透刺结合放血疗法治疗肩周炎的临床疗效观察

发布时间：2018-07-05 04:25

本文选题：肩周炎 + 透刺　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的:本课题旨在探讨透刺结合放血疗法治疗肩关节周围炎的临床疗效。通过对透刺配合放血疗法治疗肩周炎的临床研究,客观、科学地探究透刺配合放血疗法的临床有效性,进一步推广针灸疗法,为今后选择治疗肩关节周围炎更有效的途径提供依据。方法:采用随机数字表、单盲的研究方法,将来自于湖北省中医院光谷院区符合本试验要求的70例患者,随机分为透刺放血组和常规针刺组,每组35例。透刺放血组最终完成34例,脱落1例,采用透刺结合放血疗法治疗肩周炎,透刺取穴为肩毭透肩前、肩毼透臂佈、肩贞透佈俞、外关透内关(以上均为患侧),条口透承山(健侧),针灸治疗每天1次,每周连续5次,5次为1疗程,两个疗程间间隔2天;针刺后对阿是穴进行放血疗法,每周2次,分别为第1次和第4次针灸治疗后进行放血疗法,共治疗4个疗程。常规针刺组最终完成33例,脱落2例,采用常规针刺疗法(参考王启才版《针灸治疗学》中肩周炎的治疗方法)治疗肩周炎,针刺取穴为肩毭、肩前、肩贞、阳陵泉、中平穴、阿是穴,每天1次,每周连续5次,5次为1疗程,两个疗程间休息2天,共治疗4个疗程。分别评估两组治疗前、治疗2个疗程后、治疗4个疗程后McGill疼痛问卷评分、Constant-murley评分、ADL评分及进行疗效评定,并对数据进行统计学分析。结果:1.在缓解肩周炎疼痛方面:两组McGill疼痛评分比较,组内比较,治疗2个疗程和4个疗程后分别与治疗前比较,均P0.05,差异均有统计学意义,说明两组在改善肩周炎疼痛症状方面均有效。组间比较,治疗2个疗程后,两组比较,P0.05,差异无统计学意义,因此,不能说明透刺放血组改善肩周炎疼痛症状疗效优于常规针刺组;治疗4个疗程后,两组比较,P0.05,差异具有统计学意义,说明透刺放血组改善肩周炎疼痛症状优于常规针刺组。2.在改善肩周炎肩关节功能活动方面:两组Constant-murley评分比较,组内比较,治疗2个疗程后、4个疗程后分别与治疗前比较,均P0.05,差异均有统计学意义,说明两组在改善肩周炎功能活动方面均有效;组间比较,两组在治疗2个疗程及4个疗程后分别进行比较,均P0.05,差异均有统计学意义,说明透刺放血组在改善肩周炎功能活动方面优于常规针刺组。3.在改善日常生活能力方面:两组ADL评分比较,组内比较,在治疗2个疗程、4个疗程后分别与治疗前比较,均P0.05,差异均有统计学意义,说明两组在改善肩周炎功能活动方面均有效;组间比较,两组在治疗2个疗程及4个疗程后分别进行比较,均P0.05,差异均有统计学意义,说明透刺放血组在改善日常生活能力方面优于常规针刺组。4.疗效评定:透刺组34例,痊愈13例,显效16例,有效4例,无效1例,总有效率均为97.06%;常规针刺组33例,痊愈6例,显效11例,有效13例,无效3例,总有效率均为90.9%,两组疗效比较,经秩和检验,差异具有统计学意义(P0.05),说明透刺结合放血疗法治疗肩周炎疗效优于常规针刺。结论:1.两种治疗方法在改善肩周炎疼痛、功能活动及日常生活能力方面均有效;透刺结合放血疗法在改善肩周炎疼痛、功能活动及日常生活能力方面有明显优势。2.短期内治疗肩周炎在改善疼痛方面,透刺结合放血疗法无明显优势,但改善功能活动、日常生活能力有明显优势。3.本课题研究表明,透刺结合放血疗法治疗肩周炎疗效确切,具有极大的临床应用价值,值得进一步临床推广。
[Abstract]:Objective: the purpose of this study is to explore the clinical efficacy of puncture combined with blood letting therapy for the treatment of periarthritis of shoulder. Through the clinical study of the treatment of scapulohumeral periarthritis with the combination of puncture and blood letting therapy, the clinical effectiveness of puncture and blood letting therapy is objectively and scientifically explored, and the needle moxibustion therapy is further popularized to be more effective for the treatment of periarthritis of the shoulder in the future. Methods: a random number table, a single blind study method, 70 patients in Optics Valley Hospital District of Hubei Provincial Traditional Chinese Medical Hospital, which meet the requirements of the test in the future, were randomly divided into 35 cases in each group. 34 cases were completed by puncture and blood release group, 1 cases were dropped out, and the scapulohumeral periarthritis was treated by puncture combined with blood letting therapy. There were 1 times a day, 5 times a week, 5 times for 1 courses, 2 days between two courses, and 2 times a week after acupuncture, 2 times a week, first and fourth times respectively. A total of 4 courses of treatment were performed. The routine acupuncture group was treated with 4 courses of treatment. 33 cases were completed in the routine acupuncture group, 2 cases were dropped out, and the treatment of scapulohumeral periarthritis was treated by conventional acupuncture (reference Wang Qicai edition < acupuncture therapy > middle scapulohumeral periarthritis). Acupuncture points were taken as shoulder, shoulder, shoulder chastity, Yang Ling spring, middle Ping acupoint, and acupoint, 1 times a day, 5 consecutive 1 courses, two courses of 1, two After 2 days of treatment, 4 courses were treated. Before treatment of two groups, after treatment of two groups, after treatment for 2 courses, after 4 courses of treatment, the pain questionnaire, Constant-murley score, ADL score and curative effect were evaluated, and the data were statistically analyzed. Results: 1. in alleviating the pain of shoulder periarthritis: the two groups of McGill pain scores were compared and the intra group ratio was compared. Compared with the treatment of 2 courses and 4 courses, compared with before treatment, the difference was P0.05, the difference was statistically significant, indicating that the two groups were effective in improving the pain symptoms of scapulohumeral periarthritis. Group comparison, after the treatment of 2 courses, the two groups were compared, P0.05, the difference was not statistically significant, because this could not explain the improvement of the pain symptoms in the scapulohumeral periarthritis. After 4 courses of treatment, the two groups were compared, P0.05, and the difference was statistically significant. It showed that the pain symptom of scapulohumeral periarthritis was better than that of the conventional acupuncture group.2. in improving shoulder joint function activities in the scapulohumeral periarthritis: the two group Constant-murley score compared with the group, after the treatment of 2 courses, after the 4 course of treatment, respectively, Before treatment, the difference was P0.05, the difference was statistically significant, indicating that the two groups were effective in improving the function of scapulohumeral periarthritis, and the two groups were compared in 2 courses and 4 courses respectively, and the difference was statistically significant, indicating that the group of penetrating blood and letting blood were better than the conventional acupuncture group in improving the function of scapulohumeral periarthritis. .3. in the improvement of daily life capacity: two groups of ADL score comparison, in group comparison, in the treatment of 2 courses, after 4 courses compared with before treatment, respectively, were P0.05, the difference was statistically significant, indicating that the two groups were effective in improving the function of periarthritis of shoulder; the two groups were compared in 2 courses and after 4 courses, respectively. All P0.05, the difference was statistically significant, indicating that through the thorns and letting blood group is better than the conventional acupuncture group.4. efficacy evaluation in improving the daily life ability: 34 cases in the puncture group, 13 cases, effective 16 cases, effective 4 cases, invalid 1 cases, the total effective rate is 97.06%; the routine acupuncture group 33 cases, 6 cases, 13 cases, invalid 3 cases, the total effective rate are all 90.9%, the comparison of the two groups, through the rank sum test, the difference has statistical significance (P0.05), indicating that the treatment of periarthritis of shoulder is better than the conventional acupuncture. Conclusion: 1. two kinds of treatment methods are effective in improving the pain of scapulohumeral periarthritis, functional activity and daily living ability; through the puncture combined with blood letting therapy in improving the pain of scapulohumeral periarthritis There is obvious advantage in activity and daily life ability,.2. in the short term treatment of periarthritis of shoulder in the improvement of pain, through the combination of puncture and blood letting therapy has no obvious advantages, but the improvement of functional activities and daily living ability has obvious advantages.3. research shows that through the combination of puncture and blood letting therapy with the rule of law treatment of scapulohumeral periarthritis is effective and has great clinical application. The value is worth further clinical promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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