穴位与非穴位针刺治疗慢性颈痛的临床研究

发布时间：2018-05-21 10:05

本文选题：电针 + 慢性颈痛　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的通过观察穴位与非穴位针刺治疗慢性颈痛患者的疗效差异,探讨穴位在针刺治疗疼痛类疾病中是否存在特异性及针刺的安慰针效应。方法本课题为穴位与非穴位针刺治疗慢性颈痛的临床研究,已通过广东省中医院伦理委员会委员伦理审查批准,并在中国临床试验注册中心注册,注册号为ChiCTR-IOR-15006886,主要招募以颈痛为主诉的慢性颈痛患者,纳入符合标准的70例受试者,按照完全随机分组原则,将符合临床要求的受试者随机分为3组：穴位针刺组、非穴位浅刺组和非穴位深刺组。穴位针刺组选取双侧颈百劳、肩中俞穴位,非穴位浅刺与非穴位深刺组均选取双侧颈百劳、肩中俞外(除阿是穴)lcm的针刺点；穴位针刺组和非穴位的深刺组针刺深度为10-20mm,非穴位浅刺组的针刺深度5mm,3组针刺方向均是直刺,均使用G6805-I型电针治疗仪予加一定刺激的电刺激,每周3次,2-3天一次,每次25min,共10次。每次治疗前后均记录患者VAS评分和压痛阈值评分以及当时针刺状态或不良反应、得气情况等；在第一次针刺治疗前、第5次治疗后以及整个疗程结束后予记录患者NPQ量表评分及简式McGill量表。疗程结束后(10次针刺完后)采用统计软件spss22.0进行统计数据分析。结果本次研究共完成70例慢性颈痛病例,其中有穴位针刺组24例和非穴位深刺与浅刺组各23例受试者,共计脱落5例。三组患者入组时的基线情况差异无统计学意义(P＞0.05),具有可比性。组内比较：(1)穴位针刺组：第5、10次针刺治疗后NPQ、McGill量、VAS评分均较第1次针刺前降低(P＜0.05),第10次针刺治疗后NPQ、McGill量、VAS评分较第5次针刺后降低(P＜0.05)；(2)非穴位浅刺组：第10次针刺治疗后NPQ、McGill量、VAS评分较第1次针刺前降低(P＜0.05),第5次针刺治疗后VAS评分较第1次针刺前降低(P＜0.05),第10次针刺治疗后压痛阈值评分较第1次针刺、第5次针刺后升高(P＜0.05)；(3)非穴位深刺组：第5、10次针刺治疗后NPQ、McGill量、VAS评分均较第1次针刺前降低(P＜0.05),第10次针刺治疗后NPQ、McGill量、VAS评分较第5次针刺前降低(P＜0.05)。组间疗效比较：a.穴位针刺组与非穴位浅刺组两两比较NPQ、McGil、压痛阈值疗效比较差异有统计学意义(P＜0.05)；b.穴位针刺组与非穴位深刺组两两比较NPQ量表评分疗效比较差异有统计学意义(P＜0.05)； c.非穴位浅刺组与非穴位深刺组两两比较NPQ、McGil、VAS量表评分疗效比较差异有统计学意义(P＜0.05)。结论：穴位针刺组、非穴位浅刺组及非穴位深刺组针刺治疗慢性颈痛均有效,提示：1)电针治疗慢性颈痛有效；2)针刺治疗疼痛类疾病中穴位特异性不明显；3)针刺治疗慢性颈痛具有一定的安慰剂效应。
[Abstract]:Objective to observe the difference between acupoints and non-acupoints in the treatment of chronic cervical pain, and to explore the specificity of acupoints in the treatment of pain diseases and the soothing acupuncture effect of acupuncture. Methods the clinical study on the treatment of chronic cervical pain by acupuncture at acupoints and non-acupoints has been approved by members of the Ethics Committee of Guangdong traditional Chinese Medicine Hospital and has been registered in the China Clinical trial Registration Center. The registration number was ChiCTR-IOR-15006886. The patients with chronic cervical pain were recruited and 70 subjects who met the standard were included. According to the principle of complete random grouping, the subjects who met the clinical requirements were randomly divided into three groups: acupuncture group at acupoint, Non-point shallow needling group and non-acupoint deep pricking group. The acupoints acupuncture group selected bilateral cervical BaiLao, shoulder Zhongshu acupoint, non-acupoint shallow and non-acupoint deep needling group, all selected bilateral cervical Bairao, shoulder Zhongshu (except Ashi point). The acupuncture depth of acupoint acupuncture group and non-acupoint deep needling group was 10-20 mm, and the acupuncture depth of non-point shallow needling group was 5 mm and the direction of acupuncture was straight. G6805-I electroacupuncture apparatus was used to give electrical stimulation with certain stimulation, three times a week, 2-3 days a week. Each time for 25 minutes, a total of 10 times. Before and after each treatment, the patients' VAS score, tenderness threshold score and the state of acupuncture or adverse reactions were recorded. The scores of NPQ and McGill were recorded after the fifth treatment and the end of the whole course. Statistical software spss22.0 was used to analyze the statistical data. Results there were 70 cases of chronic cervical pain in this study, including 24 cases of acupoint acupuncture group and 23 cases of non-point deep needling group and superficial needling group. There was no significant difference in baseline status among the three groups (P > 0.05), which was comparable. Comparison of acupoint acupuncture group: after 5 ~ 10 times acupuncture treatment, the VAS scores of NPQN McGill and VAS were lower than those of the first acupuncture group (P < 0.05), and the NPQN McGill volume and VAS scores after the 10th acupuncture treatment were lower than those of the 5th acupuncture group (P < 0.05); the 10 times acupuncture group: the 10th time acupuncture group: 10 times acupuncture group After treatment, the VAS score of NPQQ McGill was lower than that before the first acupuncture (P < 0.05), the VAS score after the fifth acupuncture was lower than that before the first acupuncture (P < 0.05), and the tenderness threshold score after the 10th acupuncture was lower than that after the first acupuncture. After the 5th acupuncture treatment, the NPQI McGill volume and VAS score of the non-acupoint deep needling group were all lower than that of the first acupuncture group (P < 0.05), and the NPQI McGill VAS score after the 10th acupuncture treatment was lower than that of the 5th acupuncture group (P < 0.05). Comparison of curative effects between groups: a. The comparison of NPQ McGiland tenderness threshold effect between acupoint acupuncture group and non-point superficial needling group had statistical significance (P < 0.05). There was significant difference in the efficacy of NPQ scale between acupoint acupuncture group and non-acupoint deep acupuncture group (P < 0.05). There was a significant difference in the efficacy of NPQG McGiln VAS scale between the non-point shallow needling group and the non-acupoint deep needling group (P < 0.05). Conclusion: acupuncture of acupoint acupuncture group, non-point superficial acupuncture group and non-point deep needling group are effective in treating chronic cervical pain. The results suggest that: (1) electroacupuncture is effective in treating chronic cervical pain. (2) Acupuncture has a placebo effect in the treatment of chronic cervical pain.
【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】：R246.9

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