通经散结推拿法治疗乳癖（肝郁气滞型）的有效性研究

发布时间：2018-06-03 17:54

  本文选题：通经散结法 + 乳癖　； 参考：《长春中医药大学》2016年硕士论文

【摘要】：目的:观察通经散结法对肝郁气滞型乳癖的治疗效果,探讨其临床应用价值。方法:本临床研究所有入组患者均选取自2014年1月至2015年12月长春中医药大学附属医院推拿科门诊及住院患者共59例,确诊为乳癖(乳腺小叶增生,肝郁气滞型)。通经散结推拿法的具体操作方法:(1)推按手三阴经;(2)拿揉胸大肌;(3)团揉腹部;(4)通背部督脉、膀胱经。通过比较乳房疼痛,乳房肿块硬度、范围、大小及全身伴随症状评分变化,通过乳腺超声和红外热像技术判定患者的恢复情况。结果:(1)临床症状评价结果:经治疗,所有患者的乳房疼痛、乳房肿块硬度、范围、大小及全身伴随症状评分均明显优于治疗前(P0.05),差异具有统计学意义;(2)超声评价结果:经治疗,所有患者中发生乳腺超声改善19例,其中BI-RADSⅡ级、Ⅲ级改善效果明显;(3)红外线热像评价结果:乳房组织灰阶度0级6例,Ⅰ级38例,Ⅱ级13例,Ⅲ级2级,改善程度明显优于治疗前(P0.05),差异具有统计学意义;血管分型A型29例,B型30例,改善程度明显优于治疗前(P0.05),差异具有统计学意义。(4)经Pearson相关性分析,发现超声评价及红外线扫描结果与临床症状变化存在相关性,结果显示:乳房胀痛,乳房肿块硬度、范围、大小,患者情绪变化,两胁胀满呈相关性(P值均0.05),但与月经异常和腰膝酸软症状无显著相关性。结论:(1)通经散结法能有效治疗乳癖即乳腺小叶增生症;(2)手法明显改善了乳房胀痛、烦躁易怒、胸胁胀痛等相关症状,明显减小了乳房肿块;(3)红外线热像结合乳腺超声可作为乳癖即乳腺小叶增生症的评价手段之一;(4)通经散结法临床应用操作简便、安全,不仅提高了患者的依从性,而且更好的改善了患者的生活质量。
[Abstract]:Objective: to observe the therapeutic effect of Tongjing Sanjie method on the type of liver depression and qi stagnation and to explore its clinical application value. Methods: from January 2014 to December 2015, 59 patients in the Department of Tuina, affiliated Hospital of Changchun University of traditional Chinese Medicine, were selected from our clinical research institute. 59 patients were diagnosed as nipple (mammary lobular hyperplasia, liver stagnation and qi stagnation). The concrete operation method of the massage method of Tongjing Sanjie massage is: 1) push the hands three yin meridians 2) take and knead the pectoralis major muscle (3) group knead the abdomen and make 4) the back jugular vein, bladder meridian. By comparing the changes of breast pain, breast mass hardness, range, size and systemic associated symptoms, the recovery of patients was evaluated by breast ultrasound and infrared thermography. Results: after treatment, all patients' breast pain, breast mass hardness, range, size and systemic associated symptom score were significantly better than those before treatment (P 0.05). The difference was statistically significant. Among all the patients, 19 cases were improved by breast ultrasound. The results of infrared thermography were as follows: the grayscale of breast tissue was 0 in 6 cases, grade 鈪，

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