内热针结合督脉灸治疗胸背部肌筋膜炎的临床研究

发布时间：2018-05-26 04:40

本文选题：内热针 + 督脉灸　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：背景胸背部肌筋膜炎又称胸背部疼痛综合症,是临床常见的一种胸背部疼痛病症之一。其主要临床表现为胸背局部肌肉弥漫性钝痛、酸胀、触之僵硬,以两肩胛间为著。随着信息时代的迅猛发展,电子化设备如智能手机、电子化办公系统等给人们的生活带来了极大的便利,但“手机党”、“电脑族”、“低头族”随处可见,其中以年青人为主体。由于人们长时间保持同一姿势,胸背部肌肉紧绷,局部软组织粘连,久之局部无菌性炎症甚至刺激组织形成条索状结节,患者出现一系列临床症状。虽然该病不会危及生命,但疼痛迁延,严重影响患者的生活质量。当前中医药治疗肌筋膜炎的手段多样,笔者在临床过程中遇到了大量胸背部肌筋膜炎的患者,经观察发现:内热针可改促进局部血液循环,降低肌肉张力,能够有效缓解疼痛;督脉灸火力温和,其渗透力强,能有效深入病灶,达到温经补气、祛湿除寒的功效。两种疗法联合使用,对胸背部肌筋膜炎有较好的临床疗效。目的本课题探讨内热针联合督脉灸治疗胸背部肌筋膜炎的临床疗效,为临床使用该法提供一定参考,并为胸背部肌筋膜炎治疗提供新的思路。方法选取2015年1月至2016年12月十堰太和医院康复科收治的胸背部肌筋膜炎患者90例,随机分为3组,每组30名患者。其中以内热针联合督脉灸为治疗组,以单独采用内热针及单独采用督脉灸为两个对照组,每组每周治疗1次,连续治疗3次。观察各组治疗前后患者有效率、《中医药新临床指导原则》中规定的软组织损伤症状评分表、简式McGill疼痛问卷评分、以及治疗过程中的不良反应,并进行统计学分析。结果1.基线比较:治疗前督脉灸组、内热针组、治疗组三组患者在性别、年龄、病程方面无差异,具有可比性。2.简式McGill疼痛问卷疼痛分级指数(PRI)比较:治疗前三组患者PRI无差异(p0.05),具有可比性。治疗后,治疗组PRI显著低于内热针组(p0.01),治疗组与督脉灸组比较差异有统计学意义(p0.01)。3.简式McGill疼痛问卷视觉模拟定级(VAS)比较:治疗前三组患者VAS无差异(p0.05),具有可比性。治疗后,治疗组VAS明显低于内热针组与督脉灸组,差异有统计学意义(p0.01)。4.简式McGill疼痛问卷现有疼痛强度(PPI)比较:治疗前三组患者PPI无差异(p0.05),具有可比性。治疗后,治疗组PPI明显低于内热针组(p0.05);与督脉灸组,差异有统计学意义(p0.01)。5.疗效比较:治疗后,治疗组显效率为86.7%,明显高于内热针组(66.7%)与督脉灸组(50%),差异均具体统计学意义(p0.01)。结论本研究表明,经过3次治疗,内热针结合督脉灸治疗胸背部肌筋膜炎,较单独使用内热针法或督脉灸法更有效,且试验中无不良反应发生。内热针与督脉灸结合发挥了“温通”的功效,能较好的缓解患者疼痛不适等临床症状,可以有效的改善软组织损伤情况,说明内热针结合督脉灸能够简单有效的治疗胸背肌筋膜炎。
[Abstract]:Background Thoracic back myofascitis, also known as chest and back pain syndrome, is one of the common chest and back pain. The main clinical manifestations are diffuse dull pain, distension, and stiffness of the muscles in the chest and back, between the shoulder blades. With the rapid development of the information age, electronic devices such as smart phone, electronic office system and so on have brought great convenience to people's life, but "mobile phone party", "computer family", "Phubber" are everywhere. Among them, young people are the main body. Because people keep the same posture for a long time, the chest and back muscles are tight, the soft tissue adhesions, the local aseptic inflammation and even stimulates the tissue to form the stripe shape nodule for a long time, the patient appears a series of clinical symptoms. Although the disease is not life-threatening, but the pain continues, seriously affecting the quality of life of patients. There are many ways of treating myofascitis with traditional Chinese medicine at present. The author has encountered a large number of patients with myofascitis of chest and back in the clinical process. After observation, it is found that internal hot acupuncture can promote local blood circulation, reduce muscle tension and relieve pain effectively; Du-meridian moxibustion with mild fire, strong permeability, can effectively penetrate into the focus, achieve the effect of warming the meridian and replenishing qi, dispelling dampness and removing cold. The combination of the two treatments has a good clinical effect on thoracic and back myofascitis. Objective to explore the clinical effect of internal heat acupuncture combined with moxibustion on thoracic back myofascitis, to provide some references for clinical use of this method, and to provide a new idea for the treatment of thoracic back myofascitis. Methods from January 2015 to December 2016, 90 patients with thoracic and back myofascitis were randomly divided into 3 groups with 30 patients in each group. The treatment group was treated with internal heat acupuncture combined with du meridian moxibustion, the control group was treated with internal heat acupuncture alone and du vein moxibustion alone, each group was treated once a week for 3 consecutive times. The effective rate of patients before and after treatment, the soft tissue injury symptom scale stipulated in "New Clinical guiding principles of TCM", the score of simple McGill pain questionnaire, and the adverse reactions in the course of treatment were observed and analyzed statistically. Result 1. Baseline comparison: there were no differences in sex, age and course of disease among the three groups before treatment, such as moxibustion group, internal heat acupuncture group and treatment group. Comparison of pain grading index (Pi) of simple McGill pain questionnaire: there was no difference in PRI between the three groups before treatment (p 0.05), which was comparable. After treatment, the PRI of the treatment group was significantly lower than that of the internal heat acupuncture group (P 0.01), and the difference between the treatment group and the du pulse moxibustion group was statistically significant (p 0.01). Comparison of visual analogue grading with simple McGill pain questionnaire: there was no difference in VAS between the three groups before treatment (p 0.05), which was comparable. After treatment, the VAS in the treatment group was significantly lower than that in the internal heat acupuncture group and the du meridian moxibustion group, and the difference was statistically significant (P 0.01). 4. Comparison of the current pain intensity of the simple McGill pain questionnaire: there was no difference in PPI between the three groups before treatment (p 0.05), which was comparable. After treatment, the PPI in the treatment group was significantly lower than that in the internal heat acupuncture group (P 0.05), and the difference between the treatment group and the du vein moxibustion group was statistically significant (P 0.01). Comparison of curative effect: after treatment, the effective rate of treatment group was 86.7, which was significantly higher than that of internal heat acupuncture group (66.7%) and du meridian moxibustion group (50%). The difference was statistically significant (P 0.01). Conclusion after 3 times of treatment, internal heat acupuncture combined with moxibustion of du vessel is more effective than internal heat acupuncture or moxibustion alone in treating thoracic and back myofascitis, and there is no adverse reaction in the experiment. The combination of internal heat acupuncture and moxibustion of du meridian exerts the effect of "warming through", which can relieve the clinical symptoms such as pain and discomfort of patients, and can effectively improve the condition of soft tissue injury. It shows that internal heat acupuncture combined with moxibustion of du pulse can treat thoracic dorsal myofascitis simply and effectively.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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