调体针刺法治疗慢性盆腔炎的临床疗效观察

发布时间：2018-05-12 09:42

本文选题：慢性盆腔炎 + 体质　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的:从患者的实际体质出发,选取主穴,用调体针刺的方法治疗女性慢性盆腔炎,对治疗有效率、治疗前后的血清炎症因子水平、症状积分、湿热、血瘀体质积分、盆腔B超变化、3个月复发率及不良反应和并发症发生率进行观察,客观评价根据患者的实际体质选取穴位进行调体针刺治疗慢性盆腔炎的可行性和安全性,从而为慢性盆腔炎针刺疗效的改善提供临床依据,为中医理论体系中通过调体治疗疾病提供临床应用资料。方法:前瞻性选取2014年3月至2015年3月就诊于惠城区水口人民医院中医康复科及妇科的慢性盆腔炎患者60例,随机分为对照组和治疗组各30例,对照组进行常规针刺治疗;治疗组在常规针刺治疗的基础上,进行体质穴位选取和调体针刺。两组患者的疗程为三个周期,一疗程为10次,日均治疗1次,在连续治疗5d之后间隔两天再继续。患者经期暂停治疗并在经期3d后继续治疗。对两组治疗有效率、治疗前、治疗1个疗程、2个疗程和3个疗程的血清炎症因子水平、下腹疼痛积分、症状积分和湿热、血瘀体质积分、盆腔B超变化、3个月复发率等进行比较。结果:(1)对照组的治疗有效率达到56.67%(17/30),治疗组明显高于对照组,高达93.33%(28/30);治疗组疗效显著率为53.33%(16/30),亦高于对照组的26.67%(8/30),差异有统计学意义(P0.05)。(2)两组在治疗前比较血清C反应蛋白(CRP)水平,比较差异无统计学意义(P0.05)。治疗前后,两组的下腹疼痛积分均比较差异无统计学意义(P0.05)。与治疗前比较,治疗组治疗1个疗程、2个疗程和3个疗程的血清CRP水平降低,对照组治疗2个疗程和3个疗程的血浆CRP水平亦均降低,差异有统计学意义(P0.05)。治疗组的血清CRP水平均低于对照组,比较差异有统计学意义(P0.05)。(3)比较两组在治疗前的病情轻重程度,比较差异无统计学意义(P0.05)。与治疗前比较,两组治疗2个疗程和3个疗程的病情为轻度的患者比例均升高,病情为重度的患者比例则均降低,差异有统计学意义(P0.05)。与对照组比较,治疗组治疗2个疗程和3个疗程的病情为轻度的患者比例均升高,病情为重度的患者比例则均降低,差异有统计学意义(P0.05)。(4)在治疗前湿热、血瘀体质积分方面,两组的比较差异无统计学意义(P0.05)。与治疗前比较,两组治疗2个疗程和3个疗程的湿热、血瘀体质积分均降低,差异有统计学意义(P0.05)。治疗组在湿热、血瘀体质方面的积分均低于同期的对照组,差异有统计学意义(P0.05)。(5)治疗组治疗后的盆腔B超检查的盆腔炎性包块消失率、输卵管积液消失率和盆腔积液消失率均高于对照组,差异有统计学意义(P0.05)。(6)治疗组在停止治疗3个月后的复发率为6.67%(2/30),低于对照组的26.67%(8/30),差异有统计学意义(P0.05)。结论:(1)根据患者的实际体质选取穴位进行调体针刺治疗慢性盆腔炎有助于更快缓解患者下腹疼痛、控制炎症反应、改善患者体质,缓解病情。(2)根据患者的实际体质选取穴位进行调体针刺治疗慢性盆腔炎的疗效良好,可有效改善患者的临床症状及体征,促进疾病康复。(3)根据患者的实际体质选取穴位进行调体针刺治疗慢性盆腔炎在患者停止治疗3个月后复发率低,其长期治疗效果亦较佳,且安全性良好,对慢性盆腔炎的治疗起到良好的效果。
[Abstract]:Objective: from the actual physique of the patients, select the main point, use the method of acupuncture to treat female chronic pelvic inflammatory disease, to observe the efficiency of treatment, the level of serum inflammatory factors, the integral of symptoms, the body integral of damp heat, blood stasis, the changes of pelvic B ultrasound, the recurrence rate of 3 months, the incidence of adverse reactions and complications, and objective evaluation of the root. According to the actual physique of the patient, it is feasible and safe to select acupuncture points to treat chronic pelvic inflammatory disease, thus providing clinical basis for the improvement of the curative effect of chronic pelvic inflammatory disease, and providing clinical data for the treatment of diseases through regulating body in the theory system of traditional Chinese medicine. Method: a forward-looking selection of Yu Huicheng from March 2014 to March 2015 60 patients with chronic pelvic inflammation in the traditional Chinese medicine and gynecology were randomly divided into the control group and the treatment group (30 cases), and the control group was treated with conventional acupuncture. On the basis of the conventional acupuncture treatment, the physique acupoint selection and the body acupuncture were carried out in the treatment group. The course of treatment for the two groups was three cycles, one course of treatment was 10 times, and the daily average treatment was 10. The patients were treated 1 times and continued after two days of continuous treatment of 5D. The patients were suspended for two days. The patients were pause and continued after the menstrual period. The treatment of two groups was effective, before treatment, 1 courses of treatment, 2 courses and 3 courses of serum inflammatory factors, lower abdominal pain score, symptom integral and damp heat, blood stasis constitution integral, pelvic B ultrasonic change, 3 months later. Results: (1) the effective rate of treatment in the control group was 56.67% (17/30), the treatment group was significantly higher than the control group, up to 93.33% (28/30), the curative effect was 53.33% (16/30) and 26.67% (8/30) in the control group, and the difference was statistically significant (P0.05). (2) the level of serum C reactive protein (CRP) was compared to the two groups before treatment, compared with the two groups. There was no statistically significant difference (P0.05). The scores of lower abdominal pain in the two groups were not statistically significant before and after treatment (P0.05). Compared with before treatment, the treatment group had 1 courses of treatment, 2 courses and 3 courses of serum CRP levels decreased, and the levels of plasma CRP in the 2 and 3 courses of the control group were also decreased, the difference was statistically significant. P0.05. The level of serum CRP in the treatment group was lower than that of the control group, and the difference was statistically significant (P0.05). (3) there was no significant difference between the two groups before the treatment (P0.05). Compared with the pre treatment group, the proportion of the two groups for the treatment of 2 courses and 3 treatments was higher, and the severity of the disease was severe. The proportion of patients decreased, the difference was statistically significant (P0.05). Compared with the control group, the proportion of 2 courses of treatment and 3 courses of mild patients increased, the proportion of patients with severe condition decreased, and the difference was statistically significant (P0.05). (4) the difference between the two groups was poor before the treatment of heat and heat and blood stasis. No statistical significance (P0.05). Compared with before treatment, the two groups of 2 courses of treatment and 3 courses of damp heat, blood stasis constitution score decreased, the difference was statistically significant (P0.05). The treatment group in the heat, blood stasis physique scores were lower than the same period of the control group, the difference was statistically significant (P0.05). (5) the treatment group after the pelvic B ultrasound examination The rate of pelvic inflammatory mass loss, the vanishing rate of oviduct effusion and the vanishing rate of pelvic cavity effusion were higher than those in the control group (P0.05). (6) the recurrence rate of the treatment group was 6.67% (2/30) after 3 months of cessation treatment, which was lower than that of the control group (8/30), and the difference was statistically significant (P0.05). (1) according to the actual physical constitution of the patients Acupoint acupuncture treatment of chronic pelvic inflammation can help to relieve the pain of the lower abdomen, control the inflammatory reaction, improve the physique of the patients and alleviate the disease. (2) the effect of acupuncture on the treatment of chronic pelvic inflammatory disease is good according to the actual physique of the patient, which can improve the clinical symptoms and signs of the patients and promote the disease health. (3) according to the actual physique of the patient, acupoints are selected for the treatment of chronic pelvic inflammatory disease with low recurrence rate after 3 months of treatment, and the long-term effect is better, and the safety is good, and it has good effect on the treatment of chronic pelvic inflammation.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.3

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