慢性稳定性心绞痛患者的针刺疗效及其与期待效应的相关性研究

发布时间：2018-04-21 23:03

本文选题：慢性稳定性心绞痛 + 针刺疗效　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：以慢性稳定性心绞痛(chronic stable angina pectoris, CSAP)患者作为研究对象,评价经穴组、非穴组和等待治疗组之间的临床疗效差异,并探讨患者治疗前的期待值与针刺疗效的相关性。方法：采用多中心、随机、对照试验设计,将符合纳入标准的CSAP患者通过中央随机系统分为经穴组(A组)、非穴组(B组)和等待治疗组(C组)。所有组均采用相同的基础治疗。A、B组均双侧取穴,腧穴得气后连接韩氏电针仪；3次/周,30分钟/次,治疗4周共12次。研究包括基线期和治疗期各4周。评价指标有心绞痛发作次数、疗效应答者比例、疼痛程度(VAS评分)、西雅图量表(SAQ)、患者针刺疗效总体评价和针灸期待值评价。结果：1、研究共招募符合纳入标准的受试者303例,其中A组100例、B组102例、C组101例；三组间基线资料呈均衡性；2、针刺结束后,A、B组的心绞痛发作次数、VAS评分、SAQ总分较入组前均有统计学差异(P0.05)；C组仅心绞痛发作次数较入组前有统计学差异(P0.05);3、A组在心绞痛发作次数、疗效应答者比例、VAS评分、SAQ评分、患者针刺疗效总体评价方面与B组、C组相比有统计学差异(P0.05)；B组在心绞痛发作次数、SAQ评分方面与C组相比有统计学差异(P0.05)；4、同组中不同期待值患者之间的疗效应答情况无显著差异(P0.05)；相同期待值A组患者的疗效应答者比例与B组相比有统计学差异(P0.05)；结论：1、针刺治疗CSAP安全有效。针刺能明显降低心绞痛的发作次数和疼痛程度,改善患者生活质量,与单纯的基础药物治疗相比具有一定的优势；2、经穴组中各项指标的疗效优于非穴组和等待治疗组；非穴组中心绞痛发作次数、SAQ评分的疗效优于等待治疗组；3、同组中不同期待值患者之间的针刺疗效无显著差异,说明患者治疗前期待值的高低与针刺疗效不存在相关性；4、相同期待值患者经穴的针刺疗效优于非穴,说明腧穴是针刺疗效的关键,进一步证实经穴效应具有特异性。
[Abstract]:Objective: to evaluate the difference of clinical efficacy between acupoint group, non-point group and waiting group in patients with chronic stable angina pectoris (CSAP), and to explore the correlation between the expected value before treatment and the effect of acupuncture in patients with chronic stable angina pectoris (CSAP). Methods: by using a multicenter, randomized, controlled trial design, the patients with CSAP who met the inclusion criteria were divided into two groups by central random system: group A (group A) and group B (group B) and group C (waiting for treatment). All the groups were treated with the same basic treatment. All the acupoints were taken from both sides in group A. the acupoints were connected with Han's electroacupuncture device 3 times a week for 30 minutes per week, and 12 times a week for 4 weeks. The study included a baseline period of 4 weeks and a treatment period of 4 weeks. The evaluation indexes included the number of angina pectoris attacks, the proportion of patients who responded to the curative effect, the degree of pain and the VAS score, the Seattle scale SAQA, the general evaluation of acupuncture effect and the evaluation of the expected value of acupuncture and moxibustion. Results in the study, 303 subjects were recruited according to the inclusion criteria, including 100 cases in group A, 102 cases in group B and 101 cases in group C; The baseline data of the three groups were balanced. There were significant differences in the frequency of angina pectoris attack and the total score of SAQ between group A and group A after acupuncture. There was only significant difference in the frequency of angina pectoris attack between group P0.05 and group C before acupuncture, and there was statistical difference in the frequency of angina pectoris attack between group A and group A after acupuncture. The proportion of patients who responded to the curative effect was evaluated by VAS score and SAQ score. There was significant difference in the total evaluation of acupuncture effect between group B and group C (P 0.05) and SAQ score of angina pectoris in group B (P 0.05) and SAQ score in group C (P 0.05), and the response of patients with different expected values in the same group. There was no significant difference between the two groups (P 0.05), and there was a significant difference between group A and group B in response to curative effect. Conclusion Acupuncture is safe and effective in the treatment of CSAP. Acupuncture can significantly reduce the number of angina pectoris attack and pain degree, improve the quality of life of patients, compared with the simple treatment of basic medicine has a certain advantage. The curative effect of each index in the meridian acupoint group is better than that in the non-point group and waiting treatment group. The effect of SAQ score of angina pectoris attack in non-point group was better than that in waiting treatment group, but there was no significant difference in acupuncture effect among patients with different expectation value in the same group. The results showed that there was no correlation between the expected value before treatment and the acupuncture effect. The acupuncture effect of the patients with the same expectation value was better than that of the non-acupoints, indicating that acupoints were the key to the acupuncture effect and further confirming the specificity of the acupoint effect.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

【相似文献】