壮医莲花针拔罐逐瘀法治疗Behcet病性葡萄膜炎的临床疗效研究

发布时间：2018-05-10 05:50

本文选题：Behcet病 + 葡萄膜炎　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察Behcet病性葡萄膜炎在常规治疗基础上,配合壮医莲花针拔罐逐瘀法,观察治疗前、后各项指标的变化,为临床上治疗Behcet病性葡萄膜炎提供一种新的疗法。方法:选择符合湿热瘀毒型Behcet病性葡萄膜炎的患者40名,按其先后就诊顺序,采用随机对照方法,分为治疗组(壮医莲花针拔罐逐瘀+西药组)和对照组(西药组),每组各20例。治疗组:在常规西医治疗方案基础上加用壮医莲花针拔罐逐瘀法,5天一次,10次为一个疗程,总共2个疗程,2疗程之间休息1周;对照组:常规西医治疗(参考杨培增主编《葡萄膜炎诊断与治疗》中对本病的治疗,急性期,按公斤体重(1-1.2mg\kg)口服醋酸泼尼松片,或按外院激素用量继续递增\递减,伴有虹膜睫状体炎者,眼局部复方托吡卡胺滴眼液散瞳,妥布霉素地塞米松眼液及妥布霉素地塞米松眼膏,普拉洛芬滴眼液,随症状变化加减滴眼次数。在风湿免疫科指导下,口服环孢素)。分别对两组Behcet病性葡萄膜炎患者血沉、全血粘度、眼部症状体征及中医症候积分等前后对比统计。计量资料以x±s表示,使用t检验,计数资料使用卡方检验,分组比较VAS评分采用单因素方差分析,组间检测指标的比较使用独立样本的t检验。懫用SPSS22.0统计软件进行所有资料的统计学分析,得出结论。结果:通过对治疗前后的组间比较,得出以下结果:1.在葡萄膜炎症状、体征积分方面,两组治疗后均较治疗前降低,但治疗组症状、体征积分低于对照组,且治疗组对于“羞明、流泪、角膜后沉积物、玻璃体混浊、眼底改变”症状改善优于对照组,P0.05,差异有统计学意义;2.在湿热瘀毒中医症候积分方面,两组治疗前比较,差异无统计学意义(P0.05),具有可比性。经治疗后:治疗组中医症候积分较治疗前降低,差异有统计学意义(P0.05);对照组差异无统计学意义(P0.05)。治疗后两组间相比较:治疗组中医症候积分低于对照组,差异有统计学意义(P0.05),说明治疗组优于对照组。3.在全血粘度、血浆粘度方面,两组治疗后全血粘度、血浆粘度数值均较治疗前降低,治疗后组间相比,治疗组优于对照组,差异有统计学意义(P0.05);4.在血沉方面,两组治疗后全血粘度数值均较治疗前降低,但P0.05,差异无统计学意义。5.在眼压方面,两组治疗前双眼眼压比较,差异无统计学意义(P0.05),具有可比性;两组治疗后及治疗后组间比较,P0.05,差异无统计学意义。结论:介入壮医莲花针拔罐逐瘀治疗不仅可以调整Behcet病性葡萄膜炎患者湿热瘀毒的体质偏畸,同时还可以使患者的湿热瘀毒症状明显低于对照组,壮医莲花针拔罐疗法操作简单,疗效可靠,突出了壮医莲花针拔罐逐瘀法民族医学及中西医结合的优势,为临床上治疗Behcet病性葡萄膜炎提供一种新的疗法,同时也丰富了壮医理论。
[Abstract]:Objective: to observe the changes of indexes before and after treatment of Behcet's disease uveitis on the basis of routine treatment, and to provide a new therapy for the treatment of Behcet's disease uveitis. Methods: forty patients with Behcet's disease uveitis of damp-heat stasis toxin type were selected. The patients were divided into two groups: treatment group (20 cases in each group) and control group (20 cases in each group). The treatment group: on the basis of routine western medicine treatment, the treatment group was treated with Lianhua needle cupping and removing blood stasis method for 5 days as a course of treatment, with a total of 2 courses of treatment and 2 courses of rest for one week; Control group: routine western medicine therapy (referring to Yang Pei-zeng 's "diagnosis and treatment of uveitis"). In the acute phase, prednisone acetate tablets were given orally according to kg body weight of 1-1.2 mg / kg, or the amount of hormone used in the external hospital continued to increase and decrease. In patients with iridocyclitis, local compound topiramine eye drops, tobramycin dexamethasone eye ointment and Prabuprofen eye drops were added and decreased with the change of symptoms. Under the guidance of Rheumatological Immunology Department, oral cyclosporine. The erythrocyte sedimentation rate (ESR), whole blood viscosity, ocular symptoms and signs, and TCM symptom scores were compared between the two groups of patients with Behcet's disease uveitis. The measurement data were expressed as x 卤s, t test was used, chi-square test was used for counting data, VAS score for group comparison was single factor ANOVA, and t test for independent sample was used for comparison between groups. The statistical analysis of all the data was carried out by SPSS22.0 statistical software, and the conclusion was drawn. Results: by comparing the two groups before and after treatment, the following results were obtained: 1: 1. The scores of symptoms and signs of uveitis in both groups were lower than those before treatment, but the scores of symptoms and signs in the treatment group were lower than those in the control group. The improvement of symptoms was better than that of the control group (P 0.05), and the difference was statistically significant (P 0.05). In the aspect of TCM symptom integral of dampness and heat stasis toxin, the difference between the two groups before treatment was not statistically significant (P 0.05), which was comparable. After treatment, the score of TCM symptom in the treatment group was lower than that before treatment, and the difference was statistically significant (P 0.05), while the difference in the control group was not statistically significant (P 0.05). Comparison between the two groups after treatment: the score of TCM symptom in the treatment group was lower than that in the control group, the difference was statistically significant (P 0.05), which indicated that the treatment group was better than the control group. 3. In terms of whole blood viscosity and plasma viscosity, the whole blood viscosity and plasma viscosity in the two groups were lower than those before treatment. After treatment, the treatment group was superior to the control group, and the difference was statistically significant (P 0.05). In terms of erythrocyte sedimentation rate, the whole blood viscosity of the two groups after treatment was lower than that before treatment, but the difference was not statistically significant (P 0.05). In terms of intraocular pressure, the difference between the two groups before treatment was not statistically significant (P 0.05), but there was no significant difference between the two groups after treatment and after treatment (P 0.05). Conclusion: interventional therapy of Lianhua needle cupping and removing blood stasis can not only adjust the physique of Behcet disease uveitis patients with damp-heat stasis toxin, but also make the symptoms of damp-heat stasis toxin obviously lower than that of the control group. Lianhua needle cupping therapy in Zhuang medicine is simple in operation and reliable in curative effect. It highlights the advantages of traditional Chinese medicine and combination of traditional Chinese medicine and western medicine, and provides a new therapy for the treatment of Behcet's disease uveitis. At the same time, it enriches the theory of Zhuang medicine.
【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】：R276.7

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