基于经筋辨证探讨颈椎病分型与筋结压痛点的相关性研究

发布时间：2018-05-28 04:44

本文选题：颈椎病 + 经筋　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：观察并总结80例颈椎病患者(颈型及神经根型各40例)压痛点与经筋之间的关系,揭示颈椎病经筋病变及痛点的发病规律,丰富经筋辨证及颈部压痛点对颈椎病诊疗作用的整体认识,为颈椎病的临床诊疗提供参考。方法：选取2014年3月至2015年7月四川省中医院骨伤科、针推科门诊诊断为颈型颈椎病患者40例,记作A组；神经根型颈椎病患者40例,记作B组。分别提取颈椎病VAS评分4分以上的压痛点,根据压痛点分布归纳并总结其经筋证型,采用SPSS17.0统计软件进行统计学分析,最终得出压痛点、经筋证型分布规律。结果：1.位于手足太阳经筋上的压痛点：A组(颈型颈椎病)共101个,B组(神经根型颈椎病)共69个；位于手少阳经筋上的压痛点：A组共87个,B组共92个；位于足少阳经筋上的压痛点：A组共34个,B组共19个；位于手足阳明经筋上的压痛点：A组共65个,B组共24个。2.颈部压痛点比值A组36.59%、B组53.92%,组间对照P0.01,具有统计学意义；肩部压痛点比值A组62.02%、B组43.14%,组间对照P=0.0140.05,具有统计学意义。3.A组经筋发病规律：手足太阳经筋手少阳经筋手足阳明经足少阳经筋,B组经筋发病规律：手少阳经筋手足太阳经筋手足阳明经筋足少阳经筋；两组在手足太阳经筋上的压痛点分布比较P=0.020.05,手少阳经筋的比较P0.01,足少阳经筋的比较P=0.020.05,具有统计学意义,手足阳明经筋的比较P=0.5340.05,无统计学差异。4.常见压痛点按比值高低排列依次为：A组(颈型颈椎病)手足阳明经筋的肩井次10.80%、曲垣次10.80%,手少阳经筋的天髂次10.80%、天宗次10.45%,手足太阳经筋的C5棘突旁4.18%和足少阳经筋的风池次3.83%；B组(神经根型颈椎病)手少阳经筋的C5横突5.88%、C6横突5.88%、天毼次5.39%、天宗次5.39%、C4横突4.90%,手足阳明经筋的肩井次5.39%、曲垣次5.39%和手足太阳经筋的肩痛点次4.90%、下肩痛点4.90%。结论：1.手足太阳、手足阳明及手少阳经筋均是颈型颈椎病好发的经筋；手少阳经筋是神经根型颈椎病发病的主要经筋。2.若肩井次、曲垣次、天毼次有明显压痛,则提示为颈型颈椎病；若C5、C6有明显压痛,则提示为神经根型颈椎病。3.对颈型颈椎病的治疗可考虑侧重针对手足太阳经筋,着重由肩部的相关筋结点入手：神经根型颈椎病的治疗可考虑侧重针对手少阳经筋,着重由颈部的相关筋结点入手。
[Abstract]:Objective: to observe and summarize the relationship between tenderness points and meridians in 80 patients with cervical spondylosis (40 cases of cervical type and 40 cases of nerve root type), and to reveal the pathogenesis of meridian diseases and pain points of cervical spondylosis. To enrich the overall understanding of the diagnosis and treatment of cervical spondylosis by differentiation of meridians and cervical tenderness, and to provide reference for clinical diagnosis and treatment of cervical spondylosis. Methods: from March 2014 to July 2015, 40 patients with cervical spondylopathy of cervical type and 40 patients with cervical spondylopathy of nerve root type were selected from Department of Orthopedics and Trauma of Sichuan traditional Chinese Medicine Hospital of Sichuan Province from March 2014 to July 2015. The tenderness points of cervical spondylopathy (VAS) score above 4 points were extracted respectively. The distribution of tenderness points and meridians syndrome types were summarized and summarized according to the distribution of tenderness points. Finally, the distribution rules of tenderness points and meridian syndrome types were obtained by statistical analysis with SPSS17.0 software. The result is 1: 1. There were 101 tenderness points (cervical spondylosis) in group A (cervical spondylosis), 69 in group B (cervical spondylosis of nerve root type) and 92 in group B (87 points of tenderness on the meridians of Shaoyang meridian of hand and foot). There were 19 tenderness points in group A and 24 in group B, and in group B, there were 65 tenderness points in group A, and in group B, there were 65 points of tenderness on the meridian of foot and foot. The ratio of cervical tenderness point in group A (36.59) and group B (53.92) was significantly higher than that in control group (P 0.01). The ratio of shoulder tenderness point to group A is 62.02 and 43.14 in group B, and the control group is P0.0140.05, which has statistical significance. 3.The incidence rule of meridian in group A: the incidence of meridian in group B: in group B, the incidence of meridian in group B is less than that in group B: in group A, the incidence of meridian is statistically significant. Sun Meridian hand foot Yangming Meridian foot Shaoyang Meridian; The distribution of tenderness points in the two groups on the solar meridian of the hand and foot was 0.020.05, the comparison of the hand Shaoyang meridian and the foot Shaoyang meridian was P0.01 and P0.020.05 respectively, which had statistical significance. The comparison of the hand and foot Yangming meridian was not statistically significant (P0.5340.05, P < 0.05). The common tenderness points in order of ratio are as follows: group A (cervical spondylosis), the shoulder and well times of Yangming meridian of hands and feet 10.80, Quyuan 10.80, Tiangliu 10.80 of hand Shaoyang meridians, Tianzong 10.45, C5 spinous process of hand and foot 4.18% and foot Shaoyang Meridian of hand and foot. In group B (cervical spondylosis of nerve root type), there were 5.88 points in C5 transverse process, 5.39 in days, 4.90 in C4 transverse process, 5.39 in Tianzong, 5.39in shoulder well of Yangming meridian of hand and foot, 5.39% in Quyuan, 4.90 in shoulder pain point of yang meridian of hand and foot, 4.90 in shoulder pain point of hand and foot, and 4.90 in lower shoulder pain point. Conclusion 1. The sun of hand and foot, Yangming of hand and foot and Shaoyang meridian of hand are the most common meridians of cervical spondylosis of neck type, and the main meridians of cervical spondylosis of root type of cervical spondylosis of hand are Shaoyang meridian tendons of hand and foot. 2. If the shoulder well times, Quyuan times, Tianzao have obvious tenderness, then it is cervical type cervical spondylopathy, if C5C6 has obvious tenderness, it is the nerve root type cervical spondylosis. 3. The treatment of cervical spondylosis can be focused on the sun meridians of the hand and foot, and the related tendons in the shoulder. The treatment of the cervical spondylosis of the nerve root type can be considered to focus on the small yang meridians of the hands and the related tendons in the neck.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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