针药并用治疗颞下颌关节紊乱病疗效观察

发布时间：2018-04-29 20:59

本文选题：颞下颌关节紊乱病 + 中医　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:通过针药并用的方法治疗颞下颌关节紊乱病并观察其疗效,依据中医辩证分型来治疗颞下颌关节紊乱病,针刺部位及针刺手法以及中药处方的选取。临床资料与方法:笔者依照该病种的诊断标准、纳入标准、排除标准以及脱落标准,于辽宁中医药大学附属医院收入患者90例,依照数字表随机原则,随机均分每组30例并命名为针药并用组,常规针灸组,以及中药辩证组三组并编号。针药并用组根据辩证分型给予针灸和中药汤剂服用处理,针灸组给予治疗颞下颌关节紊乱病常规穴位处理,中药组根据辨证分型给予中药汤剂服用处理。三组患者给予相同治疗周期,记录观察项目:疼痛视觉模拟尺(VAS)疼痛评分[1],Friction颞下颌关节指数(其中包括颞下颌关节功能障碍指数,肌肉压痛指数)。结果:1.针药并用法、常规针灸法以及辩证中药法分别用于TMD疼痛患者后疼痛程度均有缓解(p0.05),并且针药并用法对TMD疼痛的治疗作用在同一治疗周期内较其他两法的作用较为迅速(p0.05),具有统计学意义。2.三种方法在治疗后对缓解肌紧张,改善关节结构等均有效果(p0.05)。同时认为针药并用法较其他两组的方法的作用相对有效(p0.05),具有统计学意义。3.与证型的相关性:针药并用法在VAS值指标上反映出针药并用法对瘀血阻络、脾胃虚弱和肾阳亏虚型有明确疗效(显效率均为100%),而对于湿热痹阻型的疗效有一定的差异性。4从Friction指数是反映出针药并用对TMD的四个证型均有治疗作用,但与常规针灸组和辩证中药组所达到的治疗效果无明显差异。结论:1.针药并用可以用于治疗颞下颌关节紊乱病中针对瘀血阻络型,脾胃虚弱型以及肾阳亏虚型的疼痛有较好的缓解效果。2.在针灸、中药和针药并用中,对颞下颌关节紊乱病针对性的治疗效果无明显的差别。3.针药并用治疗颞下颌关节紊乱病是一种还尚未可作为最佳治疗,但却为有效的治疗方法,尚需进一步研究,深入分析。
[Abstract]:Objective: to treat temporomandibular joint disorder with acupuncture and medicine and observe its curative effect. To treat temporomandibular joint disorder, acupuncture position, acupuncture manipulation and Chinese medicine prescription according to the dialectical classification of traditional Chinese medicine. Clinical data and methods: according to the diagnostic criteria, inclusion criteria, exclusion criteria and abscission criteria of the disease, 90 patients were enrolled in the affiliated hospital of Liaoning University of traditional Chinese Medicine, according to the random principle of digital table. There were 30 cases in each group and named as acupuncture combined group, routine acupuncture group and traditional Chinese medicine dialectical group. Acupuncture and medicine combined group according to the dialectical classification of acupuncture and traditional Chinese medicine decoction taking treatment, acupuncture and moxibustion group to treat temporomandibular joint disorder routine point treatment, traditional Chinese medicine group according to syndrome differentiation of traditional Chinese medicine decoction taking treatment. Three groups of patients were given the same treatment cycle. The observation items were as follows: pain visual analogue ulnar vas) pain score [1] Friction temporomandibular joint index (including temporomandibular joint dysfunction index, muscle tenderness index). The result is 1: 1. Acupuncture and medicine, The pain degree of patients with TMD pain was alleviated by routine acupuncture method and dialectical Chinese medicine method respectively, and the effect of acupuncture and medicine combined therapy on TMD pain was faster than that of other two methods in the same treatment cycle, which had statistical significance. The three methods can relieve muscle tension and improve joint structure after treatment. At the same time, the effect of acupuncture and medicine combined method is relatively effective compared with the other two groups, which has statistical significance. The correlation with syndrome type: the combination of acupuncture and medicine reflected the value of VAS on the blood stasis obstruction of collaterals by the combination of acupuncture and medicine, Spleen and stomach deficiency and kidney-yang deficiency have definite curative effect (obvious rate is 100g), and there is certain difference in curative effect for damp-heat arthralgia. 4 according to Friction index, acupuncture combined with medicine has therapeutic effect on all four syndrome types of TMD. However, there was no significant difference in therapeutic effect between acupuncture group and dialectical Chinese medicine group. Conclusion 1. Acupuncture and medicine can be used in the treatment of temporomandibular joint disorders in the blood stasis obstruction collaterals type, spleen and stomach weakness type and deficiency of kidney yang type pain relief effect. 2. In the combination of acupuncture, traditional Chinese medicine and acupuncture and medicine, there is no significant difference in the effect of targeted treatment of temporomandibular joint disorder. The treatment of temporomandibular joint disorder with acupuncture and medicine is not yet the best treatment, but it is an effective treatment method, which needs further study and in-depth analysis.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.83

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