针刺任督脉腧穴治疗后循环缺血性眩晕（气血亏虚型）的临床疗效观察

发布时间：2018-03-14 17:40

本文选题：针刺　切入点：任督脉　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的研究针刺任、督脉腧穴对后循环缺血性(PCI)眩晕的临床疗效以及观察治疗前后针刺任、督腧穴对相关血管血流、搏动指数客观指标的变化。旨在通过剖析针刺任、督二脉腧穴治疗该病的作用机制,初步探讨针刺治疗后循环缺血性眩晕的有效治疗方法,力求在临床治疗上为患者提供更为有效的优化方法,为后循环缺血性眩晕患者的早期预防及治疗提供一定的科学依据。方法本课题通过综合西医诊断和中医诊断后循环缺血性眩晕的标准进行诊断,采用简单随机抽样的方法将符合要求的研究对象(2015年2月至2016年2月以眩晕为主要症状就诊于河南中医药大学第一附属医院脑病科的患者,全部病例均严格根据纳入标准和排除标准进行筛选)分为对照组和研究组,各30例。两组患者年龄、性别、病程及合并症方面均需经统计学处理,若差异均无显著性差异(P0.05),具备可比性,方可进入治疗观察阶段。所纳入研究对象中医辨证分型均属于气血亏虚型。其中,研究组采用:针刺任、督脉腧穴加静脉输注奥扎格雷钠、丹红注射液。对照组采用:针刺常规穴位加静脉输注奥扎格雷钠、丹红注射液。通过住院病历收集两组患者的年龄、性别、血压、血糖、血脂等资料;采用经颅多普勒超声仪器(TCD)测患者大脑基底动脉(BA)、左椎动脉(LVA)和右椎动脉(RVA)的血流峰值速度(Vp)和搏动指数(PI)。所选腧穴每日针刺1次,每次30min(分钟),7天为1疗程,第1疗程结束后休息1天,共2个疗程。治疗后询问患者的情况,有无心慌、胸闷、气短等不适感。观察两组患者治疗2个疗程前后所记录的中医症候积分、TCD相关客观指标及总有效率的变化,并根据中医症候积分、TCD客观指标及总有效率的变化,对两组的临床疗效进行分析评定。采用IBM SPSS Statistics SPSS21.0对数据进行双人录入并统计分析:分别采用率及均数±标准差((?)±s)指标对计数资料和计量资料进行统计描述;对计量资料统计分析前,先对数据进行正态分布检验,对于服从正态分布的计量资料进行t检验,不服从正态分布的计量资料采用秩和检验;对于治疗前后总有效率差异的比较,采用2x检验,作推断性分析。结果1.本研究共纳入60名患者,研究组和对照组各30人,对两组患者治疗前基线数据(年龄、性别、本地居住时间、眩晕临床症候积分、客观指标TCD的变化)进行分析比较,差异均无统计学意义(P0.05),具有可比性。2.数据结果显示:研究组及对照组两组患者治疗前后在中医症候积分、TCD所示VA、BA的血流速度及搏动指数均有改善,将两组治疗前、后情况进行分析比较,其差异具有统计学意义(P0.05)。3.将研究组和对照组治疗后的结果进行比较,研究组在中医症候积分、TCD客观指标两个方面较对照组改善明显,经分析,其差异具有统计学意义,在一定程度上说明研究组治疗效果优于对照组。疗效评定:两组患者治疗后临床疗效比较,研究组总有效率96.6%,对照组总有效率83.3%,差异具有统计学意义(P0.05)。4.两组患者复发率方面的评估无统计学差异(P0.05)。5.在两组患者中均未见明显不良反应。结论本病从中医整体辩证的观点及结合经络学说,选用任督脉腧穴治疗气血亏虚性眩晕,证明了针刺任督脉腧穴对本病的临床疗效,并进一步验证了任督脉与脑及气血的联系。根据统计学结果显示,研究组及对照组两组的治疗方案对大脑后循环缺血性眩晕均有疗效,而针刺任督脉腧穴合并常规西药治疗后循环缺血性眩晕较常规穴位合并西药治疗在眩晕症状及全身症状方面有更好的临床疗效,为本病的治疗提供了一种更为有效的治疗方案。
[Abstract]:Objective to study the acupuncture Ren and Du Meridians on posterior circulation ischemic vertigo (PCI) before and after the treatment and observation of clinical curative effect of acupuncture on acupoints, and blood flow changes, pulsatility index objective index. Through analysis of acupuncture, acupoint Du two veins in the treatment of this disease with acupuncture treatment mechanism, to explore the effective method of treatment pciv, in the clinical treatment for patients with a more effective optimization method for posterior circulation, to provide a scientific basis for early prevention and treatment of patients with ischemic vertigo. The criteria for the diagnosis method of this project through the comprehensive diagnosis of Western medicine and TCM diagnosis pciv, using simple random sampling method will in accordance with the requirements of the research object (from February 2015 to February 2016 by vertigo was the main symptom of brain diseases in the First Affiliated Hospital of Henan University of traditional Chinese medicine patients And all of the cases were strictly according to the inclusion and exclusion criteria) were divided into control group and study group, 30 cases each. Two groups of age, gender, disease duration and complications were statistically, if there are no significant difference (P0.05), comparable to enter observation of the treatment stage. The research object is divided into TCM syndrome type belong to deficiency of Qi and blood type. Among them, the study group using acupuncture Ren and Du Meridians, plus intravenous infusion of ozagrel sodium, Danhong injection. The control group: conventional acupuncture plus intravenous infusion of auza Grena, Danhong injection through medical records collected from two. Groups of patients with age, sex, blood pressure, blood glucose, blood lipids and other data; by transcranial Doppler ultrasound instrument (TCD) test in patients with cerebral basilar artery (BA), the left vertebral artery (LVA) and right vertebral artery (RVA) blood flow peak velocity (Vp) and pulsatility index (PI) of selected acupoints. Acupoint acupuncture 1 times a day, each time 30min (minutes), 7 days for 1 courses, first courses of treatment after 1 days of rest, a total of 2 courses. After treatment, patients were asked about, there is no palpitation, chest tightness, shortness of breath and discomfort. Observe two groups of patients before and after treatment of TCM symptoms of 2 recorded integral, TCD objective index and change the total efficiency, and according to the TCM syndrome score, TCD objective index and change the total efficiency, to assess the clinical efficacy of the two groups. The IBM SPSS Statistics SPSS21.0 the double entry of data and statistical analysis were used to rate and standard deviation ((?) + s) indicators for statistical description of count data and measurement data; analysis of measurement data statistics, the normal distribution test, to obey the normal distribution measurement data using t test, do not obey the normal distribution measurement data using the Wilcoxon rank sum test; The comparison of the total effective rate for the difference before and after treatment, the 2x test, as the analysis concluded. 1. results of this study included 60 patients, study group and control group of 30 people on the baseline data of two groups of patients (the change of age, gender, residence time, vertigo clinical symptom integral, objective index TCD) were analyzed and compared, there were no significant differences (P0.05), comparable.2. data showed: study group and control group before and after treatment in two groups of patients in TCM syndrome score, TCD shows VA, blood flow velocity and pulsatility index of BA were improved, the two groups before and after the situation the analysis and comparison, the difference was statistically significant (P0.05.3.) in study group compared with the control group after treatment results in the study group, TCM syndrome score, two TCD objective index improved significantly than the control group, after analysis, the difference was statistically significant, Research shows that the treatment group is better than the control group in a certain extent. The curative effect evaluation: To compare the clinical efficacy of two groups of patients after treatment, the total effective rate of study group 96.6%, control group total effective rate was 83.3%, the difference was statistically significant (P0.05.4.) two groups of patients with recurrence rate evaluation showed no significant difference (P0.05) in.5. two patients had no obvious adverse reactions. Conclusion the disease from the point of view of traditional Chinese medicine and the combination of holistic meridian theory, the Ren and Du Meridians to treat Qi and blood deficiency vertigo, proved that acupuncture Ren and Du Meridians clinical curative effect on this disease, and further validation of the brain and blood of the Ren and Du and according to the statistical results show that the contact., study group and control group two groups of treatment for ischemic vertigo curative effect after cerebral circulation, while acupuncture at Ren and Du Meridians combined conventional western medicine in the treatment of posterior circulation ischemic vertigo compared with conventional acupoint combination The treatment of Western medicine has a better clinical effect in vertigo and systemic symptoms, and provides a more effective treatment for the treatment of this disease.

【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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