背俞穴温针灸治疗瘀血阻窍型后循环缺血的临床研究

发布时间：2018-06-08 00:28

  本文选题：瘀血阻窍型 + 后循环缺血　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:根据临床经验,选择背俞穴温针灸作为本研究干预手段,初步评价背俞穴温针灸治疗瘀血阻窍型后循环缺血的临床疗效,明确其治疗特点、优势及安全性,观察是否具有临床推广价值,丰富针灸治疗本疾病、证型的治疗方法,为今后后循环缺血本证型的疾病提供一定的临床、科研的思路和方法。方法:收集符合后循环缺血西医诊断标准、符合眩晕病瘀血阻窍证中医诊断且同意参加本次实验的病例63例,签署知情同意书后随机分至治疗组及对照组,按剔除标准、脱落标准等筛除,最后收集完整资料为治疗组(背俞穴温针灸)29人,对照组(常规针刺)29人。治疗前收集病人基本资料并按DARS量表、眩晕症候积分量表进行评分,记录病人TCD检查结果。治疗组予背俞穴温针灸进行治疗,对照组予常规针刺治疗,隔天治疗1次,两组均以2周为一个治疗周期,有基础疾病者在不影响本研究前提下可按之前医嘱服药。疗程结束后观察并记录两组治疗前后的临床疗效、DARS量表评分、眩晕症候积分量表评分、TCD检查结果的变化,同时密切注意治疗时出现的异常情况以作为临床安全性观察资料。结果:按照疗效评定标准,治疗组痊愈9人,占32.03%,治疗组显效15人,占51.72%,治疗组有效4人,占13.79%,治疗组无效2人,占6.90%,总有效率93.10%;对照组痊愈4人,占13.79%,对照组显效10人,占34.48%,对照组有效9人,占31.03%,对照组无效6人,占20.69%,总有效率79.31%。治疗组在治疗后循环缺血性眩晕的整体疗效明显优于对照组(P0.01)。治疗后两组DARS评分均明显改善(P0.01),且治疗组对DARS评分改善程度优于对照组(P0.01)。治疗后两组对眩晕症候积分均有明显改善(P0.01),且在总积分上,治疗组改善程度要优于对照组(P0.01)。在各个症状积分上,在眩晕程度、头痛、失眠多梦三项上的P值均小于0.01,证明治疗组在治疗后循环缺血时对眩晕程度、头痛、失眠多梦三方面的治疗效果要明显优于对照组。在眩晕频次及持续时间、神疲乏力二项上的P值均小于0.05,证明治疗组在改善后循环缺血眩晕频次及持续时间、神疲乏力二方面的效果要优于对照组。在恶心呕吐、耳鸣、心烦健忘、咽干口燥方面,P值均大于0.05,证明两组在治疗后循环缺血时对恶心呕吐、耳鸣、心烦健忘、咽干口燥都有积极效果,无明显统计学差异。TCD检查结果显示,经过治疗,两组血流速度明显增快(P0.01),TCD检查结果差值相比较,治疗组在改善瘀血阻窍型后循环缺血的后循环整体血流速度及左侧椎动脉搏动指数方面疗效明显优于对照组。总体来说,背俞穴温针灸对于TCD检查结果的整体改善程度要优于常规针刺。结论:从治疗总疗效、DARS量表评分、眩晕症候量表评分、TCD检查结果的改变上看,背俞穴温针灸对于瘀血阻窍型后循环缺血临床症状的改善十分显著,有着比常规针刺更理想的效果。同时本法安全性较高,操作无误基本不会造成额外损伤,免去了药物治疗对肝肾功能造成伤害的可能性,具有安全、简单、便捷、廉价、有效等特点,值得临床推广。
[Abstract]:Objective: according to clinical experience, we choose warm acupuncture at back Shu point as a means of intervention, and evaluate the clinical efficacy of back Yu Xuewen acupuncture and moxibustion for the treatment of posterior circulation ischemia of blood stasis and obstruct orifices, clarify its therapeutic characteristics, advantage and safety, observe whether it has clinical application value, Feng Fu acupuncture and moxibustion treatment of this disease, and the treatment method of syndrome type, for the future The disease of posterior circulation ischemia provides certain clinical, scientific research ideas and methods. Methods: 63 cases were collected in accordance with the standard of Western medicine, which conformed to the diagnosis of vertigo and blood stasis syndrome and agreed to take part in this experiment. After signing the informed consent book, the patients were randomly divided into the treatment group and the control group. The standard was screened. At last, the complete data were collected for 29 people in the treatment group (warm acupuncture at back Shu point) and 29 in the control group (conventional acupuncture). Before the treatment, the basic data of the patients were collected and the results were scored according to the DARS scale, the vertigo syndrome score scale, and the results of the patient's TCD examination. The treatment group was treated with the back Yu Xuewen acupuncture and moxibustion, the control group was given conventional acupuncture treatment and septum treatment. 1 times of day treatment, two groups were 2 weeks as a period of treatment. The patients with basic diseases could take medicine according to the previous doctor's orders without affecting the premise of this study. After the course of treatment, the clinical efficacy of the two groups before and after treatment were observed and recorded, DARS scale score, vertigo syndrome score score, TCD examination results, and close attention to the treatment. Abnormal conditions were used as clinical safety observation data. Results: according to the evaluation standard of curative effect, the treatment group recovered 9 people, accounted for 32.03%, the treatment group was 15, accounting for 51.72%, 4 in the treatment group, 13.79%, 2 in the treatment group, 6.90% and 93.10% in total, 4 in the control group, 13.79% in the control group, 34.48% in 10, 34.48%, and control group effective 9 People, accounted for 31.03%, the control group was invalid 6 people, accounting for 20.69%. The overall efficiency of the total effective 79.31%. treatment group after treatment was obviously better than the control group (P0.01). After treatment, the two groups of DARS scores were significantly improved (P0.01), and the treatment group improved the DARS score better than the control group (P0.01). After treatment, the two groups of vertigo syndrome scores were all in the treatment group. In the total integral, the improvement of the treatment group was better than the control group (P0.01). In the symptom score, the three P values on the dizziness, the headache and the insomnia were less than 0.01, which proved that the treatment group was better than the control in three aspects of the degree of vertigo, headache and insomnia. The P values on two items of vertigo frequency and duration were less than 0.05, which proved that the treatment group was better than the control group in improving the frequency and duration of ischemic vertigo in the treatment group. The effect of two aspects of fatigue and fatigue was better than the control group. The value of P was greater than 0.05 in nausea and vomiting, tinnitus, annoying forgetfulness and dry mouth dryness, which proved that the two groups were circulated after treatment. There were positive effects on nausea, vomiting, tinnitus, annoying amnesia and dry mouth dryness in the blood. The results of.TCD examination showed that the blood flow velocity in the two groups increased significantly (P0.01), and the difference between the results of TCD examination was compared. The treatment group was in the improvement of the posterior circulation velocity of the posterior circulation and the left vertebral artery of the posterior circulation ischemia in the treatment group. The effect of pulsation index was obviously better than that of the control group. Overall, the overall improvement of the results of TCD examination by back Yu Xuewen acupuncture was better than that of the conventional acupuncture. Conclusion: from the total therapeutic effect, the DARS scale, the vertigo syndrome scale, and the change of the TCD examination results, the back Yu Xuewen acupuncture and moxibustion for the posterior circulation ischemia of the stasis obstructing type. The improvement of the bed symptoms is very significant and has a better effect than the conventional acupuncture. At the same time, this method has a higher safety and no error in operation. It is safe, simple, convenient, inexpensive and effective. It is safe, simple, convenient, cheap and effective.
【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】：2017
【分类号】：R246.6
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本文编号：1993520