滞动针结合温针灸疗法治疗风寒阻络型腰三横突综合征的临床研究

发布时间：2018-05-04 08:39

本文选题：腰三横突综合征 + 滞动针刺疗法　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:本课题通过对滞动针结合温针灸疗法治疗风寒阻络型腰三横突综合征临床研究,客观的的评价该疗法的临床疗效和安全性,为滞动针疗法治病提供新的思路以及为该疗法的推广应用提供依据。方法:将68例符合纳入标准的腰三横突综合征患者用随机数字表分配法分为治疗组和对照组,每组各34例。治疗组选取腰三横突区域的阿是穴和夹脊穴,采用滞动针结合温针灸疗法治疗,方法是:进针得气后滞针,行提拉、摇摆、合谷刺等动针操作,时间约1分钟,完成后在滞动针的针柄上插长约2.5cm的艾条,共1根,待艾条燃尽,皮肤红晕潮红,出针前再行一次滞动针操作。对照组给予口服双氯芬酸钠双释放肠溶胶囊75mg,每天一次,每次75mg。两组患者在治疗期间严禁服用其他对研究结果造成影响的药品或采取治疗方法,两个组均以治疗5天作为一个疗程,总共治疗两个疗程,疗程结束当日,采用JOA日本骨科学会(Japanese Orthopaedic Association)下腰痛评分表、VAS(Visual Analogue Scale/Score)评分量表进行压痛疗效评定,研究结果采用SPSS23.0进行数据分析。结果:1.疗程结束后,治疗组JOA评分,对比治疗前(p0.01),差异有显著统计意义;对比对照组(p0.01),差异有显著统计学意义,说明滞动针结合温针灸有明显的临床疗效,优于口服西药。2.疗程结束后,治疗组的VAS评分,对比治疗前(p0.01),差异有显著统计学意义;对比对照组(p0.01),差异有显著统计学意义,说明滞动针结合温针灸可以改善患者压痛等体征,优于口服西药。3.治疗组:痊愈率21.88%,总有效率为96.88%;对照组:痊愈率9.38%,总有效率为84.38%组,治疗组的痊愈率和总有效率都高于对照组。4.治疗组出针后出现2例局部轻微肿痛出血;对照组出现9例腹胀腹泻、口干便秘等胃肠道不良反应。出现不良反应的患者经处理后均能够完成试验,另有4例患者因家里有紧急事情或者临时出差等个人原因未能完成最后试验。结论:1.滞动针结合温针灸具有温通经络、松解粘连作用,治疗风寒阻络型腰三横突综合征临床疗效显著。2.滞动针结合温针灸在改善患者症状、体征和日常生活方面的等综合疗效明显优于口服西药。是具有操作安全、疗效显著、无副作用的治疗方法,值得临床推广。
[Abstract]:Objective: to evaluate objectively the clinical efficacy and safety of hysteretic acupuncture combined with warm acupuncture in the treatment of the syndrome of lumbar three transverse process of wind-cold blocking collaterals. To provide a new idea for the treatment of stagnation acupuncture therapy and to provide the basis for the popularization and application of the therapy. Methods: 68 cases of lumbar three transverse process syndrome were divided into treatment group and control group with 34 cases in each group. The treatment group selected Ashi and Jiaji points in the area of lumbar three transverse processes, and used stagnation acupuncture combined with warm acupuncture therapy. The methods were as follows: acupuncture after getting Qi into the needle, pulling, rocking, and Hegu acupuncture for about 1 minute, and so on. After completion, insert about 2.5cm 's moxa on the needle handle of hysteretic needle, a total of 1 stick, wait for the moxa to burn out, the skin is red and flushed, the needle should be operated again before the needle is released. The control group was given oral diclofenac sodium double release enteric capsule 75 mg, once a day, each time 75 mg. During the course of treatment, patients in both groups were not allowed to take any other drugs or methods that affected the results of the study. Both groups were treated with a course of treatment of 5 days, a total of two courses of treatment, on the day of the end of the course of treatment. The JOA Japanese Orthopaedic Association was used to evaluate the curative effect of tenderness. The results were analyzed by SPSS23.0. The result is 1: 1. At the end of the course of treatment, the JOA score of the treatment group was significantly higher than that of the control group (P 0.01), and that of the control group was significantly higher than that of the control group (P 0.01), which indicated that the hysteretic acupuncture combined with warm acupuncture had obvious clinical effect and was superior to the western medicine. 2. At the end of the course of treatment, the VAS score of the treatment group was significantly higher than that of the control group before treatment, and the difference between the control group and the control group was statistically significant, indicating that the hysteretic acupuncture combined with warm acupuncture could improve the tenderness and other signs of the patients, and was superior to the western medicine. 3. In the treatment group, the cure rate was 21.88, the total effective rate was 96.88, in the control group, the cure rate was 9.38 and the total effective rate was 84.38%. The cure rate and the total effective rate in the treatment group were higher than those in the control group. There were 2 cases of local slight swelling and pain hemorrhage in the treatment group and 9 cases of abdominal distension diarrhea dry mouth constipation and other adverse reactions in the control group. The patients with adverse reactions were all able to complete the trial after treatment, and 4 patients could not complete the final trial because of emergency at home or temporary business trip. Conclusion 1. Stagnation acupuncture combined with warm acupuncture has the effect of warming the meridian and loosening the adhesion and treating the syndrome of wind cold blocking collaterals and three transverse processes. 2. The comprehensive effect of stagnation acupuncture combined with warm acupuncture in improving the symptoms, signs and daily life of patients was significantly better than that of oral western medicine. It is a safe, effective and no side effect treatment method. It is worth popularizing.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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