特定针法治疗肺气虚型脑瘫患儿及其发育学意义

发布时间：2018-05-25 17:34

本文选题：小儿脑瘫 + 肺气虚　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究从中医理论出发,采用调任通督法结合靳三针的特定针法治疗以具有肺气虚为征的脑瘫患儿,对其临床疗效进行量化,观察治疗前后的症状改变,从而确定此种特定针法在临床上的治疗效果；同时,对其发育学意义进行探讨。为治疗小儿脑瘫肺气虚的表现提供更完善有效的治疗方法,并为脑瘫患儿的发育提供正确的指导方向。方法：根据小儿脑瘫的诊断标准、纳入标准及排除标准,在我院针灸科门诊就诊的患者中筛选合格受试者60例。将合格者随机分成2组,每组各30例。对照组予普通针刺法治疗,治疗组予调任通督法结合靳三针疗法进行治疗。通过比较对照组与治疗组,运用肺气虚症状分级量表分别对治疗前及治疗后的症状进行评分,观察两种治疗方法对治疗肺气虚型脑瘫患儿的临床效果,并分析患儿治疗前后脑瘫儿童综合功能评定量表评分的变化,对本研究的发育学意义进行探讨。所用的实验数据,均采用SPSS19.0统计软件,严格根据其使用原则进行统计学分析,以双侧检验作为标准。不同组别性别等基线资料使用卡方检验。年龄、肺气虚症状及脑瘫儿童综合功能评分等数据都为计量资料,如果符合正态性分布且方差齐性,则治疗前、后的数据比较使用组内配对t检验,如果计量资料不符合正态性分布和(或)方差不齐或者计数资料中的等级资料部分使用非参数检验。检验结果以P0.05为差异具有统计学意义,P0.01为差异具有显著的统计学意义。结果：两组病例肺气虚症状疗效：其中对照组共有30例,总有效率为80%,治疗组共有30例,总有效率为96.667%,治疗组总有效率优于对照组(P0.05)。两组病例患儿发育比较：脑瘫综合功能评定量表总评分,治疗组与对照组在治疗前后总分的改变差异均有统计学意义(P0.05)；特别是在认知能力还有社会适应能力的方面,治疗组在治疗前后的积分差异均有统计学意义(P0.05),且治疗组在治疗的前后,差异显著优于对照组治疗前后的差异(P0.01)。结论：调任通督结合靳三针对肺气虚脑瘫患儿具有确切的临床疗效,与对照组的普通针刺疗法相比较,对肺气虚型脑瘫患儿的症状改善有显著的效果。普通针刺与调任通督结合靳三针疗法对脑瘫患儿发育均有疗效,但后者疗效更显著,尤其是在认知能力及社会适应能力方面,治疗组治疗前后差异对比显著性明显优于对照组治疗前后的疗效差异。对肺气虚型脑瘫患儿的治疗能够反作用于患儿的发育状态,具有积极的发育学意义。
[Abstract]:Objective: based on the theory of traditional Chinese medicine (TCM), a special acupuncture method was used to treat children with cerebral palsy with deficiency of lung qi. The clinical effect was quantified and the changes of symptoms before and after treatment were observed. In order to determine the clinical efficacy of this specific acupuncture method, at the same time, to explore its developmental significance. To provide a more complete and effective treatment for children with cerebral palsy lung qi deficiency, and to provide a correct direction for the development of children with cerebral palsy. Methods: according to the diagnostic criteria of cerebral palsy in children, including criteria and exclusion criteria, 60 eligible subjects were selected from the outpatient department of acupuncture and moxibustion in our hospital. The eligible patients were randomly divided into 2 groups with 30 cases in each group. The control group was treated with common acupuncture and the treatment group with Jin's three-needle therapy. By comparing the control group and the treatment group, the symptoms before and after treatment were scored with the lung qi deficiency symptom scale, and the clinical effects of the two treatment methods on the treatment of children with cerebral palsy of pulmonary qi deficiency type were observed. The developmental significance of this study was discussed by analyzing the changes of the comprehensive functional assessment scale before and after treatment in children with cerebral palsy. All the experimental data were analyzed by SPSS19.0 software, according to the principle of statistical analysis, and the bilateral test was used as the standard. Chi-square test was used for baseline data of different gender groups. Age, symptoms of deficiency of lung qi and comprehensive functional score of children with cerebral palsy were all measured data. If the distribution was normal and the variance was homogeneity, the data before and after treatment were compared with in-group paired t test. If the measurement data does not conform to the normal distribution and / or variance, or the rank data part of the counting data uses nonparametric test. The test results with P0.05 as the difference has statistical significance and P0.01 as the difference has significant statistical significance. Results: there were 30 cases in the control group and 30 cases in the treatment group, the total effective rate was 96.6677.The total effective rate in the treatment group was better than that in the control group (P 0.05). Comparison of development between the two groups: the total score of the comprehensive functional assessment scale for cerebral palsy, the difference of the total score between the treatment group and the control group before and after treatment were statistically significant (P 0.05), especially in the cognitive ability and the ability of social adaptation. The scores of the treatment group were significantly different before and after treatment, and the difference before and after treatment in the treatment group was significantly better than that in the control group before and after treatment. Conclusion: transfer of Tongdu combined with Jin San has definite clinical effect on children with cerebral palsy due to deficiency of lung qi. Compared with the common acupuncture therapy of control group, it has significant effect on the improvement of symptoms of children with cerebral palsy due to deficiency of lung qi. Common acupuncture and transfer to Tongdu combined with Jin's three-needle therapy have curative effects on the development of children with cerebral palsy, but the latter is more effective, especially in cognitive ability and social adaptation. The difference before and after treatment in the treatment group was significantly better than that in the control group before and after treatment. The treatment of lung qi deficiency type cerebral palsy can counteract the developmental state of the children, which has positive developmental significance.
【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】：R246.6

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