电针颈部交感神经节治疗颈源性心脏神经症的临床观察

发布时间：2018-03-05 06:21

本文选题：电针　切入点：交感神经节　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察电针颈部交感神经节治疗颈源性心脏神经症(CN)的临床疗效,探讨此方法治疗颈源性心脏神经症的优势,为此类型患者提供一个新的绿色的治疗方法。方法:选取由交感型颈椎病所致的心脏神经症患者60例,随机分成A组(交感神经节组),B组(常规针刺组),C组(药物组)三组,每组20例。A组主穴针对颈部交感神经节(双侧颈上神经节、双侧颈下神经节)针刺,两对主穴分别通电,予连续波治疗(频率2Hz),强度以患者可耐受为度。配穴:心俞(双侧)、厥阴俞(双侧)、巨阙、膻中、神门(双侧)、内关(双侧)。每次治疗时间为30分钟,每日1次,每周5日,连续治疗四周。B组主穴为颈夹脊穴(颈4—颈7),选取颈4与颈7夹脊穴通电。配穴及脉冲治疗仪连接方法均同A组。C组为药物组,谷维素片20mg日三次口服,连续服用20天。治疗前后均对三组患者进行中医症候积分表、HAMA量表、HAMD量表的评估。治疗结束后对三组的量表结果进行统计学分析比较。结果:1.三组中医症状积分经非参数检验,A组、B组、C组治疗前后相比,三组治疗后较治疗前差异显著(P△0.01);治疗后AC组间差异显著(P▲0.01);AB组间疗效差异显著(P°0.05)。BC组间疗效差异不显著(P▲=0.3290.05)2.三组中医症候疗效经秩和检验,P0.01,三组数据差异具有统计学意义,A组总有效率为95%,B组总有效率为80%,C组总有效率为55%,提示A组有效率最高,其次为B组。3.三组HAMA评分比较:经配对t检验,A组、B组、C组治疗前后相比,三组患者在治疗后较治疗前差异显著(P[0.01);经单因素方差分析检验,AC组、BC组间疗效差异显著(P▲0.01);AB组间疗效差异显著(P°0.01)。4.三组HAMD评分比较:经配对t检验,A组、B组、C组治疗前后相比,三组患者在治疗后较治疗前差异显著(P[0.01);经单因素方差分析检验,AC组、BC组间疗效差异显著(P▲0.01);AB组间疗效差异显著(P°0.01)。5、三组治疗前后HAMA减分率(T)比较:三组数据经秩和检验,三组的HAMA减分率(T)上具有统计学意义(Z=0.5917,P=0.0000.01),具有显著性差异,三组总有效率A组(95%)B组(85%)C组(60%)。6.三组治疗前后HAMD减分率(T)比较:三组数据经秩和检验,三组的HAMD减分率(T)上具有统计学意义(Z=0.5278,P=0.0010.01),具有显著性差异,三组总有效率A组(95%)B组(80%)C组(65%)。结论:1、电针颈部交感神经节疗法与传统针刺夹脊穴疗法对于颈源性心脏神经症均是有效的治疗方法。2、在改善中医症状上,电针颈部交感神经节组最好,而针刺夹脊穴组与药物组在改善中医症状积分上基本一致。3、在改善颈源性心脏神经症患者焦虑、抑郁状态上,电针颈部交感神经节疗法效果最好。
[Abstract]:Objective: to observe the clinical effect of electroacupuncture on cervical sympathetic ganglion in the treatment of cervical cardiac neurosis (CNN), and to explore the advantages of this method in the treatment of cervical cardiac neurosis. Methods: sixty patients with cardiac neurosis caused by sympathetic cervical spondylosis were randomly divided into group A (group B) (group B) and group C (drug group). The main points of group A were acupuncture for cervical sympathetic ganglion (bilateral superior cervical ganglion, bilateral inferior cervical ganglion). Continuous wave therapy (frequency 2HzD, intensity is tolerable to patient). Acupoints: Xinshu (bilateral Flower, Jueyinshu (bilateral, Giu que, Tanzhong, Shenmen), Neiguan (bilateral). Treatment time is 30 minutes, once a day, 5th per week, For four weeks, the main point of group B was cervical Jiaji point (cervical 4-neck 7jiao), and the points of cervical 4 and Jiaji of neck 7 were electrified. The methods of combination of acupoints and pulse therapy instrument were the same as group A and group C as drug group, and oryzanol tablets were taken orally three times a day, 20 mg per day. After 20 days of continuous administration, three groups of patients were evaluated with Hama scale and Hamd scale before and after treatment. After the treatment, the results of the three groups were statistically analyzed and compared. After nonparametric test, the difference between group A and group B was compared before and after treatment. There was a significant difference between the three groups after treatment than before, and there was significant difference between the AC group and the AC group after the treatment. There was no significant difference in the curative effect between the three groups (P 掳0.05) .BC group had no significant difference in the curative effect between the three groups. There was no significant difference in the curative effect between the three groups (P < 0.01). The total effective rate of group A was 95%, the total effective rate of group B was 80 and the total effective rate of group C was 55, indicating that the total effective rate of group A was the highest. The HAMA score of group B was compared with that of group B before and after treatment. After treatment, there was significant difference (P < 0.01) between the three groups compared with that before and after treatment, and there was significant difference in curative effect between the AC group and the BC group by univariate analysis of variance (ANOVA). There was a significant difference in the curative effect among the three groups (P 掳0.01g 路4.The HAMD scores of the three groups were compared with those before and after treatment in group A and group B by paired t test), and compared with those before and after treatment in group A, group B and group B were compared with each other before and after treatment. After treatment, there was significant difference (P < 0.01) between the three groups compared with that before and after treatment, and there was significant difference in the curative effect between the AC group and the BC group by univariate analysis of variance (ANOVA). There was a significant difference in the curative effect among the three groups (P 掳0.01g 路5). Comparison of the HAMA score reduction rate before and after treatment and before and after treatment in the three groups: the data of the three groups were compared with the rank sum test. There was significant difference in the HAMA reduction rate of three groups (P < 0. 5917), and there was significant difference among the three groups. The total effective rate of three groups was compared with that of group A, group B, group B, group B and group C. Comparison of the HAMD score reduction rate before and after treatment in three groups: the data of the three groups were tested by rank sum test, and the results were compared with those of the three groups before and after treatment, and the total effective rate of the three groups was compared with that of the control group before and after treatment. There was a significant difference in the HAMD reduction rate between the three groups (P < 0.05, P < 0.05, P > 0.0010.01, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05). The total effective rate of group A and B was 650.Conclusion electroacupuncture of cervical sympathetic ganglion therapy and traditional acupuncture of Jiaji point therapy are effective treatment methods for cervical cardiac neurosis, and can improve the symptoms of traditional Chinese medicine. Electroacupuncture in cervical sympathetic ganglion group was the best, while acupuncture at Jiaji point group and drug group had the same effect on improving TCM symptom score. The effect of electroacupuncture on cervical sympathetic ganglion was the best in improving anxiety and depression of patients with cervical cardiac neurosis.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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