针刀整体松解术治疗颈型颈椎病的临床研究

发布时间：2018-03-07 22:05

本文选题：颈型颈椎病　切入点：针刀整体松解术　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的颈型颈椎病是各型颈椎病的前驱阶段,该阶段颈椎间盘还未出现退变或退变不明显,不易引起人们的重视,病情日久,严重影响人们正常工作、生活。为提高人们的生活质量,改善普遍存在的亚健康状态,达到未病先防的目的,本课题采用针刀整体松解术治疗颈型颈椎病,重点观察其临床治疗效果,并对针刀治疗颈椎病的作用机理进行了初步探讨,以期为本病今后的临床诊疗思路提供参考。方法本研究纳入的85例颈型颈椎病患者均为十堰市中医医院针灸科2015年3月~2016年9月住院病人,采用计算机随机编号法分为两组,治疗组43例患者给予针刀整体松解术治疗,其中有3例患者脱失;对照组42例患者采取针刀痛点松解治疗,其中有2例患者脱失。所有患者在治疗过程中不给予其他干预措施,3次治疗结束后,评定临床疗效。通过颈型颈椎病症状体征评分量表记录患者症状体征积分,简化Mc Gill疼痛量表记录患者疼痛评分,治疗结束后进行比较分析。结果1.两组患者临床疗效比较:治疗组40例,治愈27例,显效7例,愈显率为85%;1例无效,总有效率为97.5%。对照组40例,治愈15例,显效9例、愈显率为60%;8例无效,总有效率为80%。经统计学分析,两组愈显率比较,具有显著性差异(P0.05);两组总有效率比较,具有显著性差异(P0.05),表明治疗组疗效优于对照组。2.两组患者治疗结束后症状、体征积分改善比较:治疗组经过针刀整体松解术治疗后症状、体征积分有显著的改善,数据经统计学分析,差异具有极显著性意义(P0.01);治疗组症状、体征积分与对照组治疗后比较,数据经统计学分析,差异具有显著性的意义(P0.05)。表明两种治疗方案均能改善患者的临床症状、体征,但针刀整体松解术治疗效果更为显著。3.两组治疗后McGill评分比较:两组内治疗前后比较,PRI、VAS、PPI评分均明显降低,数据经统计学分析,有显著性差异(P0.01);两组间治疗后PPI评分比较,具有显著性差异(P0.05);PRI、VAS评分比较,数据经统计学分析,具有极显著性差异(P0.01)。两组治疗后,Mc Gill总分均降低,与治疗前比较,数据经统计学分析,差异具有极显著性意义(P0.01);治疗组与对照组治疗后比较,数据经统计学分析,差异具有显著性意义(P0.05)。表明治疗组减轻患者疼痛疗效明显优于对照组。结论观察结果显示,针刀整体松解术治疗颈型颈椎病,临床疗效显著,能明显改善颈型颈椎病患者的临床症状和体征,可显著降低患者Mc Gill量表疼痛积分;在降低患者现有疼痛强度、疼痛分级指数及视觉模拟评分方面,明显优于对照组。
[Abstract]:Objective Cervical spondylosis is the precursor stage of all types of cervical spondylosis. Life. In order to improve people's quality of life, improve the prevailing sub-health state, and achieve the goal of prevention before illness, this subject uses the needle knife holistic release to treat cervical spondylopathy, with emphasis on the clinical treatment effect. The mechanism of acupuncture knife in treating cervical spondylosis was discussed. Methods Eighty-five patients with cervical spondylosis included in this study were all hospitalized from March 2015 to September 2016 in the Department of Acupuncture and moxibustion, Shiyan traditional Chinese Medicine Hospital, and were randomly divided into two groups by computer random number method. In the treatment group, 43 patients were treated with total release of needle knife, among which 3 patients were lost, while 42 patients in the control group were treated with needle knife pain point release. Two of them were lost. All the patients were evaluated after 3 times of treatment without other intervention. The scores of symptoms and signs of cervical spondylosis were recorded by the symptom and sign scale of cervical spondylosis, and the scores of symptoms and signs were recorded by the scale of symptoms and signs of cervical spondylosis. Results 1. Comparison of clinical efficacy between the two groups: 40 cases in the treatment group, 27 cases were cured, 7 cases were significantly effective, and the effective rate was 85% (1 case). The total effective rate was 97.5. in the control group, 40 cases were cured, 15 cases were cured, 9 cases were markedly effective, the effective rate was 60%, 8 cases were ineffective, and the total effective rate was 80%. By statistical analysis, there was significant difference between the two groups (P 0.05), the total effective rate of the two groups was higher than that of the other two groups, and the total effective rate of the two groups was higher than that of the control group (P < 0.05). There was significant difference (P 0.05), which indicated that the curative effect of the treatment group was better than that of the control group. The difference was statistically significant (P 0.01). The scores of symptoms and signs in the treatment group were compared with those in the control group. The difference was significant (P 0.05). The results showed that both of the two treatments could improve the clinical symptoms and signs of the patients. However, the effect of the treatment was more significant. 3. Comparison of McGill scores between the two groups after treatment: before and after treatment, the McGill scores of the two groups were significantly decreased, the data were statistically analyzed, there was significant difference between the two groups (P 0.01), and the PPI scores were compared after treatment between the two groups, and there was no significant difference between the two groups after treatment. There was a significant difference between the two groups in the scores of P0.05 Gill and P0.01.The total score of Mc Gill in the two groups decreased after treatment, and compared with that before treatment, the data were statistically analyzed. The difference was very significant (P 0.01), the data of the treatment group and the control group were statistically significant (P 0.05), which indicated that the curative effect of the treatment group was obviously better than that of the control group. Conclusion the observation results show that the treatment group is better than the control group in reducing pain. The treatment of cervical Spondylotic spondylosis with acupuncture knife is effective, which can obviously improve the clinical symptoms and signs of patients with cervical spondylopathy, can significantly reduce the pain score of patients with MC Gill scale, and reduce the existing pain intensity of patients with cervical spondylosis. Pain grading index and visual analogue score were significantly better than the control group.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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