“靳三针”理论指导针刺治疗卒中后偏侧肢体肿胀的临床研究

发布时间：2018-01-14 13:33

本文关键词：“靳三针”理论指导针刺治疗卒中后偏侧肢体肿胀的临床研究　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

更多相关文章： 靳三针 卒中后 肢体肿胀 临床研究

【摘要】：目的：本研究通过观察“靳三针”理论指导针刺对比常规针刺治疗卒中后偏侧肢体肿胀的临床疗效,探寻针刺治疗脑卒中后偏瘫侧肢体肿胀更有效的方法。方法：本研究纳入60例符合纳入标准的患者,按区组随机化分组方法分为治疗组和对照组各30例。在中风偏瘫治疗的基础上,治疗组通过“靳三针”理论指导针刺治疗(颞三针、四神针、支沟、阴陵泉),对照组为常规针刺治疗(八邪、八风),每日1次,20次为1个疗程,共1个疗程。应用卒中肢体瘫痪程度评分表,肢体肿胀评分表及自拟患肢周径测量表观察临床疗效,并将数据采用SPSS19.0统计软件进行分析。结果：1、基线资料评价：经卡方检验分析,治疗前两组病例一般资料(性别、年龄、病程、病性、辨证分型、肿胀部位)具有可比性(P0.05)。2、临床疗效评价：治疗组共完成29例,其中基本恢复10例,显著进步17例,有效2例,无效0例,总有效率100%,显效率93.10%,对照组共完成28例,其中基本恢复4例,显著进步13例,有效11例,无效0例,总有效率100%,显效率60.71%。经Ridit分析,两组差异显著(P0.05),说明“靳三针”理论指导针刺组在改善患侧肢体肿胀方面的临床疗效优于常规针刺组。3、通过对肢体肿胀评分表中各项指标及总分的观察,治疗前两组间具有可比性(P0.05),治疗前后两组组内及治疗后两组间比较,均差异显著(P0.05)。说明两组均对治疗肢体肿胀有效,但“靳三针”理论指导针刺组较常规针刺组改善更为显著。4、应用患肢周径测量表观察掌指(跖趾)关节与腕(踝)横纹连线中点处两组的周径缩小程度,治疗前两组间具有可比性(P0.05),治疗前后组内比较均差异均显著(P0.05),治疗后两组间无明显差异(P0.05),但两组治疗前后的差值比较差异显著(P0.05),说明“靳三针”理论指导针刺组在消除掌指(跖趾)关节与腕(踝)横纹连线中点处肿胀疗效优于常规针刺组。5、应用患肢周径测量表观察在掌指(跖趾)关节连线处两组的周径减小程度,治疗前两组间具有可比性(P0.05),治疗前后组内比较均差异显著(P0.05),治疗后两组间及两组治疗前后的差值均无明显差异(P0.05)。说明“靳三针”理论指导针刺组与常规针刺组在掌指(跖趾)关节连线处功效相当。6、通过卒中肢体瘫痪程度评分表测得治疗前两组间比较具有可比性(P0.05),治疗前后,两组组内、组间均差异显著(P0.05),说明“靳三针”理论指导针刺组在改善患侧肢体运动功能方面优于常规针刺组。结论：综上所述,“靳三针”理论指导针刺组和常规针刺组均能在不同程度上改善卒中后偏侧肢体肿胀情况及运动功能,“靳三针”理论指导针刺组治疗效果更加显著且全面,值得临床推广。
[Abstract]:Objective: to observe the clinical effect of acupuncture on hemiplegia after stroke by observing Jin's three-needle theory. To explore a more effective method of acupuncture in treating hemiplegic side limb swelling after stroke. Methods: 60 patients with hemiplegia were included in this study. Based on the treatment of apoplexy hemiplegia, the treatment group was guided by Jin's three-needle theory (temporal three-needle, four-mind acupuncture, branch-ditch). The control group was treated with routine acupuncture (Baxia, Bafeng, 20 times a day as a course of treatment, a course of treatment). The clinical efficacy was observed with the limb swelling score table and the self-made peripheral diameter scale of the affected limb, and the data were analyzed by SPSS19.0 software. Results: 1, baseline data evaluation: chi-square test analysis. Before treatment, the general data (sex, age, course of disease, disease, syndrome differentiation, swelling site) of the two groups were comparable (P0.05. 2). Evaluation of clinical efficacy: 29 cases were completed in the treatment group. There were 10 cases of basic recovery, 17 cases of significant improvement, 2 cases of effective, 0 cases of ineffectiveness, 100% of total effective rate and 93.10% of markedly effective rate. In the control group, 28 cases were completed, among which 4 cases were basically recovered. There were 13 cases of significant improvement, 11 cases of effective and 0 cases of ineffectiveness. The total effective rate was 100%, and the significant effective rate was 60.71%. According to Ridit analysis, the difference between the two groups was significant (P 0.05). The results showed that the clinical curative effect of the acupuncture group was better than that of the routine acupuncture group in improving the swelling of the affected side by the theory of Jin's three needles. The indexes and the total score in the score table of the swelling of the limbs were observed. There was significant difference between the two groups before and after treatment, which indicated that both groups were effective in treating limb swelling. However, the "Jin three-needle" theory guided the acupuncture group improved more significantly than the conventional acupuncture group. The circumference of the metacarpophalangeal (metatarsophalangeal) joint and carpal (ankle) transverse line was observed by using the Peripheral diameter Measurement scale of the affected limb. Before treatment, there were significant differences between the two groups (P 0.05). There was no significant difference between the two groups before and after treatment (P 0.05). But the difference between the two groups before and after treatment was significant (P0.05). The results showed that the curative effect of the acupuncture group was better than that of the routine acupuncture group in eliminating the swelling at the midpoint of the joint of metacarpophalangeal (metatarsophalangeal) and wrist (ankle). The circumference of the two groups at the metacarpophalangeal (metatarsophalangeal) joint line was observed by using the circumference diameters scale of the affected limbs, and the two groups were comparable before treatment (P0.05). The difference before and after treatment was significant (P0.05). There was no significant difference in the difference between the two groups after treatment and before and after treatment, indicating that the "Jin three Needles" theory guided the acupuncture group and the conventional acupuncture group in the metacarpophalangeal (metatarsophalangeal) joint line. The comparison between the two groups before treatment was comparable (P 0.05). Before and after treatment, the difference between the two groups was significant (P 0.05). It is shown that the "Jin three-needle" theory is superior to the conventional acupuncture group in improving the motor function of the affected limbs. Conclusion: in summary, the acupuncture group can improve the motor function of the affected limbs. Jin's three-needle theory guided acupuncture group and routine acupuncture group can improve the swelling of hemifacial limb and motor function in varying degrees. Jin three-needle theory guidance acupuncture group more significant and comprehensive therapeutic effect. It is worth popularizing in clinic.
【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】：R246.6

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