 7 days. Results: according to the improvement of hemiplegia in the middle wind limbs, both the traditional acupuncture group and the staged treatment group can make significant progress. There are significant differences before and after treatment. And from the traditional acupuncture and phased treatment for improving the function of hemiplegia, the motor function of patients with FMA score. Clinical neurological impairment score showed that the treatment group was better than the traditional acupuncture group, there was a significant difference between the two groups. 4. Conclusion: stage therapy and traditional acupuncture can effectively improve motor function and daily living ability of stroke patients, but phased therapy is superior to traditional acupuncture.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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