夹脊穴深刺治疗颈椎病的临床随机试验研究

发布时间：2018-05-11 01:06

本文选题：颈椎病 + 夹脊穴　；参考：《华北理工大学》2017年硕士论文

【摘要】：目的本研究结合导师的临床经验采用夹脊穴深刺的方法治疗颈椎病。探讨夹脊穴深刺治疗颈椎病的疗效,观察其在疼痛的缓解及功能障碍改善方面的差异,为治疗颈椎病的针刺深度提供更有效的方法。方法采用随机单盲的试验方法,依据国家中医药管理局颁布的《国家中医药管理局·中医病证诊断疗效标准》被诊断为颈椎病的患者纳入本试验,且患者自愿加入本试验并签署知情同意书。一共纳入患者96例,按照随机数字表法将其随机分为两组,即深刺组和常规针刺组每组各48例,其中深刺组针刺深度为2~3寸,常规针刺组针刺深度为0.5~1寸。选取颈部两侧与天柱、颈百劳水平位置的夹脊穴共4针为主穴,同时常规针刺组结合其他症状配伍相应穴位。针刺后进行电针治疗20分钟,每周治疗3次,共治疗4周,分别于入组前、第一次治疗结束当日、第一周治疗结束当日及第四周治疗结束当日,以视觉模拟量表(VAS)对患者病情变化给予评价。填写颈痛量表NPQ,以观察研究治疗前后患者的功能改善情况和生活质量变化;配合颈椎MRI测量颈部表皮到椎间孔后缘的距离,找出治疗颈椎病在安全范围内能达到最佳治疗效果的最佳针刺深度。使用Excel表格建立数据库,全部计量资料采用均数±标准差来表示((?)±s),使用SPSS17.0对数据进行统计学分析,得出结论。结果1视觉模拟量表(VAS)评分:无论是深刺组还是常规针刺组,入组前、第一次治疗后、第三次治疗后及第十二次治疗后,两组患者的VAS评分变化呈逐次下降趋势,差异均有统计学意义(P0.05)。2颈痛量表(NPQ)评分:无论是深刺组还是常规针刺组,入组前、第一次治疗后、第三次治疗后及第十二次治疗后,两组患者的NPQ评分变化呈逐次下降趋势,差异均有统计学意义差异(P0.05)。3比较深刺组和常规针刺组在第一次治疗后、第三次治疗及第十二次治疗后的均数,深刺组的疗效优于传统针刺组,差异有统计学意义(P0.01)。4测量颈部皮肤表面到椎间孔后缘的距离为:男:5.07~7.13cm;女:4.76~6.68cm。结论1针刺夹脊穴治疗颈椎病能够改善患者的疼痛状况、促进功能恢复、提高生活质量。2深刺较常规方法针刺夹脊穴在治疗颈椎病上效果更为显著。3夹脊穴深刺治疗颈椎病是行之安全、疗效可靠的治疗方法。
[Abstract]:Objective to study the treatment of cervical spondylopathy with Jiaji point deep pricking combined with the clinical experience of tutor. To explore the therapeutic effect of Jiaji acupoint on cervical spondylosis, to observe the difference of pain relief and dysfunction improvement, and to provide a more effective method for the treatment of cervical spondylosis with acupuncture depth. Methods A randomized, single-blind trial was conducted on the patients diagnosed as cervical spondylosis according to the criteria for the diagnosis of TCM Diseases and Syndromes issued by the State Administration of traditional Chinese Medicine. And patients voluntarily participate in the trial and sign informed consent. A total of 96 patients were randomly divided into two groups according to the method of random number table. There were 48 cases in each group in deep acupuncture group and conventional acupuncture group. The depth of acupuncture in deep acupuncture group was 2 ~ 3 inches, and that in routine acupuncture group was 0.5 ~ 1 inch. Four main acupuncture points were selected from both sides of the neck and Tianzhu and Jiaji points in the horizontal position of neck, while the routine acupuncture group combined with other symptoms were combined with corresponding acupoints. After acupuncture, the patients were treated with electroacupuncture for 20 minutes, 3 times a week for 4 weeks, respectively, before entering the group, on the end of the first treatment, on the end of the first week and on the end of the fourth week, respectively. Visual analogue scale (VAS) was used to evaluate the change of patient's condition. To observe the improvement of function and quality of life of patients before and after treatment, and to measure the distance between cervical epidermis and posterior margin of intervertebral foramina with cervical MRI. To find out the best depth of acupuncture for the treatment of cervical spondylosis in safe range. The Excel table is used to set up the database, and the mean 卤standard deviation is used to represent the data. SPSS17.0 is used to analyze the data statistically, and the conclusion is drawn. Results (1) Visual analogue scale (VAS) score: the VAS score of the two groups decreased gradually before entering the group, after the first treatment, after the third treatment and after the twelfth treatment, whether in the deep acupuncture group or the routine acupuncture group. The difference was statistically significant (P 0.05). 2 neck pain scale and NPQs: whether in the deep acupuncture group or the routine acupuncture group, the NPQ scores of the two groups decreased gradually before, after the first treatment, after the third treatment and after the twelfth treatment. The differences were statistically significant. P0.053.Compared with the conventional acupuncture group and the deep acupuncture group, after the first treatment, the third treatment and the twelfth treatment, the curative effect of the deep acupuncture group was better than that of the traditional acupuncture group. The distance between cervical skin surface and posterior margin of intervertebral foramen was measured by P0.014.The distance between male and female was: male: 5.07 ~ 7.13 cm, female: 4.76 ~ 6.68 cm. Conclusion 1 the treatment of cervical spondylosis with acupuncture at Jiaji point can improve the pain status and promote the recovery of function. To improve the quality of life .2 Deep acupuncture is more effective than the conventional method in the treatment of cervical spondylosis. 3 it is safe and reliable to treat cervical spondylopathy with deep acupuncture at Jiaji point. 3 the treatment of cervical spondylosis by deep acupuncture at Jiaji point is a safe and reliable method for treatment of cervical spondylosis.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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