祛风安神止痛针刺法治疗原发性三叉神经痛的临床观察

发布时间：2018-06-13 11:59

本文选题：原发性三叉神经痛 + 祛风安神止痛针刺法　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:探讨祛风安神止痛针刺法治疗原发性三叉神经痛(PTN)的临床疗效以及探讨该方法治疗本病可能的作用机制。方法:按随机数字表法将60例PTN患者分为两组,治疗组30例采用祛风安神止痛针刺法治疗,对照组30例采用常规针刺法治疗。治疗组取百会、四神聪、太阳、内关、神门、其他腧穴参照针灸学教材,第一支痛:攒竹、阳白、鱼腰、丝竹空、外关;第二支痛:四白、颧毼、迎香、下关、合谷;第三支痛:夹承浆、翳风、颊车、大迎、内庭。对照组取穴参照针灸学教材。两组均每日针灸1次,留针时间50min,7天为一个疗程,连续针灸4个疗程后,进行治疗前后疼痛视觉模拟(VAS)评分、焦虑量表(SAS)评分、匹兹堡睡眠指数(PSQL)评分以及两组总有效率的比较。利用统计学软件对所有数据进行分析,从而得出综合的临床疗效评价。结果:1.疼痛视觉模拟评分法(VAS):治疗组患者与对照组患者治疗前VAS评分对比,P0.05,没有显著性差异,具有可比性;针灸4个疗程后,治疗组患者与对照组患者VAS评分对比,P0.05呈显著性差异;且针灸4个疗程后,治疗组患者与对照组患者VAS差值对比,治疗组病患VAS评分下降比对照组明显,P0.05呈显著性差异。2.匹兹堡睡眠质量指数(PSQL)评分:治疗组患者与对照组患者治疗前PSQL评分对比,P0.05没有显著性差异,具有可比性;针灸4个疗程后,治疗组患者与对照组患者PSQL评分对比,P0.05呈显著性差异;且针灸4个疗程后,治疗组患者与对照组患者PSQL差值对比,治疗组患者PSQL评分下降比对照组明显,P0.05呈显著性差异。3.焦虑量表(SAS)评分:治疗组患者与对照组患者治疗前SAS评分对比,P0.05,没有显著性差异,具有可比性;针灸4个疗程后,治疗组患者与对照组患者SAS评分对比,P0.05呈显著性差异;且针灸4个疗程后,治疗组病患与对照组病患SAS差值对比,治疗组病患SAS评分下降比对照组明显,P0.05呈显著性差异。4.总有效率:祛风安神止痛针刺组和常规针刺组总有效率分别为86.6%和76.6%,祛风安神止痛针刺组病患的疗效更优。结论1.祛风安神止痛针刺法能够明显缓解PTN病患的疼痛程度,且疗效强于常规针刺法。2祛风安神止痛针刺法能够改善病人的焦虑和睡眠状况,从而帮助缓解PTN患者的疼痛。
[Abstract]:Objective: to investigate the clinical effect of treating primary trigeminal neuralgia (PTNN) with the acupuncture of dispelling wind and soothing spirit and relieving pain, and to explore the possible mechanism of this method. Methods: 60 patients with PTN were randomly divided into two groups: the treatment group (30 cases) was treated with the acupuncture method of dispelling wind and calming the spirit and the pain relieving pain, and the control group (30 cases) was treated with the routine acupuncture method. The treatment group took Baihui, Sishen Cong, Sun, Neiguan, Shenmen, other acupoints refer to acupuncture and moxibustion teaching materials, the first pain: save bamboo, yang white, fish waist, silk bamboo empty, outside Guan; second branch pain: four white, zygomaticus, Yingxiang, Xiguan, Hegu; The third pain: clamping paste, pannelian, buccal car, big Ying, chamber. In the control group, acupoints were taken for reference. The acupuncture and moxibustion were performed once a day for 50 minutes and 7 days as a course of treatment. After 4 consecutive courses of acupuncture and moxibustion, the visual analogue pain score and the anxiety scale (SAS) were evaluated before and after the treatment. Pittsburgh Sleep Index (PSQL) score and total effectiveness comparison between the two groups. Statistical software was used to analyze all the data, and a comprehensive evaluation of clinical efficacy was obtained. The result is 1: 1. Visual analogue score of pain: the VAS scores of patients in treatment group and control group were compared before treatment (P 0.05), there was no significant difference (P 0.05), there was significant difference in VAS score between patients in treatment group and control group after four courses of acupuncture and moxibustion (P < 0.05), and there was no significant difference in VAS score between patients in treatment group and control group (P < 0.05). After 4 courses of acupuncture and moxibustion, the VAS difference between the treatment group and the control group was compared. The VAS score of the treatment group was significantly lower than that of the control group (P0.05). Pittsburgh Sleep quality Index (PSQL) score: there was no significant difference in PSQL score between the treatment group and the control group before treatment (P0.05). There was significant difference in PSQL score between the treatment group and the control group (P0.05). After four courses of acupuncture and moxibustion, the PSQL difference between the treatment group and the control group was compared, the PSQL score of the treatment group decreased significantly than that of the control group (P0.05). 3. SAS score: there was no significant difference in SAS score between the treatment group and the control group before treatment, there was no significant difference, and there was significant difference in the SAS score between the treatment group and the control group after 4 courses of acupuncture and moxibustion. After 4 courses of acupuncture and moxibustion, the difference of SAS between the treatment group and the control group was compared. The SAS score of the treatment group was significantly lower than that of the control group (P0.05). The total effective rate was 86. 6% and 76. 6% in the acupuncture group and 76. 6% in the routine acupuncture group, respectively. The curative effect of the acupuncture group was better than that of the control group. Conclusion 1. The acupuncture method of dispelling wind and soothing spirit and relieving pain can obviously alleviate the pain degree of PTN patients, and the curative effect is stronger than that of routine acupuncture method .2 the acupuncture method of dispelling wind and soothing the mind to relieve pain can improve the anxiety and sleep condition of patients with PTN, thus help to alleviate the pain of PTN patients.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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