基于“气伤痛”理论探讨针灸疗法对颈椎病颈痛症状及SF-36生活质量量表的影响

发布时间：2018-03-08 11:47

本文选题：颈椎病颈痛　切入点：针灸　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨基于“气伤痛”理论针灸疗法对颈椎病颈痛症状及SF-36生活质量量表的影响。方法:选择符合纳入标准的60例颈椎病颈痛患者,患者来自于广西中医药大学第一附属医院针灸科病房及门诊,按1:1的比例随机分为两组,治疗组30例,对照组30例。治疗组采用针灸结合拔罐治疗,对照组采用常规针灸治疗。1、治疗组:穴位:合谷(双)、太冲(双)、大椎、天柱(双)、颈椎夹脊、后溪(双);具体操作:(1)针刺治疗:患者取舒适的俯卧位,充分暴露皮肤和穴位,对皮肤和穴位进行常规消毒后,选用一次性的25号1.0寸、1.5寸的无菌针灸针,直刺后行小幅度的提插捻转,得气后,每10分钟再行针1次,留针30分钟。(2)拔罐治疗:患者取舒适的俯卧位,充分暴露颈项部和背部,选取大小合适的玻璃罐,迅速将玻璃罐扣在应拔的皮肤上,留罐10-15分钟后,迅速将罐取下。(3)艾灸治疗:选取大椎穴,采用艾炷灸法,选用陈年艾绒,将艾绒搓成麦粒大小的圆锥形艾炷,在穴位皮肤涂少许凡士林,将艾炷放于皮肤穴位上,点燃后至患者有温热感或者轻微的灼痛感时,将艾炷移去,每穴灸5壮,灸至局部皮肤红晕温热为度。2、对照组:根据全国高等中医药院校规划的教材,新世纪(第二版)《针灸治疗学》中的治疗,选择穴位:大椎、天柱(双)、颈椎夹脊、后溪(双),针刺操作方法同治疗组。3、疗程及评价方法:两组治疗均以5次为一个疗程,共进行2个疗程10次的治疗。分别在治疗前后观察疗效指标NPQ颈痛量表、VAS评分、SF-36量表,采用统计软件对数据进行统计分析,评价其临床疗效。结果:1、治疗前,对两组的一般资料进行比较,包括性别、年龄、病程长短等,均无显著性差异(P0.05),具有可比性。2、治疗前后比较,NPQ颈痛量表评分,两组的评分较治疗前均显著下降(P0.05),表明两组治疗均能改善颈椎病颈痛情况;治疗后组间比较,差异有统计学意义(P0.05),表明治疗组的疗效要优于对照组。3、治疗前后比较,VAS评分,两组的评分较治疗前均显著下降,(P0.05);治疗后组间比较,差异有统计学意义(P0.05),表明治疗组的疗效要优于对照组。4、SF-36量表评分,两组治疗前各项指标比较,差异无统计学差异(P0.05),具有可比性;两组治疗前后组内各项指标比较,差异均有统计学意义(P0.05);治疗后,治疗组在改善一般健康状况、社会功能、情感职能、精神健康方面、生理机能、躯体疼痛、生理职能和精力方面更明显,有显著性差异(P0.05)。结果表明,治疗组采用针灸疗法治疗颈椎病颈痛方案在改善生活质量方面优于对照组。5、对两组的临床疗效进行比较,结果有显著性差异(P0.05),说明治疗组的总体临床疗效要优于对照组。结论:基于“气伤痛”针灸治疗方案和常规针灸治疗方案均能改善颈椎病颈痛,但“气伤痛”针灸方案治疗在改善患者疼痛、生活质量及总体临床疗效方面要优于常规针灸治疗。
[Abstract]:Objective: to investigate the effect of acupuncture and moxibustion therapy on cervical pain and SF-36 quality of life of cervical spondylosis based on "Qi pain" theory. Methods: sixty patients with cervical pain of cervical spondylosis were selected. The patients were from the Acupuncture ward and outpatient department of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine. According to the ratio of 1: 1, the patients were randomly divided into two groups: the treatment group (30 cases) and the control group (30 cases). The treatment group was treated with acupuncture combined with cupping. The control group was treated with routine acupuncture and moxibustion. The treatment group: acupoints: Hegu (Shuangli, Taichong (Shuangli, Dazhui, Tianzhu) (Shuangli, cervical spine, Hexi; specific operation: 1) acupuncture treatment: the patients took comfortable prone position, fully exposed their skin and acupoints, After routine disinfection of the skin and acupoints, a single sterile acupuncture needle of 25 1.0 inch or 1.5 inch was selected. After direct acupuncture, the needle was raised and twirled by a small margin. After getting qi, the needle was again used once every 10 minutes. Cupping treatment: the patient takes a comfortable prone position, fully exposes the neck and back, selects a glass can of the right size, quickly fastens the glass jar to the skin that should be pulled, and leaves the can for 10-15 minutes. Take off the pot quickly. 3) moxibustion treatment: select Dazhui acupoint, adopt moxa cone moxibustion method, use the aged moxa curd, rub it into a conical moxa stick the size of wheat grain, apply a little vaseline on the skin of the acupoint, put the moxa stick on the skin acupoint, put the moxa stick on the skin acupoint, After kindling, when the patient has a sense of warm heat or mild burning pain, remove the moxa stick, each point moxibustion 5 strong, moxibustion to local skin redness and warm heat degree of .2.Contral group: according to the teaching materials planned by the National College of traditional Chinese Medicine, Treatment in New Century (2nd Edition) Acupuncture Therapeutics, choose acupoints: Dazhui, Tianzhu (Shuangli, cervical spine), Houxi (Shuangjiao, acupuncture operation method, same as treatment group .3, course of treatment and evaluation method: 5 times as one course of treatment in both groups). Before and after treatment, the curative effect index of NPQ cervical pain scale and SF-36 scale were observed, and the data were statistically analyzed by statistical software to evaluate the clinical efficacy. Results: before and after treatment, the clinical efficacy was evaluated. The general data of the two groups were compared, including gender, age, duration of disease, etc. There was no significant difference between the two groups (P 0.05), which was comparable. The scores of NPQ cervical pain scale were compared before and after treatment. The scores of the two groups were significantly lower than those before treatment, indicating that both groups could improve the neck pain of cervical spondylosis, and the difference between the two groups was statistically significant (P 0.05), which indicated that the curative effect of the treatment group was better than that of the control group, and the VAS score was higher in the treatment group than in the control group before and after treatment. The scores of the two groups were significantly lower than those before treatment, and the difference between the two groups was statistically significant, which indicated that the curative effect of the treatment group was better than that of the control group with the score of SF-36, and the indexes before treatment were compared between the two groups. There was no statistical difference between the two groups (P 0.05), there was no statistical difference between the two groups (P 0.05), there were significant differences between the two groups before and after treatment, and after treatment, the treatment group improved general health status, social function, emotional function and mental health. The physiological function, body pain, physiological function and energy were more obvious, and there were significant differences (P 0.05). The treatment group was superior to the control group in improving the quality of life by using acupuncture and moxibustion therapy to treat cervical pain of cervical spondylosis. The clinical efficacy of the two groups was compared. The results showed that the total clinical effect of the treatment group was better than that of the control group. Conclusion: both acupuncture and moxibustion therapy based on "Qi pain" can improve cervical pain of cervical spondylosis. But "Qi pain" acupuncture treatment is superior to routine acupuncture treatment in improving patients' pain, quality of life and overall clinical effect.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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