火针点刺法治疗脑卒中后肩—手综合征临床研究

发布时间：2018-06-29 11:50

本文选题：火针点刺法 + 针刺　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的观察火针点刺法与单纯针刺法治疗脑卒中后肩-手综合征的临床疗效以及其疗效差异,验证火针点刺法对脑卒中后肩-手综合征的有效性,并且对比两种疗法各自的优势与不足,并分析探讨其原因。方法将符合入组标准的60例脑卒中后肩-手综合征患者根据随机分组法分为治疗组(火针点刺组)和对照组(单纯针刺组),每组各30例。治疗组运用火针点刺患侧手臂腧穴(肩毭穴、肩毼穴、肩贞穴、臂佈穴、曲池穴、曲泽穴、外关穴、合谷穴、阳池穴、中渚穴)进行治疗,隔日1次,14天为1个疗程,持续治疗2个疗程,每疗程后休息2天;对照组运用单纯针刺患侧手臂腧穴(肩毭穴、肩毼穴、肩贞穴、臂佈穴、曲池穴、曲泽穴、外关穴、合谷穴、阳池穴、中渚穴)进行治疗,每日1次,14天为1个疗程,连续治疗2个疗程,每疗程后休息2天。本研究选用视觉模拟评分(VAS)法、水肿程度测定以及肩-手综合征评估量表为观察指标,在治疗开始前、1个疗程治疗后以及2个疗程治疗后对疼痛、水肿以及整体状况进行量化评分,然后进行数据分析、疗效评价。结果1治疗组与对照组治疗前后,疼痛评分组间对比,经独立样本t检验,均为P0.05,差异未见统计学意义,提示治疗组与对照组在改善疼痛方面经2疗程治疗后改善未见明显差异。两组治疗前后疼痛评分组内比较,2个疗程治疗后分别组内比较,经配对样本t检验,均为P0.05,提示在2个疗程后,治疗组与对照组在改善疼痛方面均具有统计学差异。2治疗组与对照组治疗前后,水肿积分组间对比,经独立样本t检验,均为P0.05,差异未见统计学意义,提示治疗组与对照组在改善水肿症状方面经两疗程治疗后未见明显差异。两组治疗前后水肿积分组内比较,2个疗程后分别组内比较,经配对样本t检验,均为P0.05,提示在2个疗程后,治疗组与对照组对水肿程度的改善均有统计学差异。3治疗组与对照组治疗前后,SHS积分组间,经1个疗程治疗后,两组组间经独立样本t检验,P0.05,提示两组组间在SHS积分改善方面未见统计学差异;经2个疗程治疗后,两组组间经独立样本t检验,P0.05,提示治疗组与对照组在改善SHS积分差异具有统计学意义,治疗在改善SHS积分方面优于对照组。两组治疗前后SHS积分组内比较,2个疗程分别与治疗前比较,经配对样本t检验,两组均为P0.05,治疗组与对照组在改善SHS积分方面均具有统计学差异。4治疗组与对照组治疗前后,对两组临床疗效进行有序分类秩和检验,两组对比差异具有统计学意义(P0.05)。治疗组总有效率为96.67%,显效率为50.00%,对照组总有效率为100%,显效率为13.33%,提示治疗组在改善SHS患者整体症状方面优于对照组。结论1火针点刺法与单纯针刺法治疗SHS对于疼痛程度均有改善作用,两种治疗方法对于疼痛的改善未见统计学差异。2火针点刺法与单纯针刺法治疗SHS对于水肿方面均有改善作用,两种治疗方法对于水肿的改善未见统计学差异。3火针点刺法与单纯针刺法治疗SHS对于SHS评估积分的改善均有统计学意义,且火针点刺法优于单纯针刺组。4火针点刺法在疗效评定方面优于单纯针刺法,治疗显效率高于单纯针刺组。
[Abstract]:Objective To observe the clinical effect and the difference of the curative effect of the Fire Needling and simple acupuncture in the treatment of shoulder hand syndrome after stroke, and to verify the effectiveness of the fire needling method for the shoulder hand syndrome after stroke, and compare the advantages and disadvantages of the two therapies, and analyze the reasons. The method will be in accordance with the standard of the 60 cases of cerebral apoplexy. The patients with posterior shoulder hand syndrome were divided into the treatment group (fire needling group) and the control group (simple acupuncture group), 30 cases in each group. The treatment group was treated with the acupuncture point (shoulder points, shoulder points, shoulder chastity points, JIACHU point, Qu Chi point, Qu Ze point, Wai Guan acupoint, Hegu Point, Yang Chi acupoint, Zhong Zhu acupoint). For 1 courses, 2 courses of treatment were continued, and after 2 days after each course of treatment, the control group was treated with simple acupuncture at the arm acupoints (shoulder points, shoulder points, shoulder chastity points, JIACHU point, Qu Chi point, Qu Ze point, Wai Guan acupoint, Hegu Point, Yang Chi acupoint, Zhong Zhu acupoint), 1 times a day, 14 days for 2 courses, and 2 days after each course. The study selected visual analogue score (VAS), edema degree and shoulder hand syndrome assessment scale as the observation index. Before the treatment began, after 1 courses of treatment, and after 2 courses of treatment, the pain, edema and overall status were quantified, and then the data were analyzed and the curative effect was evaluated. Results the 1 treatment group and the control group were treated before treatment. After the pain score group comparison, the independent sample t test, all P0.05, the difference was not statistically significant, suggesting that the treatment group and the control group were not significantly different after 2 courses of treatment improvement in pain improvement. The two groups before and after treatment in the pain score group, after 2 courses of treatment in the group comparison, the paired sample t test, all P0.05 After 2 courses of treatment, the treatment group and the control group have statistical difference in improving the pain,.2 treatment group and the control group before and after treatment, the edema score group comparison, the independent sample t test, all are P0.05, the difference is not statistically significant, suggesting that the treatment group and the control group have not seen the improvement of edema symptoms after two courses of treatment. The two groups were compared before and after treatment in the edema score group, after 2 courses of comparison, the paired sample t test was P0.05, suggesting that after 2 courses of treatment, the improvement of edema in the treatment group and the control group was statistically different between the.3 treatment group and the control group before and after the treatment of the SHS integral group, and after 1 courses of treatment, the two groups were between the two groups. Independent sample t test, P0.05, indicating that there was no statistical difference between the two groups in improving the SHS score. After 2 courses of treatment, the two groups were tested by independent sample t test and P0.05, suggesting that the treatment group and the control group were statistically significant in improving the difference of SHS integral, and the treatment was better than the control group in the improvement of the SHS score. The SHS product of the two groups before and after treatment. In the group comparison, the 2 courses were compared with those before the treatment, the paired sample t test, the two groups were all P0.05, the treatment group and the control group had statistical difference in improving the SHS score. Before and after the treatment of the.4 treatment group and the control group, the two groups of clinical curative effects were classified and tested in order, and the difference of the two groups was statistically significant (P0.05). The total effective rate of the treatment group was 96.67%, the effective rate was 50%, the total effective rate of the control group was 100%, the effective rate was 13.33%, suggesting that the treatment group was better than the control group in improving the overall symptoms of SHS patients. Conclusion the 1 acupuncture point pricking method and the simple acupuncture treatment of SHS have an improved effect on the degree of pain, and the two treatment methods have no statistics on the pain improvement. The difference between the.2 acupuncture method and the simple acupuncture treatment for the edema of SHS was improved. There was no statistical difference between the two methods for the improvement of edema..3 Fire Needling and simple acupuncture treatment of SHS for the improvement of the score of SHS were statistically significant, and the fire needling method was superior to that of the pure acupuncture group.4 Fire Needling. The curative effect of the method was better than that of the acupuncture alone, and the effective rate of treatment was higher than that of the simple acupuncture group.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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