火针结合针刺治疗粘连期风寒湿型肩周炎的临床研究

发布时间：2018-03-08 20:43

本文选题：火针　切入点：肩周炎　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的本研究从临床观察的角度,客观评价火针疗法结合针刺治疗粘连期风寒湿型肩周炎的临床疗效,为临床治疗本病寻找有效的方法及提供必要的依据,以祈更好的推广应用。方法本实验共选取病例60例,以随机方法分成治疗组和对照组,各组为30例,入选者均符合中西医诊断标准,并经标准筛选排除不合格者。以肩关节活动度和肩部疼痛范围为观察指标,并对治疗结果进行统计学处理,以得出最终结论。治疗组(火针结合针刺组)：在常规针刺治疗的基础上,寻找病灶局部最明显的压痛敏感点,靠近施针部位,用中火针密集式围刺刺激,针刺深浅以病程长短,病情轻重而定,轻者1-2mm,重者不超过3mm。最后让患者做外展、上抬等动作2-3min。每次以刺3个痛点为限,交替取穴,每隔2-3天1次,每周治疗2次,6次为一个疗程。对照组(常规针刺组)：取穴肩毭、肩髂、肩前(肩髑前1寸)、肩贞、臂膈、曲池、合谷、后溪、阿是穴、陵下穴(阳陵泉直下2寸凹陷处压痛点上)。选用直径0.30mm-0.32mm的1-2寸不锈钢毫针,快速直刺进针,进针深度约为0.8-1.5寸,留针30min。同时,肩髑宜向肩关节直刺,作捻转手法。肩贞不宜向胸侧深刺。每隔l0min行手法1次。唯独后溪,取1寸不锈钢毫针,直刺0.5-1寸,只留针,不作捻转。施治完成后嘱(协助)患者作肩部上臂上举、翻臂擦背、攀对肩、外旋、内旋等动作十分钟。每日1次,每周治疗5次,15次为一个疗程。结果1.治疗组30例,男性12例,女性18例,年龄38-61岁,平均48.7±5.5岁,对照组30例,男性14例,女性16例,年龄40-64岁,平均49.4±5.8岁,两组病例在性别、年龄、病程方面无明显差异,具有可比性(P0.05)。2.对照组治疗后的疼痛评分是51.33±7.99,而治疗组的疼痛评分则是57.5±9.84两组疗法的疗效具有明显差异(P0.01),表示治疗组优于对照组。3.对照组治疗后的活动能力评分是29.40±5.49,而治疗组的疼痛评分则是33·30±4.84。两组数据具有统计学上的明显差异(P0.01)。在提升肩关节活动能力疗效方面,治疗组优于对照组4.在治疗总疗效方面,治疗组愈显率为60%,对照组愈显率为30%,两组比较具有非常显著性差异(P0.01)。结论火针结合针刺疗法治疗粘连期风寒湿型肩周炎的疗效优于单纯常规针刺,值得临床推广应用。
[Abstract]:Objective to evaluate objectively the clinical effect of fire acupuncture combined with acupuncture on the treatment of rheumatic, cold and dampness shoulder periarthritis in the period of adhesion from the clinical observation point of view, and to find an effective method and provide necessary basis for clinical treatment of this disease. Methods A total of 60 cases were selected and randomly divided into treatment group and control group (30 cases in each group). The range of shoulder motion and shoulder pain were taken as the observation indexes, and the results of treatment were analyzed statistically. In order to reach the final conclusion, the treatment group (fire acupuncture combined with acupuncture group: on the basis of routine acupuncture treatment, looking for the most obvious local tenderness sensitive point of the focus, near the acupuncture position, using the medium fire needle dense type of circumscribed acupuncture stimulation, acupuncture depth and shallow with the course of disease, the treatment group, the treatment group (fire acupuncture combined with acupuncture group), the most obvious local tenderness sensitive point of the focus, According to the severity of the disease, the patient is light (1-2mm), and the heavy (not more than 3mm). Finally, the patient is allowed to do the outreaching and lifting for 2-3 mins. Take the acupoints alternately every 2-3 days, limited to 3 pain points at a time. Two times a week, 6 times a week as a course of treatment. The control group (routine acupuncture group: take points of shoulder, shoulder and iliac, shoulder (1 inch before shoulder resuscitation, shoulder virginity, arm diaphragm, convoluted pool, Hegu, Houxi, Ashi), Lingxia point (Yanglingquan 2 inch indentation). Choose 1-2 inch stainless steel needle with diameter 0.30mm-0.32mm, fast and straight into needle, the depth of needle is about 0.8-1.5 inch, keep needle for 30 mins. At the same time, shoulder resuscitation should be directed straight to shoulder joint. Twist manipulation. Shoulder virginity should not be pricked deep into the chest. Once every 10 minutes. Take 1 inch stainless steel millimeter needle, direct puncture 0.5-1 inch, only keep needle, do not twist. Ask (assist) the patient to do shoulder arm lift after treatment. The results were as follows: 1. There were 30 patients in the treatment group, 12 males and 18 females, aged 38-61 years, with an average age of 48.7 卤5.5 years, and 30 patients in the control group. There were 14 males and 16 females, aged 40-64 years (mean 49.4 卤5.8 years). There was no significant difference in sex, age and course of disease between the two groups. The pain score of the control group was 51.33 卤7.99, while the pain score of the treatment group was 57.5 卤9.84, which indicated that the treatment group was superior to the control group. The score of activity ability after treatment was 51.33 卤7.99, while that of the treatment group was 57.5 卤9.84, which indicated that the treatment group was superior to the control group. 29.40 卤5.49, while the pain score of the treatment group was 33.30 卤4.84.The difference between the two groups was statistically significant (P 0.01). The treatment group is superior to the control group 4. The effective rate of the treatment group was 60 and that of the control group was 30. The difference between the two groups was very significant (P 0.01). Conclusion the curative effect of fire acupuncture combined with acupuncture therapy is better than that of simple routine acupuncture in treating rheumatism and dampness type shoulder periarthritis in adhesive period, and it is worth popularizing in clinic.
【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】：2016
【分类号】：R246.9

【相似文献】