温通法治疗气血瘀阻型神经性耳鸣的临床疗效观察

发布时间：2018-07-16 17:30

【摘要】：目的通过观察“温通法”针刺为主治疗神经性耳鸣的临床疗效及影响,设置常规针刺对照组进行比较,客观评价两种针刺治疗的疗效差异,从而丰富针灸治疗神经性耳鸣的手段,为临床筛选出更有效、更便捷的治疗方案。方法将符合纳入标准的62例神经性耳鸣患者,采用随机数字分组法随机分为治疗组和对照组,其中治疗组32例,对照组30例。治疗组采用温通法的针刺治疗方法,对照组采用常规针刺治疗。两组均每日治疗1次,10次作为1个疗程,每1个疗程结束后,嘱患者休息1天,再继续下1个疗程,总共治疗3个疗程。3个疗程治疗结束后,通过比较两组患者的耳鸣症状及各项积分对比,进行临床疗效观察,客观评价两种方法治疗神经性耳鸣的差异性。结果(1)临床疗效对比:经3个疗程治疗后,治疗组(温通法组):治愈8例,显效15例,有效7例,无效2例,总有效率为93.75%;对照组(常规针刺组):治愈3例,显效13例,有效6例,无效8例,总效率为73.33%。两组治疗后疗效对比经统计学分析,P0.05,有显著统计学意义。(2)耳鸣严重程度各项指标对比:治疗组在治疗前后的对比,经过秩和检验分析后,治疗组在治疗前后过程中,以上各项的P0.05,其中耳鸣出现的环境、持续的时间、对睡眠影响、对生活工作影响以及总体感受P0.01,差异具有显著的统计学意义。对照组在治疗前后的对比,经过秩和检验分析后,其中耳鸣持续的时间、对睡眠影响、对情绪的影响以及总体感受均P0.05,差异具有统计学意义;对耳鸣出现的环境及生活工作方面,P0.05,无差异,没有统计学意义。(3)耳鸣严重程度评估指标及评分标准(简称“青岛标准”)对比:治疗前两组各项症状积分间比较,均P0.05,无显著统计学差异,具有可比性;经过3个疗程治疗,两组患者各项症状积分比较经秩和检验分析,其中耳鸣出现环境及对睡眠影响方面,P0.05,差异无统计学意义。在耳鸣持续的时间、对情绪的影响、生活工作及总体感受几个方面,P0.05,差异有统计学意义。结论(1)经过三个疗程治疗后,两组患者中治疗组(温通法组)总有效率93.75%,对照组(常规针刺组)总有效率73.33%,通过对比,两种针刺疗法均能有效治疗气血瘀阻型神经性耳鸣,但温通法针刺疗法的临床疗效要优于常规针刺法,而且温通法针刺疗法在愈显率及总有效率上均优于常规针刺疗法。(2)两种针刺疗法均能改善气血瘀阻型神经性耳鸣患者的各项症状及功能,但温通法为主针刺疗法在改善患者的耳鸣响度及相关症状(出现环境、持续时间、对睡眠、情绪、生活工作及总体感受的影响)方面具有显著的统计学意义,所以治疗组(温通法组)在提高患者生活质量和工作环境等方面要优于常规针刺疗法。(3)温通法和常规针刺疗法均能有效地降低患者耳鸣持续时间、改善患者睡眠质量及耳鸣对情绪方面的影响,降低患者对耳鸣的总体感受,但以温通法为主的针刺疗法不仅能通过艾灸及针刺的双重效应对患耳进行刺激作用,通过针体将艾条之热能传到耳部深处,使温热之气透达,针至病所,通其经脉,并调其气血,使耳部瘀阻之经气得到疏通,气血调和,经络畅通,“壅塞”之耳窍得以濡养,改善耳部供血及血液循环,促进周围组织新陈代谢,最终达到扶正祛邪、平衡阴阳,提高治疗效果,达到治疗目的。因此温通法在治疗气血瘀阻型神经性耳鸣方面具有独特的优势,温通法的治疗效果确切,操作简单、取穴简便、安全有效,利于临床的推广。
[Abstract]:Objective To observe the clinical effect and influence of "Wen Tong" acupuncture in the treatment of neurogenic tinnitus, set a comparison between the conventional acupuncture control group and objectively evaluate the difference of the curative effect between the two kinds of acupuncture treatment, so as to enrich the means of acupuncture and moxibustion for the treatment of neurogenic tinnitus, and to screen out a more effective and convenient treatment scheme. 62 patients with neurogenic tinnitus were randomly divided into the treatment group and the control group, with 32 cases in the treatment group and 30 in the control group. The treatment group was treated with the method of warming through the acupuncture, and the control group was treated with conventional acupuncture. The two groups were treated 1 times a day and 10 times as 1 courses. After every 1 course of treatment, the patients were asked to rest After 1 days, then continued the next 1 courses, after a total of 3 courses of treatment for.3 course of treatment after the end, by comparing the symptoms of ringing in the two groups of patients and the overall comparison, to observe the clinical effect, objectively evaluate the difference between the two methods of treating neurogenic tinnitus. Results (1) comparison of clinical efficacy: after 3 courses of treatment, the treatment group (Wen Tong Group): 8 cases were cured, 15 cases were effective, 7 cases were effective, 2 cases were invalid, the total effective rate was 93.75%. The control group (routine acupuncture group): cured 3 cases, 13 cases, effective 6 cases and 8 cases, the total efficiency was statistically analyzed after 73.33%. two group treatment, P0.05, there were significant statistical significance. ((2) the treatment group was treated before and after treatment. After the analysis of the rank sum test, the P0.05 in the treatment group before and after the treatment, the environment in which the tinnitus appeared, the duration of the tinnitus, the influence on the sleep, the influence on the life work and the overall feeling of the P0.01, the difference has significant statistical significance. The duration of the tinnitus, the influence on sleep, the influence on the mood and the overall feelings were P0.05, and the difference was statistically significant. There was no difference in the environment and life work of the tinnitus. (3) the evaluation index of the severity of the tinnitus and the standard of grading ("Qingdao standard") were compared: the two groups before the treatment. After 3 courses of treatment, the symptom scores of the two groups were analyzed by the rank sum test, and the environment of the tinnitus and the effect on sleep, P0.05, were not statistically significant. The duration of the tinnitus, the influence of the emotion, the life work, and the difference of the symptoms were compared. P0.05, the difference was statistically significant. Conclusion (1) after three courses of treatment, the total effective rate of the two groups of patients (Wen Tong Group) was 93.75% and the control group (conventional acupuncture group) had a total effective rate of 73.33%. Through comparison, the two kinds of acupuncture therapy could effectively treat the type of nervous tinnitus with Qi and blood stasis type, but the method of Wen Tong acupuncture treatment was effective. The clinical curative effect is superior to the conventional acupuncture method, and the warming through method is superior to the conventional acupuncture therapy in the healing rate and the total effective rate. (2) the two kinds of acupuncture therapy can improve all the symptoms and functions of the patients with Qi and blood stasis type neurogenic tinnitus, but the method of acupuncture is the main method to improve the ringing and related symptoms of the patients. The present environment, duration, influence on sleep, emotion, life work and overall feelings have significant statistical significance, so the treatment group (Wen Tong Group) is better than the conventional acupuncture in improving the quality of life and working environment of the patients. (3) both warm and conventional acupuncture can effectively reduce the durations of tinnitus in patients. In the meantime, the effect of sleep quality and tinnitus on the emotion of the patients was improved and the overall feeling of tinnitus was reduced. However, the acupuncture therapy based on the method of warming through moxibustion and acupuncture can not only stimulate the affected ears, but also pass the heat of the bar to the deep of the ear through the needle body, so that the warm air is permeable, and the needle goes to the disease place. Meridian, and adjust its Qi and blood, so that the ear stasis of the meridian to get dredging, Qi and blood harmonization, smooth channels and channels, "choked" ear orifices can be nourishing, improve the ear blood supply and blood circulation, promote the metabolism of surrounding tissue, finally achieve positive dispel evil, balance Yin and Yang, improve treatment effect, to achieve therapeutic purposes. Therefore Wen Tong method in the treatment of Qi and blood stasis There is a unique advantage in the treatment of tinnitus type. The therapeutic effect of warming and dredging therapy is exact, simple operation, simple, safe and effective, and is conducive to clinical promotion.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.81

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