内关穴关刺法治疗腕管综合征的临床观察

发布时间：2018-07-10 01:19

  本文选题：腕管综合征 + 内关　； 参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本课题以轻中度腕管综合征患者为研究病例,选取以内关穴为主穴的相同穴位,运用不同针刺手法,治疗组患者采用内关穴关刺法,对照组患者采用普通针刺法,探讨不同针刺手法对本病的临床疗效,为针灸疗法治疗腕管综合征选穴方案提供临床依据。方法：课题组在研究期间一共纳入60例符合临床诊断纳入标准的腕管综合征患者60例。运用DME随机分组方法,分为治疗组30例,对照组30例。两组患者选用相同穴位,采用不同针刺手法,均连续治疗5天为一个疗程。共治疗4个疗程。在治疗结束后统计两组患者的VAS评分、Levine腕管综合征问卷评分,通过比较两组患者的临床疗效,评价针灸疗法治疗腕管综合征的最佳治疗方案。结果：纳入60例腕管综合征患者随机分为两组,治疗前比较两组患者的基线资料具有可比性(P＞0.05),两组患者一般情况分布均衡,研究观察具有科学性和可信性。(1)VAS评分：在治疗前的基数资料分析中,两组患者VAS评分具有可比性(P＞0.05)。经过4个疗程治疗后,关刺组和普通针刺组VAS评分均下降,疼痛均有缓解。而关刺组VAS评分较普通针刺组下降更为显著(P＜0.05)。关刺疗法对腕管综合征患者具有显著的镇痛效果。(2) Levine评分：在治疗前的基数资料分析中,两组患者Levine评分具有可比性(P＞0.05)。经过4个疗程治疗后,关刺组和普通针刺组Levine评分均下降,临床症状均有缓解,腕关节功能不同程度恢复。而关刺组VAS评分较普通针刺组下降更为显著(P＜0.05)。关刺疗法显著缓解对腕管综合征患者的临床症状,更有助于患者局部功能的恢复。(3)临床疗效分析：根据临床疗效统计,关刺组患者临床治愈为4例,显效19例,有效5例,无效2例,治愈率为13.33%,总有效率为93.33%。普通针刺组患者临床治愈为1例,显效12例,有效8例,无效9例,治愈率为3.33%,总有效率为70.00%。经统计分析,关刺组患者临床疗效优于普通针刺组(P＜0.05)。结论：腕管综合征属于传统医学“经筋病”范畴,而“关刺”治“筋病”。本课题选取位于正中神经循行区域的内关穴,行关刺手法,以松止痛,以疏缓急,以通为补,有效的缓解腕管综合征的临床症状,有助于局部功能的恢复,对轻中度腕管综合征具有良好的临床疗效,作为本病的保守治疗方案值得临床推广。
[Abstract]:Objective: to study the patients with mild to moderate carpal tunnel syndrome, select the same acupoints with Neiguan acupoint as the main point, and apply different acupuncture methods to treat the patients in the treatment group and the general acupuncture method in the control group. To explore the clinical effect of different acupuncture manipulation on carpal tunnel syndrome. Methods: a total of 60 patients with carpal tunnel syndrome who met the criteria of clinical diagnosis were included in the study. DME was randomly divided into treatment group (n = 30) and control group (n = 30). The patients in the two groups were treated for 5 days with the same acupoints and different acupuncture manipulations. There were 4 courses of treatment. After the treatment, the VAS scores and Levine carpal tunnel syndrome questionnaire scores of the two groups were counted, and the best treatment of carpal tunnel syndrome was evaluated by comparing the clinical efficacy of acupuncture and moxibustion therapy. Results: sixty patients with carpal tunnel syndrome were randomly divided into two groups. The baseline data of the two groups were compared before treatment (P > 0.05). (1) VAS score: in the analysis of baseline data before treatment, the VAS scores of the two groups were comparable (P > 0.05). After 4 courses of treatment, the VAS scores of Guan acupuncture group and general acupuncture group were decreased and the pain was relieved. However, the VAS score of Guan acupuncture group was significantly lower than that of common acupuncture group (P < 0.05). (2) Levine score: in the analysis of cardinal data before treatment, Levine scores were comparable between the two groups (P > 0.05). After 4 courses of treatment, Levine scores of Guan acupuncture group and general acupuncture group were decreased, clinical symptoms were alleviated, wrist joint function was recovered to different degrees. However, the VAS score of Guan acupuncture group was significantly lower than that of common acupuncture group (P < 0.05). Guan acupuncture significantly alleviated the clinical symptoms of patients with carpal tunnel syndrome, and also contributed to the recovery of local function of the patients. (3) Clinical efficacy analysis: according to the clinical curative effect statistics, the patients of Guan acupuncture group were clinically cured in 4 cases, significantly effective in 19 cases, and effective in 5 cases. The cure rate was 13.33 and the total effective rate was 93.33. In the common acupuncture group, 1 case was cured, 12 cases were effective, 8 cases were effective, 9 cases were ineffective, the cure rate was 3.33 and the total effective rate was 70.00g. The clinical effect of Guan acupuncture group was better than that of common acupuncture group (P < 0.05). Conclusion: carpal tunnel syndrome belongs to the category of meridian disease in traditional medicine. This topic selects Neiguan acupoint located along the median nerve region, carries on the closing prickle manipulation, to relax the pain, to be sparse and urgent, to take the communication as the tonic, effectively alleviates the clinical symptom of carpal tunnel syndrome, and is helpful to the recovery of the local function. Mild to moderate carpal tunnel syndrome has a good clinical efficacy, as a conservative treatment of this disease is worthy of clinical promotion.
【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】：R246.9

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