通元针法治疗腰肌劳损的临床研究

发布时间：2018-06-02 01:17

本文选题：通元针法 + 腰肌劳损　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的:通过观察通元针法治疗腰肌劳损的临床疗效,探讨通元针法治疗腰肌劳损的作用机理,并与针刺夹脊穴方法进行疗效对比,为临床提供治疗腰肌劳损效果更好、远期疗效更佳的方法,以期解决治疗腰肌劳损容易复发的难题。方法:采取前瞻性随机对照的研究方法,将符合纳入标准的腰肌劳损患者通过查随机数字表的方法分分别进入实验组和对照组,对两组标本在性别、年龄、病程、疼痛指数、功能活动指数等方面做统计学分析,证明两组有可比性。实验组、对照组各完成病例30例。实验组采用通元针法电针治疗,对照组采用针刺夹脊穴方法电针治疗,两组配穴相同。每日一次,十次为一疗程,共实验两个疗程。疗程间休息两天。采用视觉模拟标尺法(VAS)及Oswestry Disability Index(ODI指数)作为临床疗效观察指标,参照相关标准进行评定,分别观察两组患者在首次治疗、疗程结束时的疗效和随访三个月、六个月时患者的复发情况,统计两种方法治疗腰肌劳损的效果。所有计量资料以均值加减标准差(x±s)表示,两组间均值比较,采用独立样本t/t'检验;所有计数资料以频数(f)、构成比或百分率(P)和平均秩次(R)表示,小样本计数资料构成比和等级资料比较,采用Mann-Whitney非参数检验;四格表资料采用Fisher确切概率法卡方(x2)检验。由spss21.0医学统计软件进行数据统计。结果:1、首次治疗结束后①实验组有效率90%,对照组的有效率86.67%,说明两组治疗方法首次均有效果,但两组间比较效果无显著性差异(Fisherx2=0.162,P=0.6880.05),无统计学意义;②两组愈显率比较,实验组愈显率63.33%,而对照组愈显率30.00%,经统计学检验,两组间有显著性差异(Fisher x2=6.696,P=0.0100.05),实验组疗效好于对照组。2、疗程结束时:①实验组总有效率96.67%,对照组总有效率93.33%,说明两组方法治疗腰肌劳损均有效果;但二组间总有效率无显著性差异(Fisherx 2=0.351,P=0.5540.05),无统计学意义;②组间比较两组临床愈显率,实验组愈显率90%,对照组愈显率43.33%,两者比较,经统计学检验有显著性差异(Fisherx2=14.700,P=0.0000.01),实验组明显高于对照组。3、治疗后两组复发率比较:①治疗后三个月时随访,实验组复发率为3.33%,对照组复发率为13.33%,对照组复I发率高于实验组,但经统计学检验,两者无显著性差异(Fisherx2=1.964,P=0.1610.05);②治疗后半年时随访,实验组的总复发率为10%,对照组的总复发率为33.33%,实验组的复发率明显低于对照组,两组间经统计学检验,有明显差异(Fisherx 2=4.812,P=0.0280.05)。结论:用通元针法治疗腰肌劳损,不仅见效快、即时止痛效果好,而且在改善患者功能障碍评分方面优于对照组;从总疗效看,不仅能治疗腰肌劳损局部病症,愈显率高,而且对患者全身的功能状态也有很好的调节作用,"正气存内,邪不可干",因而远期疗效好,复发率低,值得推广应用。
[Abstract]:Objective: to observe the clinical effect of Tongyuan acupuncture on lumbar muscle strain, to explore the mechanism of Tongyuan acupuncture in treating lumbar muscle strain, and to compare the therapeutic effect with Jiaji acupuncture, so as to provide a better effect for clinical treatment of lumbar muscle strain. The long-term effect is better to solve the problem of easy recurrence in the treatment of lumbar muscle strain. Methods: prospective randomized controlled study was used to divide the patients with lumbar muscle strain into experimental group and control group by means of random digital table. The sex, age, course of disease, pain index of the two groups were measured. Functional activity index and other aspects of statistical analysis, proved that the two groups are comparable. There were 30 cases in the experimental group and 30 cases in the control group. The experimental group was treated with Tongyuan needling method and the control group was treated with acupuncture at Jiaji point. Once a day, ten times as a course of treatment, a total of two courses of experiment. Take two days off from the course of treatment. Visual analogue scale (vas) and Oswestry Disability Index(ODI index were used as the clinical therapeutic index. The clinical efficacy of the two groups was evaluated according to the relevant criteria. The results of the first treatment, the end of the course of treatment and the follow-up for 3 months were observed respectively. Six months after the recurrence of patients, statistics of the two methods for the treatment of lumbar muscle strain effect. All the measurement data are expressed as the mean value plus or minus standard deviation (x 卤s). The mean values of the two groups are compared with the independent sample t / t 'test. All counting data are expressed in terms of frequency, constitution ratio or percentage P) and average rank r). Mann-Whitney nonparametric test and Fisher exact probability chi-square x2 test are used to test the composition ratio of small sample count data and grade data. The data were collected by spss21.0 medical statistics software. Results: after the first treatment, the effective rate of the experimental group was 90 and that of the control group was 86.67, indicating that the two treatment methods had the first effect, but there was no significant difference in the comparison between the two groups. There was no significant difference between the two groups, and there was no significant difference in the effective rate between the two groups. The effective rate of the experimental group was 63.33, while the rate of the control group was 30.00. There was significant difference between the two groups. The experimental group was better than the control group. At the end of the course of treatment, the total effective rate of the experimental group was 96.67 and the total effective rate of the control group was 93.33. The results showed that the two groups were effective in the treatment of lumbar muscle strain. However, there was no significant difference in the total effective rate between the two groups. There was no statistical significance between the two groups. The effective rate of the two groups was 90% in the experimental group and 43.33 in the control group. There was a significant difference between the two groups by statistical test. The experimental group was significantly higher than the control group. The recurrence rate of the two groups was higher than that of the control group. The recurrence rate of the experimental group was 3.33 and that of the control group was 13.33. The recurrence rate of the control group was higher than that of the experimental group. However, there was no significant difference between the two groups by statistical test. The total recurrence rate was 10 in the experimental group and 33.33 in the control group, and the recurrence rate in the experimental group was significantly lower than that in the control group. There is a significant difference between Fisherx2 and 4.812Pu 0.0280.05. Conclusion: the treatment of lumbar muscle strain with Tongyuan needling method is not only effective, but also better in improving the score of patients with dysfunction than in the control group, and can not only treat the local symptoms of lumbar muscle strain, but also has a high effective rate. Moreover, it has a good regulating effect on the patients' whole body function, "good qi stored inside, evil can not dry", so the long-term effect is good, the recurrence rate is low, it is worth popularizing and applying.
【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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