针灸与推拿结合足弓矫正疗法治疗慢性腰肌劳损的临床研究

发布时间：2018-06-09 01:45

本文选题：慢性腰肌劳损 + 针灸与推拿结合足弓矫正疗法　；参考：《广州中医药大学》2016年博士论文

【摘要】：目的：探讨针灸与推拿结合足弓矫正疗法治疗慢性腰肌劳损的临床研究。方法：将收集的病例68例,按随机分配,1：1的比例分配为两组。其中治疗组有34例,男15例,女19例；对照组34例,男16例,女18例。治疗组采用针灸与推拿结合足弓矫正疗法进行治疗。足弓矫正疗法采用自然拓印脚图法,电脑设计并制造足弓矫正器,配合针炙、推拿治疗,治疗组成员每日穿配有矫正器的矫正鞋步行1-2小时。针刺选择肾俞、大肠俞、环跳、风市、委中,承山、飞扬、阳陵泉、太冲、昆仑、阿是穴(1-2个),推拿沿脊椎两侧夹脊穴及沿胆经、膀胱经点,重点穴位有肾俞穴、环跳穴、风市穴、阳陵泉、委中穴、承山穴、飞扬穴、昆仑穴,采用推、拿、点、按等手法,时间各约为30分钟。总时间为1小时,一周三次,共治疗四周,四周为一个疗程。对照组采用针灸与推拿疗法,方法同前。一个疗程之后,再进行疗效观察,分别对两组治疗前后、治疗后进行观察,并进行对比。统计学处理：并采用SPSS20.0统计软件完成统计分析。结果：经统计分析,治疗前对两组病例的年龄、性别、病程以及临床症状和体征方面进行比较,经统计分析后, P0.05,无显著性意义,因此可以认为两组具有可比性。两组经过治疗后,经统计学分析,在临床疗效中治疗组临床痊愈率为52.94%,显效率为29.41%,有效率为11.77%,总有效率为94.12%；对照组临床痊愈率为32.35%,显效率为20.59%,有效率为29.41%,总有效率为82.35%。治疗组和对照组的总有效率均在80%以上,两组治疗慢性腰肌劳损均有效,治疗组的中医证候疗效的总有效率明显高于对照组(P0.05)。两组治疗前后的疼痛强度、冷痛重着或酸麻痛、隐痛或酸痛、持续固定痛、活动不利、腰部压痛的变化情况比较差异有显著性意义,认为治疗组治疗后这些症状体征的改善情况优于对照组(P0.05)。两组治疗后主要临床症状、体征的消失率比较中,两组在治疗后持续固定痛、得热痛减或喜温喜按、劳累、晨起、久坐加重、痛有定处、活动不利、腰部压痛这些症状体征的消失率比较差异有统计学意义,认为治疗组在治疗后对降低持续固定痛、得热痛减或喜温喜按、劳累、晨起、久坐加重、痛有定处、活动不利、腰部压痛这些症状体征的发生优于对照组(P0.05)。结论：针灸与推拿结合足弓矫正疗法治能够改善慢性腰肌劳损病患的腰部疼痛症状,并改善其生活质量,效果明显优于单纯的针灸与推拿疗法。两组治疗前血、尿、大便常规、肝肾功能、心电图正常者,治疗后未见异常改变,说明针灸与推拿结合足弓矫正疗法应用安全,值得临床推广应用。
[Abstract]:Objective: to explore the clinical study of acupuncture and massage combined with pedicle orthodontic therapy for chronic lumbar muscle strain. Methods: 68 cases were randomly divided into two groups according to the proportion of 1: 1. There were 34 cases in the treatment group, 15 cases in the male group and 19 cases in the female group, while 34 cases in the control group, 16 cases in males and 18 cases in females. The treatment group was treated with acupuncture and massage combined with pedicle correction therapy. The foot arch orthodontic therapy was done by using the method of natural foot drawing. The foot arch orthodontic appliance was designed and manufactured by computer, which was combined with acupuncture and massage treatment. The members of the treatment group walked 1-2 hours a day in orthodontic shoes with orthodontics. Acupuncture choice is Shenshu, Dachang Yu, Huan Ju, Feng City, Beizhong, Chengshan, Feiyang, Yanglingquan, Taichung, Kunlun, Ashi points 1-2, massage along both sides of the spine Jiaji points and along the gallbladder meridian, bladder meridian points, the key acupoints have Shenshu points, ring jump points, Fengshi acupoint, Yanglingquan, Beizhong, Chengshan, Feiyang, Kunlun, push, take, point, press and other techniques, the time is about 30 minutes each. The total time is 1 hour, three times a week, a total of four weeks, four weeks as a course of treatment. The control group was treated with acupuncture and massage. After a course of treatment, the curative effect was observed and compared before and after treatment. Statistical processing: SPSS 20.0 statistical software was used to complete the statistical analysis. Results: after statistical analysis, the age, sex, course of disease, clinical symptoms and signs of the two groups were compared before treatment. After statistical analysis, there was no significant difference between the two groups, so the two groups could be considered to be comparable. After the treatment, the clinical cure rate was 52.94 in the treatment group, the effective rate was 29.41, the effective rate was 11.7777 and the total effective rate was 94.12.The clinical cure rate was 32.355,20.599.The effective rate was 29.41 and the total effective rate was 82.35. The total effective rate of treatment group and control group were above 80%, both groups were effective in treating chronic lumbar muscle strain. The total effective rate of TCM syndrome in treatment group was significantly higher than that in control group (P 0.05). Before and after treatment, the changes of pain intensity, cold pain, severe pain, dull pain or sore pain, persistent fixation pain, unfavorable movement and lumbar tenderness were significantly different between the two groups. The improvement of these symptoms and signs in the treatment group was better than that in the control group (P 0.05). In the comparison of the rate of disappearance of the main clinical symptoms and signs after treatment between the two groups, the two groups continued to fix the pain after the treatment, got the heat pain reduced or happy to press, tired, from the morning, sedentary aggravation, the pain has fixed place, the activity is unfavorable, The disappearance rate of these symptoms and signs of lumbar tenderness is statistically significant. It is considered that the treatment group can reduce the sustained fixed pain after treatment, get heat pain, reduce heat pain or like warm press, tiredness, early morning, sedentary aggravation, pain has fixed place, and the activity is unfavorable. The occurrence of these symptoms and signs of lumbar tenderness was better than that of control group (P 0.05). Conclusion: acupuncture and massage combined with pedicle orthodontic therapy can improve the symptoms of lumbar pain and improve the quality of life of patients with chronic lumbar muscle strain, and the effect is obviously superior to that of simple acupuncture and massage therapy. There were no abnormal changes in patients with normal blood, urine, stool, liver and kidney function and normal electrocardiogram before treatment, indicating that acupuncture and massage combined with pedicle correction therapy were safe and worthy of clinical application.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.9;R244.1

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