针刺刺络联合艾灸治疗肝郁脾虚型抑郁性神经症临床研究

发布时间：2018-02-27 12:31

  本文关键词： 抑郁性神经症 肝郁脾虚型 针刺 刺络 艾灸　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:观察针刺刺络联合艾灸治疗肝郁脾虚型抑郁性神经症的临床疗效,为本病治疗提供一种无副作用、疗效可靠的中医传统特色疗法。方法:将符合纳入标准的66例肝郁脾虚型抑郁性神经症患者进行随机分组(用Excel产生随机数)。将研究对象分为针刺刺络联合艾灸组与针刺刺络组,脱落病例6例,实际有效病例两组各30例。针刺刺络组,针刺处方为:四关穴(太冲、合谷)、百会、印堂(参照符文彬,樊莉,朱晓平,等.针刺调肝法治疗抑郁性神经症的临床研究[J].针刺研究,2006,31(6):355-358.)。刺络取穴:第一组穴位选膈俞,第二组穴位选肝俞,均为双侧,每次选择一穴双侧,两组交替使用。针刺刺络艾灸组的针刺刺络方法和上一组相同,艾灸以神阙为中心,针刺同时将艾箱放在腹部,熏灸中脘、下脘、神阙、气海、关元等穴。两组患者每3天治疗1次,1周2次,2周为一疗程,共治疗2个疗程。分别在治疗前、治疗2周后、治疗4周后对两组患者进行SDS评分、HAMD评分及抑郁症肝郁脾虚中医证候量表评分,治疗2周及治疗4周后进行临床疗效评价。结果:一、基本资料比较两组患者在年龄、性别、SDS评分、HAMD评分及中医证候评分方面差异均无统计学意义(P0.05),具有可比性。二、观察指标比较(一)SDS评分比较经t检验,①治疗2周后:针刺刺络艾灸组与其治疗前比较评分降低,差异有统计学意义(P0.01);针刺刺络组与其治疗前比较评分降低,差异有统计学意义(P0.01);两组间评分比较,差异无统计学意义(P0.05);②治疗4周后:针刺刺络艾灸组与其治疗2周后比较评分降低,差异有统计学意义(P0.01);针刺刺络组与其治疗2周后评分比较,差异无统计学意义(P0.05);两组间评分比较,差异有统计学意义(P0.01)。(二)HAMD评分比较经t检验,①治疗2周后:针刺刺络艾灸组与其治疗前比较评分降低,差异有统计学意义(P0.01);针刺刺络组与其治疗前比较评分降低,差异有统计学意义(P0.01);两组间评分比较,差异无统计学意义(P0.05);②治疗4周后:针刺刺络艾灸组与其治疗2周后比较评分降低,差异有统计学意义(P0.01);针刺刺络组与其治疗2周后评分比较,差异无统计学意义(P0.05);两组间评分比较,差异有统计学意义(P0.01)。(三)抑郁症肝郁脾虚证候评分比较经t检验,①组内比较:针刺刺络艾灸组治疗2周后在入睡难、食欲下降、神疲乏力、时有太息、烦躁、口苦口干、头晕、头痛、胸闷、腹胀以及总分方面与治疗前比较评分降低,差异有统计学意义(P0.01);针刺刺络组治疗2周后在时有太息、烦躁、口苦口干、头痛、总分方面与治疗前比较评分降低,差异有统计学意义(P0.01);针刺刺络艾灸组治疗4周后在忧愁善感、入睡难、食欲下降、神疲乏力、兴趣索然、时有太息、烦躁、口苦口干、头晕、头痛、胸闷、腹胀、总分方面与治疗2周后比较评分降低,差异有统计学意义(P0.01);针刺刺络组治疗4周后与治疗2周后比较在各症状评分及总分方面无明显差异。②组间比较:针刺刺络艾灸组治疗2周及4周后在入睡难、食欲下降、神疲乏力、头晕、胸闷、腹胀、总分方面的评分均显著低于针刺刺络组,差异具有统计学意义(PO.01),对忧愁善感、兴趣索然、时有太息、烦躁、口苦口干、头痛症状方面在治疗2周后与针刺刺络组相比,差异无统计学意义(P0.05),但在治疗4周后相比则评分低于针刺刺络组,差异有统计学意义(P0.01)。三、疗效比较治疗2周后针刺刺络艾灸组总有效率为90%,针刺刺络组总有效率为76.67%,两组有效率差异无统计学意义(P0.05)。治疗4周后针刺刺络艾灸组总有效率为100%。针刺刺络组总有效率为80%,两组有效率差异有统计学意义(P0.01)。结论:针刺刺络联合艾灸与单纯针刺刺络治疗肝郁脾虚型抑郁性神经症均有临床疗效,但针刺刺络联合艾灸在改善SDS总分、HAMD总分以及肝郁脾虚主要症状评分和总分方面优于针刺刺络,对此证型具有较好的临床疗效。
[Abstract]:Objective: To observe the clinical effect of acupuncture combined with pricking moxibustion in the treatment of liver stagnation and spleen deficiency type of depressive neurosis, provide a no side effect for the treatment of this disease, the curative effect is reliable the characteristics of traditional Chinese medicine therapy. Methods: 66 patients met the inclusion criteria of liver and spleen deficiency of patients with depressive neurosis were randomly divided into two groups randomly (produced by Excel number). The subjects were divided into acupuncture group and acupuncture moxibustion combined with pricking cupping group, cases in 6 cases, effective two cases 30 cases in each group. Acupuncture pricking group, acupuncture prescription: four Guan (Taichong, Hegu), Baihui, Yintang (see Fu Wenbin, Fan Li, Zhu Xiaoping, etc. the treatment of depressive neurosis. Acupuncture regulating the liver and clinical study of [J]. acupuncture research, 2006,31 (6): 355-358.). Pricking acupoints: the first group of acupoints selected Geshu, second groups of acupoints selected liver Yu, were bilateral, each one hole double side, two groups of alternate use of acupuncture pricking moxibustion. Group 鐨勯拡鍒哄埡缁滄柟娉曞拰涓婁竴缁勭浉鍚，

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