针刺合四藤通络汤外洗法治疗多发性神经病的临床观察

发布时间：2018-06-19 02:48

本文选题：多发性神经病 + 四藤通络汤　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:通过对针刺合四藤通络汤外洗法治疗多发性神经病的临床疗效和对照观察,综合评价本方法治疗多发性神经病的临床疗效及安全性,以期进一步为针药结合治疗多发性神经病提供新的方法和理论,且为其临床广泛应用提供客观依据。方法:对60例符合多发性神经病西医和中医双重诊断标准的患者,按照就医的先后顺序进行编号,随机分成对照组30例和治疗组30例。对照组:给予维生素B1注射液100mg,日一次肌肉注射;维生素B12注射液0.5mg,日一次肌肉注射。一周为一个疗程,以此方法连续治疗四个疗程。治疗组:取穴:上肢:曲池,外关,阳池,合谷,八邪;下肢:足三里,解溪,足临泣,太冲,八风;并且配合四藤通络汤(青风藤、鸡血藤、海风藤、络石藤、川牛膝、红花、海桐皮、艾叶、赤芍、五加皮、泽兰、黄芪、元参、当归、丹参)外洗法治疗。每日一次,一周为一个疗程,疗程期间休息一天,以此方法连续治疗四个疗程。治疗前后分别应用自觉症状分级量化标准、感觉障碍评定积分表(改良Fugl-meyer及Lindmark评价法)和神经传导速度(NCV)3项评价指标对两组患者进行评分。结果:1.两组患者经治疗后NCV均有所改善,尤以治疗组改善情况显著。治疗后两组NCV分别进行组内对比,经t检验分析,差异均具有统计学意义(P0.01)。治疗后两组组间进行NCV比较,经t检验分析,差异具有统计学意义(P0.05)。2.两组患者积分情况方面均有所改善,尤以治疗组改善情况显著。治疗后两组积分组内对比,经过t检验分析,差异均具有统计学的意义(P0.01)。治疗之后两组积分进行组间比较,经过t检验分析,差异具有统计学意义(P0.05)。3.统计并分析数据得出结论,治疗组和对照组的总有效率分别为86.67%、73.33%。两组数据进行比较,其显著性差异具有统计学意义(P0.05)。结论:1.针刺合四藤通络汤外洗法和西药常规治疗均可以改善多发性神经病病人之神经传导速度,使病人的自觉症状情况和感觉障碍情况均有所减轻。2.针刺合四藤通络汤外洗法在改善多发性神经病患者的神经传导速度、自觉症状和感觉障碍方面优于西药治疗。3.针刺合四藤通络汤外洗法治疗多发性神经病总有效率明显优于西药治疗,有一定的应用价值,值得在临床中应用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of acupuncture combined with Siteng Tongluo decoction in the treatment of polyneuropathy. The aim is to provide a new method and theory for the treatment of polyneuropathy with acupuncture and medicine, and to provide objective basis for its wide clinical application. Methods: 60 patients with polyneuropathy were divided into control group (n = 30) and treatment group (n = 30). Control group: vitamin B1 injection 100 mg, once a day intramuscular injection, vitamin B 12 injection 0.5 mg, once a day intramuscular injection. A week as a course of treatment, this method of treatment for four consecutive courses. Treatment group: acupoints: upper limbs: Quchi, Waiguan, Yangchi, Hegu, eight evil; lower limbs: Zusanli, Jiexi, sobbing feet, Taochong, eight wind; and with Siteng Tongluo decoction (Qingfeng rattan, chicken blood vine, sea wind rattan, collateral stone rattan, Chuan Niujiao, Safflower, Paulownia Bark, leaves of Artemisia, Radix Paeoniae Alba, Radix Astragali, Radix Ginseng, Radix angelicae Sinensis, Salvia miltiorrhiza). Once a day, once a week as a course of treatment, a day off during the course, this method of treatment for four consecutive courses. Before and after treatment, the patients in the two groups were evaluated by the quantitative criteria of conscious symptom classification, sensory disturbance assessment scale (modified Fugl-meyer and Lindmark evaluation method) and nerve conduction velocity (NCVV). The result is 1: 1. After treatment, nCV was improved in both groups, especially in the treatment group. After treatment, the nCV of the two groups were compared within the group, and the difference was statistically significant by t test. After treatment, the nCV was compared between the two groups, and the difference was statistically significant by t test. The scores of both groups improved, especially in the treatment group. After treatment, the difference between the two groups was statistically significant (P 0.01). After treatment, the scores of the two groups were compared between the two groups, and the difference was statistically significant after t-test analysis. The total effective rates of the treatment group and the control group were 86.67 and 73.33, respectively. The difference between the two groups was statistically significant (P 0.05). Conclusion 1. Acupuncture combined with external washing of Siteng Tongluo decoction and routine treatment of western medicine can improve the nerve conduction velocity of patients with polyneuropathy, and reduce the conscious symptoms and sensory disorders of patients with polyneuropathy. 2. Acupuncture combined with Siteng Tongluo decoction was superior to western medicine in improving nerve conduction velocity, conscious symptoms and sensory disorders in patients with polyneuropathy. The total effective rate of acupuncture combined with Siteng Tongluo decoction in the treatment of polyneuropathy is obviously better than that of western medicine, which is worthy of clinical application.
【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】：R277.7

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