秦氏腹针治疗中风后气虚型便秘的临床疗效观察

发布时间：2018-06-14 07:54

本文选题：秦氏腹针 + 气虚型便秘　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究以典型的中风后气虚型便秘为研究对象,评价秦氏腹针对中风后气虚型便秘患者的临床疗效,并与普通针刺疗效比较,分析其疗效差异,目的是以提高临床疗效,为临床提供一种操作简捷而疗效可靠的治疗途径。方法：本研究采用随机对照的临床研究方法,共收集2015年5月-2016年2月在广东省第二中医院针灸康复科住院部和门诊部的60例中风后气虚型便秘的患者,均符合诊断标准、纳入标准。利用电脑Excel软件采取随机化方法将入组病人分配到秦氏腹针组与普通针刺组,每组各30例。两组均给予内科基础治疗、体针及康复训练。在此基础上,秦氏腹针组采用秦氏腹针的选穴及针刺方法,腹部穴位以任脉及任脉两侧旁开0.5寸(肾经)基础。以脐上2寸、4寸、6寸和脐下1.5寸、3寸各取1穴,每穴左右旁开约0.5寸各取1穴,每3穴成一横线为一组,共五组,上下共15穴,共15针。普通针刺组选取的治疗穴位为：天枢、支沟、大横、丰隆、脾俞、气海,均取双侧穴位。1个疗程是7天,第7天、第14天休息,共治疗两个疗程。分别于病例纳入第1天和第14天使用便秘症状积分和改良Barthel指数评定便秘症状、日常生活活动能力的改善程度,并评估总体临床疗效。结果：1.两组基线资料比较,分别在治疗前对两组的性别、年龄、发病时间、原发疾病、气虚型便秘症状积分、改良Barthel指数评分进行比较,差异无统计学意义(p0.05),两组基线具有可比性。2.两组治疗后与治疗前进行组内比较,气虚型便秘症状积分、改良Barthel指数评分均有明显差异,具有可比性(p0.01,p0.01)。分别对治疗后两组的气虚型便秘症状积分、改良Barthel指数评分差值组间比较,差异有统计学意义(p0.01,p0.05)。说明秦氏腹针与传统针刺方法均能有效改善患者便秘症状,提高患者日常生活活动能力,且秦氏腹针组优于普通针刺组。3.两组临床效果方面,秦氏腹针组气虚型便秘患者临床治愈13例(43.33%),显效7例(23.33%),有效9例(33.33%),无效1例(3.33%),总有效率96.67%,愈显率66.67%。普通针刺组气虚型便秘患者临床治愈3例(10.00%),显效5例(16.67%),有效18例(60.00%),无效4例(13.33%),总有效率86.67%,愈显率26.67%。两组疗效比较,两组总有效率无明显差异,两组愈显率比较,秦氏腹针组疗效较普通针刺组效果更佳。结论：秦氏腹针与普通针刺均能有效改善患者中风后气虚型便秘的临床症状,提高其日常生活活动能力,且优于普通针刺,是一种行之有效的的治疗方法。
[Abstract]:Objective: to evaluate the clinical efficacy of Qin's abdomen in treating patients with postapoplectic qi deficiency constipation, and to compare the curative effect with that of common acupuncture, and to analyze the difference of curative effect, in order to improve the clinical effect, the purpose of this study is to improve the clinical effect of Qi-deficiency type constipation after apoplexy, and to evaluate the clinical effect of Qi-deficiency constipation. To provide a simple and effective treatment for clinical approach. Methods: a randomized controlled clinical study was conducted to collect 60 patients with Qi-deficiency constipation from May 2015 to February 2016 in the Department of Rehabilitation of Acupuncture and moxibustion and the outpatient Department of the second Chinese Medicine Hospital of Guangdong Province, all of whom met the diagnostic criteria. Inclusion criteria The patients were randomly assigned to Qin's abdominal acupuncture group and common acupuncture group with 30 cases in each group by means of computer Excel software. Both groups were given basic medical treatment, body acupuncture and rehabilitation training. On this basis, Qin's abdominal acupuncture group adopted the method of selecting points and acupuncture of Qin's abdominal acupuncture, and the abdominal acupoints were based on the 0.5 inch (kidney meridian) of any vein and both sides of any vein. One acupoint was taken from 2 cubits of navel and 1 point from 3 cun of subumbilical cord, 1 point from 0.5 inch on the left side of each hole, and 1 point from each 3 points in a group of 5 points, 15 points were up and down, 15 needles were obtained from the top and bottom of the navel, and each of the three points was divided into five groups, each of which was divided into five groups. The treatment points of the common acupuncture group were: Tianshu, branch ditch, big transverse, Fenglong, Peshu and Qihai, all of which were taken from bilateral acupoints. One course of treatment was 7 days, 7 days, 14 days rest, and two courses of treatment. Constipation symptom score and modified Barthel index were used to evaluate constipation symptoms and improve the activity of daily living (ADL) respectively on the 1st and 14th day, and the overall clinical efficacy was evaluated. The result is 1: 1. The baseline data of two groups were compared before treatment, sex, age, onset time, primary disease, symptom score of Qi-deficiency type constipation and modified Barthel index were compared before treatment. There was no significant difference between the two groups (P 0.05). The baseline of the two groups was comparable. 2. The scores of constipation symptoms and modified Barthel index of Qi-deficiency type were significantly different between the two groups after treatment and before treatment. After treatment, there were significant differences between the two groups in the score of Qi-deficiency type constipation symptom and the difference of modified Barthel index score between the two groups. It shows that both Qin's abdominal acupuncture and traditional acupuncture can effectively improve the constipation symptoms and improve the activity of daily life of the patients, and the Qin's abdominal acupuncture group is better than the common acupuncture group. 3. In the two groups, 13 cases of Qi-deficiency type constipation were cured in Qin's abdominal acupuncture group (13 cases), 7 cases had remarkable effect (23. 33%), 9 cases were effective and 3. 33%, and 1 case was ineffective. The total effective rate was 96.6767 and the recovery rate was 66. 67%. In the common acupuncture group, 3 patients with Qi deficiency type constipation were cured, 5 patients with remarkable effect were treated with 16. 6767, 18 patients were effective, and 4 patients were ineffective. The total effective rate was 86.67 and the recovery rate was 26.67. There was no significant difference in the total effective rate between the two groups. The curative effect of Qin's abdominal acupuncture group was better than that of common acupuncture group. Conclusion: both Qin's abdominal acupuncture and common acupuncture can effectively improve the clinical symptoms of patients with Qi-deficiency type constipation after stroke, improve their daily life activities, and are superior to common acupuncture, which is an effective treatment method.
【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】：R246.6

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