针刺邱氏穴对输尿管结石排出的临床观察

发布时间：2018-03-10 01:11

本文选题：输尿管结石　切入点：邱氏穴　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：本研究的目的是通过观察试验组(针刺组)、对照组(非针刺组)两组患者治疗后的总疗效判定、症状积分、排石时间、不同症型、不同长径、不同位置的治愈率等差异,评价探讨针刺邱氏穴对输尿管结石排出的影响。方法：选取了广州中医药大学第一附属医院外科急诊2015年10月至2016年3月同时符合输尿管结石中医、西医诊断标准且在排出标准之外的患者72例。按照随机化的方法将所有患者分为对照组与实验组,其中对照组32例、试验组37例。首诊时详细记录患者基本信息、各项影像学及实验室检查结果。两组患者的性别、年龄、发病次数、结石长径、结石位置、中医症型均行通过统计学行基线水平的比较,保证两组基数水平差异无统计学意义,具有均衡可比性。对照组予口服盐酸坦索罗辛胶囊(0.2mgPo. qd)治疗。首诊因“肾绞痛”就诊的患者,需予常规解痉止痛治疗。其中,合并泌尿系感染,查尿组合见白细胞升高者,给予左氧氟沙星片(0.5g Po.qd.)。试验组在对照组基础上每日加用针刺邱氏穴一次。“得气”后,留针15分钟。经急诊处理后,所有患者均予生活指导(每日饮水1500-2000ml,适当运动、忌食辛辣及影响排石的各种药物、食物)。嘱患者每5日返院复诊,复查B超或腹部平片后,详细记录患者检查结果、排石情况、不良反应等。治疗期间符合剔除标准者及时剔除本研究。采用SPSS22.0统计学软件进行统计分析,对比治疗后两组患者总疗效判定、症状积分、排石时间、不同位置、不同长径、不同症型患者输尿管结石治愈率的差异是否有统计学意义。结果：1、两组患者性别、年龄、发病次数、结石长径、患者症型等基数水平分别采用T检验和卡方检验,结果显示两组患者基数水平差异无统计学意义(P0.05),具有可比性。2、经治疗后两组患者总疗效判定与症状积分比较：治疗后两组患者总疗效判定及症状积分采用秩和检验,结果显示治疗后两组总疗效判定差异有统计学意义(P0.05),疗效总结分差异无统计学意义(P0.05)。3、经治疗后两组患者排石时间的比较：治疗后两组患者排石时间采用T检验,结果显示两组排石时间差异有统计学意义(P0.05)。4、治疗后两组不同位置、长径、患者症型结石治愈情况比较：治疗后两组同位置、长径、症型的患者治愈率差异无统计学意义(P0.05)。结论：试验组比对照组排石总疗效更好、排石率更高、排石时间更短,两组结石治愈率并不因结石位置、长径、症型的不同而有不同。说明针刺邱氏穴加用口服盐酸坦索罗辛胶囊对于输尿管结石的排出比当用口服盐酸坦索罗辛胶囊效果更好。针刺邱氏穴对输尿管结石的排出疗效确切,能有效促进输尿管结石的排出、缩短排石时间。
[Abstract]:Objective: the purpose of this study was to observe the difference of the total curative effect, symptom integral, lithotomy time, different symptom type, different length diameter, different position of cure rate between the two groups (acupuncture group and control group, non-acupuncture group) after treatment. To evaluate the effect of acupuncture at Qiu's point on the excretion of ureteral calculi methods: from October 2015 to March 2016, the emergency surgery department of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine was selected to accord with the Chinese medicine for ureteral calculi. According to the randomization method, all the patients were divided into two groups: the control group (n = 32) and the experimental group (n = 37). The results of various imaging and laboratory examinations showed that the sex, age, number of cases, length of stone, location of stone, TCM syndrome type were compared with baseline level by statistics, so as to ensure that there was no significant difference in cardinal level between the two groups. The control group was treated with oral tansoroxine hydrochloride 0.2mg Po.qd. the patients who were first diagnosed with "renal colic" should be treated with routine spasmolysis and pain relief. The experimental group was given levofloxacin tablet 0.5 g Po.qd.The experimental group was treated with acupuncture at Qiu's point once a day on the basis of the control group. After "getting qi", the needle was kept for 15 minutes. After emergency treatment, all the patients were given life guidance (1500-2000ml daily drinking water, appropriate exercise). Do not eat spicy and various drugs that affect the discharge of stones. Food. Ask patients to return to hospital every 5th. After reexamination of B-ultrasound or plain abdominal films, record the results of examination and discharge of stones in detail. Adverse reactions and so on. The patients who met the criteria of elimination were eliminated in time during the treatment. The SPSS22.0 statistical software was used to analyze the total curative effect, symptom score, lithotomy time, different position, different length and diameter of the two groups after treatment. The difference of cure rate of ureteral calculi in different types of patients was statistically significant. Results: sex, age, number of cases, length and diameter of stones, cardinal numbers of ureteral calculi of two groups were measured by T test and chi-square test, respectively. The results showed that there was no significant difference in cardinal number level between the two groups (P 0.05), which was comparable. After treatment, the total curative effect and symptom score of the two groups were compared: after treatment, the total curative effect and symptom score of the two groups were evaluated by rank sum test. The results showed that there was significant difference in the total curative effect between the two groups after treatment, and there was no significant difference in the score of summary of curative effect between the two groups. After treatment, the time of lithotomy was compared between the two groups: after treatment, T test was used in the two groups of patients. The results showed that there was a significant difference in the time of stone discharge between the two groups (P0.05. 4). After treatment, the two groups had different positions, long diameter, and cure status of symptomatic calculi: the two groups had the same position and long diameter after treatment. Conclusion: the total curative effect of the treatment group is better than that of the control group, the rate of stone removal is higher and the time of stone discharge is shorter. The cure rate of stone in the two groups is not due to the location and length of stone. The effect of acupuncture at Qiu's point and oral tamsoloxin hydrochloride capsule on ureteral calculi is better than that on ureteral calculi excretion, and acupuncture at Qiu's point is effective for ureteral calculi excretion. It can effectively promote the excretion of ureteral calculi and shorten the discharging time.
【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

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