刺血拔罐治疗瘀血型腰肌劳损的临床研究

发布时间：2018-03-01 05:30

本文关键词： 刺血拔罐瘀血型腰肌劳损　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】：目的腰肌劳损,是指因外感、内伤或坐位不正,腰部用力不当,屏气闪挫导致腰部气血运行不畅,脉络绌急或失于濡养引起以腰部一侧或两侧或正中发生疼痛为主要症状的一种病证,亦可兼见其他诸多部位不适,以胸部、背部、胁部、腹部、小腿及脚部兼见不适为多见。腰痛病位在腰,与肾及足太阳膀胱经、足少阴肾经、任冲督带等经脉密切相关,初发多属实证,可因感受寒湿、湿热等外邪以及跌仆外伤等引起,病久多以肾虚最为常见。无论外感内伤,总以肾虚为本,跌仆闪挫或寒湿、湿热之邪为其诱因。作为临床上常见的疾病,本研究通过采用刺血拔罐疗法治疗瘀血型腰肌劳损患者,观察刺血拔罐对瘀血型腰肌劳损患者症状的干预作用。本研究立足瘀血型腰肌劳损患者在临床中较为多见,通过采用刺血拔罐进行多次放血疗法,以探索刺血拔罐在瘀血型腰肌劳损中应用的可行性。方法将符合诊断及纳入标准的瘀血型腰肌劳损病例60例随机分为2组,即治疗组和对照组各30例,共60例。治疗组予刺血拔罐疗法,用己消毒的三棱针快速点刺局部,通常以皮肤红润微有出血为度,任血液自行流出,随即用留罐法迅速拔在刺血部位约5分钟待血流停止后拔罐,起罐后用盐水棉球擦洗针孔处血迹,重复3次,每周治疗1次,4周为1个疗程,治疗一共2个疗程。对照组仅予单纯针刺,用华伦牌不锈钢一次性针灸针,肾俞直刺0.5～1寸,志室斜刺0.5～0.8寸,气海俞直刺0.5～1寸,命门直刺0.5～1寸,腰阳关向上斜刺0.5～1寸,次毼直刺1～1.5寸,委中直刺1～1.5寸,得气后留针30分钟,每10分钟行平补平泻手法2分钟,疗程:每周治疗2次,隔3日1次。8次为1个疗程,共治疗2个疗程,治疗结束后,以腰肌劳损疼痛的VAS评分、临床体征积分,对两组患者的各项数据进行统计分析,以探讨刺血拔罐治疗瘀血型腰肌劳损的临床疗效。所有研究结果均采用SPSS 24进行统计分析,计量资料采用均数±标准差(x±s)表示,组内治疗前后比较采用配对t检验;组间比较采用两个独立样本的t检验;疗效比较采用Ridit分析。结果经过为期2个疗程的治疗后,治疗组患者中有3例痊愈(10.0%),显著疗效13例(43.3%),有效的有11例(36.7%),无效3例(10.0%),临床总有效率为90.0%;对照组患者中,痊愈患者1例(3.33%),显效8例(26.7%),有效13例(43.4%),无效8例(26.7%),总有效率为73.3%。经ridit分化有统计学意义(P0.05),说明治疗组的疗效优于对照组。
[Abstract]:Objective Lumbar muscle strain is caused by external sensation, internal injury or improper sitting position, improper waist force, breath-holding flashes, resulting in poor operation of blood and qi in the waist. A symptom that causes pain in one or both sides of the waist or in the middle of the waist due to acute choroids or loss of nourishment. It also shows discomfort in many other parts, including the chest, back, flank, abdomen, and so on. Low back pain, located in the waist, is closely related to the kidney and foot sun bladder meridian, foot Shaoyin kidney meridian, Ren Chong governor belt and other meridians. The initial occurrence is mostly empirical and can be caused by external pathogens such as cold and dampness, dampness and heat, and trauma of falling servants, etc. Kidney deficiency is the most common disease for a long time. Regardless of the external internal injury, it is always based on kidney deficiency, falling servants to flash or cold dampness, damp-heat evil as its inducement. As a common clinical disease, In this study, blood pricking and cupping therapy was used to treat patients with blood stasis type of lumbar muscle strain, and the intervention effect of blood pricking and cupping on the symptoms of patients with blood stasis type of lumbar muscle strain was observed. In order to explore the feasibility of blood pricking and cupping in the application of blood stasis type lumbar muscle strain, 60 patients with blood stasis muscle strain were randomly divided into two groups by blood pricking and cupping therapy. That is, the treatment group (30 cases) and the control group (60 cases) were treated with blood pricking and cupping therapy. Then the blood was removed from the bloodstream for about 5 minutes. After the cupping was stopped, the blood stains in the needle holes were scrubbed with brine cotton balls. The blood was repeated for 3 times, and treated once a week for 4 weeks as a course of treatment. There were two courses of treatment. The control group was only treated with simple acupuncture. The control group was treated with a single stainless steel acupuncture needle of Warren's brand, Shenshu direct needling 0.51 inch, Zhixiao 0.5 0. 8 inch oblique puncture, Qi Hai Shu 0. 51 inch straight puncture, Mingmen 0. 510 1 inch straight, waist yang Guan upward 0. 5 + 0. 5 ~ 1 inch. 1 1. 5 inch straight prick, 1 1. 5 inch straight injection, 30 minutes retention needle after getting qi, 2 minutes treatment course: 2 times a week, once every 8 times as a course of treatment on 3rd, a total of 2 courses of treatment, after the end of treatment, According to the VAS score and clinical sign score of lumbar muscle strain pain, the data of the two groups were statistically analyzed in order to explore the clinical effect of blood pricking and cupping in the treatment of lumbar muscle strain of blood stasis type. All the results were statistically analyzed by SPSS 24. The measurement data were expressed as mean 卤standard deviation x 卤s, matched t test was used before and after treatment, two independent samples were used as t test, and Ridit analysis was used to compare curative effect. Results after two courses of treatment, In the treatment group, 3 cases were cured 10.0%, 13 cases were 43.3%, 11 cases were 36.7%, 3 cases were ineffective, the total clinical effective rate was 90.0%, while in the control group, the total effective rate was 90.0%. The total effective rate was 73.3%. The total effective rate was 73.3% by ridit differentiation, which indicated that the curative effect of the treatment group was better than that of the control group.
【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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