局部中药熏蒸联合蜡疗对第三腰椎横突综合征患者的临床应用研究

发布时间：2018-03-27 22:23

本文选题：第三腰椎横突综合征　切入点：中药熏蒸　出处：《黑龙江中医药大学》2016年硕士论文

【摘要】：目的1探讨局部中药熏蒸、局部中药熏蒸联合蜡疗对第三腰椎横突综合征患者的应用效果,旨在为临床护理干预提供参考依据和数据支持。2探寻第三腰椎横突综合征患者对中医护理技术的真实体验,尤其是其接受度、认可度、需求性以及依从性,为进一步完善中医护理技术在临床中的应用提供借鉴。方法本研究采用量性与质性相结合的研究方法。①量性研究：采取便利抽样方法,选取哈尔滨市某三级甲等中医院骨伤科、符合纳入标准的第三腰椎横突综合征保守治疗患者为研究对象。对照组给予院内常规护理和治疗,脱落后剩余32例；试验组1在对照组基础上给予局部中药熏蒸,脱落后剩余33例；试验组2在试验组1基础上给予蜡疗,脱落后剩余33例。干预前后分别采用改良后日本骨科协会下腰痛评分量表、Oswestry功能障碍指数、生存质量测定量表简表进行评价,并在干预后依据《中医病证诊断疗效标准》评价患者疗效。数据录入SPSS19.0统计软件进行处理分析,检验水准为a=0.05,P0.05为差异具有统计学意义。②质性研究：采取立意抽样方法,选取试验组2(局部中药熏蒸联合蜡疗组)中具有代表性的患者为研究对象,资料饱和时访谈11例患者,然后根据Colaizzi现象学七步分析法对访谈资料进行转录、分析,并提炼出4个主题。结果1干预前,三组患者一般资料、JOA各维度及总分、ODI评分、生存质量各维度及总分各项得分比较差异均无统计学意义(P0.05)。2干预前后组内比较,三组患者JOA各维度及总分、ODI评分、生存质量各维度及总分各项得分比较差异均有统计学意义(P0.05)。3干预后组间比较,三组患者JOA各维度及总分、ODI评分各项得分比较差异均有统计学意义(P0.05)。生存质量生理领域和社会关系领域三组间两两比较差异均有统计学意义(P0.05)。但在心理领域和环境领域试验组1与试验组2无统计学意义(P0.05)；生存质量总分方面对照组与试验组1、试验组1与试验组2也无统计学意义(P0.05)。4质性研究部分归纳为4个主题：(1)疾病认知体验：疾病认知不足；疾病对患者影响较大；(2)中医护理技术认知不足；(3)接受中医护理技术态度及行为体验：中医护理技术前、后患者感受差异较大；中医护理技术的接受度和依从性较差；(4)对中医护理技术服务需求的体验：良好服务态度与工作热情；强化心理干预与疏导；营造规模化、人性化服务环境。结论1局部中药熏蒸、局部中药熏蒸联合蜡疗均有助于改善患者的症状和体征,提高生存质量；2局部中药熏蒸联合蜡疗的改善程度要优于单纯局部中药熏蒸；3临床工作中要提高患者疾病认知,积极推广中医护理技术,以提高社会认同,从而不断完善中医护理技术管理。
[Abstract]:Objective 1 to investigate the effect of local Chinese medicine fumigation and local traditional Chinese medicine fumigation combined with wax therapy on the third lumbar vertebrae transverse process syndrome. In order to provide reference and data support for clinical nursing intervention, the purpose of this study was to explore the true experience of the third lumbar vertebrae transverse process syndrome in TCM nursing technology, especially its acceptance, acceptance, demand and compliance. Methods the method of combining quantity and quality was adopted in this study. 1 quantitative study was adopted. Convenience sampling method was adopted to select orthopedics department of Grade 3A traditional Chinese medicine hospital in Harbin. The conservative treatment of the third lumbar transverse process syndrome according to the inclusive criteria was studied. The control group was given routine nursing and treatment in hospital, and the remaining 32 cases were treated with local Chinese medicine fumigation on the basis of the control group. The remaining 33 cases were treated with wax therapy on the basis of trial group 1 and the remaining 33 cases after exfoliation. Oswestry dysfunction index was measured by the modified Japanese Orthopaedic Association low back pain scale before and after intervention. The quality of life (QOL) was evaluated by the summary table of quality of life (QOL). After the intervention, the patients were evaluated according to the criteria for diagnosis and treatment of TCM diseases and syndromes. The data were input into the SPSS19.0 statistical software for processing and analysis. The test level was 0.05% (P 0.05). The difference was statistically significant. 2 qualitative study: the representative patients in test group 2 (local Chinese medicine fumigation combined with wax therapy group) were selected as the study objects. 11 patients were interviewed when the data was saturated. Then the interview data were transcribed and analyzed according to the Colaizzi phenomenological seven step analysis method. Results 1 before intervention, three groups of patients' general data were divided into three groups: each dimension and total score were scored. There was no significant difference in the scores of each dimension and total score of quality of life between the three groups before and after P0.05.2 intervention. The scores of JOA in each dimension and total score of the three groups were significantly higher than those in the control group. The scores of each dimension and total score of quality of life were significantly different between groups after P0.05.3 intervention. There were significant differences in the scores of JOA dimensions and total scores among the three groups (P 0.05). There were significant differences in quality of life (QOL) physiological field and social relationship field (P 0.05) among the three groups, but there were significant differences in psychological field and environment. There was no significant difference between group 1 and group 2 in terms of quality of life (P 0.05); the total score of quality of life in control group and test group 1, and that in group 1 and group 2 had no statistical significance. Experience: lack of understanding of disease; (2) lack of cognition of nursing technology of traditional Chinese medicine (3) attitude and behavior experience of receiving nursing technology of traditional Chinese medicine: before and after nursing technology of TCM, patients' feelings were different; The experience of Chinese medicine nursing technology service demand: good service attitude and work enthusiasm; strengthen psychological intervention and guidance; create scale; Conclusion 1 Local Chinese medicine fumigation and local Chinese medicine fumigation combined with wax therapy can improve the symptoms and signs of the patients. The improvement of local Chinese medicine fumigation combined with wax therapy was better than that of local traditional Chinese medicine fumigation combined with wax therapy. In clinical work, patients' disease cognition should be improved, and traditional Chinese medicine nursing technology should be popularized actively in order to raise social identity. In order to constantly improve the management of traditional Chinese medicine nursing technology.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R248.2

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