穴位真刺与假刺治疗慢性颈痛的临床研究

发布时间：2018-05-25 17:21

  本文选题：慢性颈痛 + 电针　； 参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究旨在通过观察穴位针刺和穴位假针刺治疗慢性颈痛患者的疗效差异,探讨针刺的安慰剂效应。方法：本研究已经通过了广东省中医院·伦理委员会的伦理审查,并在中国临床试验注册中心登记及注册(注册号为：ChiCTR-IPO-15006886)。研究对象来源于广州市各大高校、广东省中医院针灸门诊部的慢性颈痛患者。纳入患者共62例,随机分为三组：穴位针刺组、穴位浅刺组和穴位非刺入组。针刺组的患者以毫针直刺入穴位0.5-1寸,得气后给予加电刺激；浅刺组的患者亦是以毫针直刺入穴位1-4mmm,不要求得气,并给予加电刺激；非刺入组则是在穴位上将安慰针具里的钝头针固定好,不需要刺进皮下,连接电针仪但不予通电刺激。三组均选用双侧颈百劳穴及肩中俞穴,使用G6805-I型电针治疗仪,予疏密波,强度以患者舒适为度。治疗周期均为每周3次,2-3天一次,每次25min,共10次。观察指标是：(1)受试者的VAS评分和压痛阈值：每次治疗前后记录； (2)受试者的NPQ评分及简式McGill量表：在第一次治疗前、第五次治疗后以及整个疗程结束后予记录。结果：本研究共完成62例,其中针刺组21例,浅刺组21例,非刺入组20例,各组受试者在治疗前的基本资料及各项观察指标(包括VAS评分、压痛阈值、NPQ评分及简式McGill量表)差异均无统计学意义。1.各组治疗前后比较： (1)针刺组治疗后McGill.NPQ.VAS值、压痛阈值明显下降,差异均有统计学意义(McGill:17.66±7.23 vs 7.43±3.37,P0.01;NPQ：33.19±13.92 vs 13.99±6.97,P0.01;VAS：5.80±1.21 vs 1.99±1.05,P0.01；压痛阈值：161.58±29.48 vs 130.31±45.83,P0.05)； (2)浅刺组治疗后的NPQ颈痛、McGill疼痛量表、VAS值下降,差异均有统计学意义(McGill:15.50±4.65 vs 9.81±4.04,P0.01;NPQ：25.98±9.06 vs 18.99±9.71,P0.01；VAS：4.91±1.37 vs 3.33±1.17,P0.01),压痛阈值在针刺前后无明显变化；(3)非刺入组的NPQ颈痛、McGill疼痛量表、VAS值下降(McGill:16.82±6.85 vs 11.73±4.70,P0.05;NPQ:25.78±7.31 vs 21.78±7.08,P0.01:VAS:5.02±0.90 vs 4.35±0.95,P0.05),差异具有统计学意义,压痛阈值在针刺前后无明显变化。2.组间比较：(1)针刺组各项观察指标与浅刺组及非刺入组比较,有显著差异(McGill:10.24±6.52 vs 5.69±4.12,5.10±4.89,P0.01,P0.01;NPQ:19.21±8.79 vs 6.99±4.12,3.89±4.89,P0.01;P0.01;VAS:3.81±1.28vs 1.19±0.93,0.52±0.50,P0.01,P0.01:压痛阈值：31.26±46.82 vs 10.57 ±30.75,4.14±19.24,P0.01,P0.01);(2)浅刺组与非刺入组相比：NPQ量表及VAS值较前下降,差异有统计学意义(NPQ:6.99±4.12 vs 3.89±4.89,P 0.01;VAS:1.19±0.93 vs 0.52±0.50,P0.01),压痛阈值、及简式McGill量表评分的得分均无明显变化。结论：1.穴位针刺组疗效明显优于穴位浅刺组、穴位非刺入组,提示：电针能有效地治疗慢性颈痛。2.针刺治疗慢性颈痛具有安慰剂效应,且不同假针刺组间的产生的安慰剂效应不一致(穴位浅刺组疗效优于穴位非刺入组)。
[Abstract]:Objective: to investigate the placebo effect of acupuncture on patients with chronic cervical pain by observing the curative effect of acupoint acupuncture and acupoint pseudo acupuncture. Methods: this study has passed the ethical examination of the Ethics Committee of Guangdong traditional Chinese Medicine Hospital, and has been registered and registered with the China Clinical trial Registry (registration number: ChiCTR-IPO-15006886). The subjects were chronic neck pain patients in the Department of Acupuncture and moxibustion of Guangdong Provincial Hospital of traditional Chinese Medicine. A total of 62 patients were randomly divided into three groups: acupoint acupuncture group, superficial acupoint acupuncture group and non-point needling group. The patients in the acupuncture group were punctured directly into the acupoint with a millimeter needle at 0.5-1 inch, and the patients in the shallow needling group were given electrical stimulation after getting qi, and the patients in the shallow needling group were also punctured directly into the acupoints at 1-4 mm ~ (m), so as not to get qi, and to give it electric stimulation. In the non-puncture group, the blunt needle in the comfort needle was fixed at the acupoint, without needling into the subcutaneous, connecting the electroacupuncture instrument but not the electric stimulation. All of the three groups were treated with G6805-I electroacupuncture apparatus, the intensity of which was based on the comfort of the patients. The treatment cycle was 3 times a week for 2-3 days, 25 min each time for 10 times. The VAS score and tenderness threshold of the subjects were recorded before and after each treatment, and the NPQ score and the simplified McGill scale were recorded before and after the first treatment, after the fifth treatment and after the whole course of treatment. Results: there were 62 cases in this study, including 21 cases in acupuncture group, 21 cases in superficial needling group and 20 cases in non-puncture group. There was no significant difference in the threshold of tenderness (NPQ) and the simple McGill scale (P < 0.01). Comparison before and after treatment: after treatment, the McGill.NPQ.VAS value and the tenderness threshold in the acupuncture group were significantly lower than those in the control group (P = 17.66 卤7.23 vs 7.43 卤3.37 P0.01NPQ: 33.19 卤13.92 vs 13.99 卤6.97 vs 5.80 卤1.21 vs 1.99 卤1.05P0.01; the threshold of tenderness: 161.58 卤29.48 vs 130.31 卤45.83 P0.05P0.01; P 0.01). 宸�寮傚潎鏈夌粺璁″�︽剰涔，

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