通元针法治疗中风后遗症的临床研究
发布时间：2018-08-11 11:46
【摘要】：目的:本临床实验采用随机对照研究,将例中风后遗症患者按照随机分组原则分为2组,其中治疗组采用通元针法,对照组单纯采用传统针灸治疗,进行对比观察。疗程为7天,两个疗程后,采用Barthel指数评分、FIM评分、脑卒中后偏瘫恢复六阶段测评、临床总体疗效评价标准观察实验两组对中风后遗症的临床疗效,进一步验证通元针法治疗中风后遗症的临床疗效,初步探讨通元针法的理论特色。方法:将符合纳入标准的60例中风后遗症患者按照随机分组原则分为2组,两组在基础药物治疗的基础上,治疗组(A组)采用通元针法治疗,对照组(B组)采用普通针刺疗法治疗。两组留针时间相同。治疗组与对照组每日治疗1次,七天为1个疗程,共治疗2个疗程。治疗前后均应用Barthel指数评分、FIM评分、脑卒中后偏瘫恢复六阶段测评对患者进行病情程度评估,2个疗程结束后对患者进行临床总体疗效评价。统计方法:两组计数资料采用独立样本t检验,分类资料(如性别)采用卡方检验,等级资料用双样本秩和检验,自身前后比较用配对t检验或配对秩和检验。结果：1.治疗前,两组在年龄、性别、日常生活活动能力量表(Barthel指数评分)、功能独立测定(FIM评分)、脑卒中后偏瘫恢复六阶段评定(Brunnstrom评定)无统计学差别(P0.05),两组具有可比性。2.治疗后Barthel指数评分:t=8.012,p=0.0000.01,说明两组评分存在差异(P0.01),结果有统计学意义。治疗组前后Barthel指数评分自身对照比较,t=-12.711,p=0.0000.01,说明在Barthel指数评分方面,治疗组治疗前后差异明显,结果有统计学意义。对照组前后Barthel指数评分自身对照比较,t=-5.410,p=0.0000.01,说明在Barthel指数评分方面,对照组治疗前后差异明显,结果有统计学意义。3.治疗后FIM评分:t=7.55,p=0.0000.01,说明两组治疗后FIM评分具有统计学差异(P0.01),结果有统计学意义。治疗组前后FIM评分自身对照比较,t=-16.912,p=0.0000.01,说明在FIM评分方面,治疗组治疗前后差异明显,结果有统计学意义。对照组前后FIM评分自身对照比较,t=-8.993,p=0.0000.01,说明在FIM评分方面,对照组治疗前后差异明显,结果有统计学意义。4.治疗后脑卒中后偏瘫恢复六阶段测评:通过对两组治疗后各阶段例数进行秩和检验,Z=-1.632,p=0.1030.05,两组治疗前两组Brunnstrom评定分布差异不明显,说明治疗后两组在中风后偏瘫恢复各阶段病例数对比不具有统计学意义。5.治疗后总体疗效对比:通过秩和检验分析得出:Z=-2.508,p=0.0120.05,说明两组在总体疗效上存在显著差异,结果具有统计学意义。结论:1.治疗前,两组在性别、年龄方面不具有统计学差异,在病情程度方面,包括日常生活活动能力量表(Barthel指数评分)、功能独立测定(FIM评分)、脑卒中后偏瘫恢复六阶段评定(Brunnstrom评定)均不具有统计学差异,保证了两组的实验数据的可对比性。2.治疗后,通过对Barthel指数评分、FIM评分两组组内治疗前后对比统计学分析得出结果均具有差异性(P0.01),说明两种治疗方法均可以明显改善患者的病情。而组间比较则治疗组在Barthel指数评分、FIM评分方面均与对照组有显著差异,说明治疗采用的疗法对患者的评分情况改善程度优于对照组。3.通过对两组治疗后总体疗效的对比,治疗组总有效率优于对照组,并且在显效方面优于对照组,本次课题两组均没有发现临床治愈病例。4.在Brunnstrom评定方面,两组在治疗前后各阶段病例数对比均不具有显著差异性,说明在脑卒中后偏瘫恢复六阶段评定方面,两组疗效不具有统计学意义。
[Abstract]:Objective:To study the clinical effect of Tongyuan Acupuncture on stroke sequelae by randomized controlled study.The treatment group was treated with Tongyuan Acupuncture and the control group was treated with traditional acupuncture. Methods: 60 patients with stroke sequelae were divided into two groups according to the principle of random grouping, and the two groups were divided into two groups. On the basis of basic drug therapy, the treatment group (group A) was treated with Tongyuan acupuncture, while the control group (group B) was treated with ordinary acupuncture. The needle retention time of the two groups was the same. Stage assessment was used to assess the severity of the disease and two courses were completed to evaluate the overall clinical efficacy of the patients. Before treatment, there was no significant difference between the two groups in age, sex, activity of daily living scale (Barthel index score), functional independence test (FIM score), stroke recovery six-stage assessment (Brunnstrom assessment), the two groups were comparable. 2. After treatment, Barthel index score: t = 8.012, P = 0.0000.01, indicating that the two groups were evaluated. Barthel index score before and after treatment group self-control comparison, t = - 12.711, P = 0.0000.01, indicating that the Barthel index score before and after treatment in the treatment group, the difference was significant, the results were statistically significant. In Barthel index score, the control group before and after treatment significant difference, the results were statistically significant. 3. After treatment FIM score: t = 7.55, P = 0.0000.01, indicating that the two groups after treatment FIM score was statistically significant (P 0.01), the results were statistically significant. Compared with the control group, the FIM score of the control group before and after treatment was t = - 8.993, P = 0.0000.01, indicating that the FIM score of the control group before and after treatment was significantly different, the results were statistically significant. Rank sum test, Z = - 1.632, P = 0.1030.05, the two groups before treatment Brunnstrom evaluation distribution difference is not significant, indicating that the two groups after treatment in the recovery of hemiplegia after stroke in different stages of the number of cases compared has no statistical significance.5. After treatment, the overall efficacy of comparison: through rank sum test analysis: Z = - 2.508, P = 0.0120.05, indicating that the two groups in the overall situation. Before treatment, there was no significant difference in gender and age between the two groups, including the degree of disease, including activity of daily living scale (Barthel index score), functional independence test (FIM score), stroke recovery six-stage assessment (Brunnstrom assessment) of hemiplegia. 2. There was no statistical difference between the two groups, which ensured the comparability of the experimental data. 2. After treatment, through the Barthel index score, FIM score of the two groups before and after treatment, the results were statistically different (P 0.01), indicating that the two treatment methods can significantly improve the patient's condition. Hel index score, FIM score were significantly different from the control group, indicating that the treatment used to improve the patient's score is better than the control group. 3. By comparing the overall efficacy of the two groups after treatment, the total effective rate of the treatment group is better than the control group, and is better than the control group in the significant effect, the two groups have not found impending. In Brunnstrom evaluation, there was no significant difference in the number of cases between the two groups before and after treatment, indicating that there was no statistical significance in the six-stage evaluation of hemiplegia recovery after stroke.
【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】：2017
【分类号】：R246.6
本文编号：2176908
[Abstract]:Objective:To study the clinical effect of Tongyuan Acupuncture on stroke sequelae by randomized controlled study.The treatment group was treated with Tongyuan Acupuncture and the control group was treated with traditional acupuncture. Methods: 60 patients with stroke sequelae were divided into two groups according to the principle of random grouping, and the two groups were divided into two groups. On the basis of basic drug therapy, the treatment group (group A) was treated with Tongyuan acupuncture, while the control group (group B) was treated with ordinary acupuncture. The needle retention time of the two groups was the same. Stage assessment was used to assess the severity of the disease and two courses were completed to evaluate the overall clinical efficacy of the patients. Before treatment, there was no significant difference between the two groups in age, sex, activity of daily living scale (Barthel index score), functional independence test (FIM score), stroke recovery six-stage assessment (Brunnstrom assessment), the two groups were comparable. 2. After treatment, Barthel index score: t = 8.012, P = 0.0000.01, indicating that the two groups were evaluated. Barthel index score before and after treatment group self-control comparison, t = - 12.711, P = 0.0000.01, indicating that the Barthel index score before and after treatment in the treatment group, the difference was significant, the results were statistically significant. In Barthel index score, the control group before and after treatment significant difference, the results were statistically significant. 3. After treatment FIM score: t = 7.55, P = 0.0000.01, indicating that the two groups after treatment FIM score was statistically significant (P 0.01), the results were statistically significant. Compared with the control group, the FIM score of the control group before and after treatment was t = - 8.993, P = 0.0000.01, indicating that the FIM score of the control group before and after treatment was significantly different, the results were statistically significant. Rank sum test, Z = - 1.632, P = 0.1030.05, the two groups before treatment Brunnstrom evaluation distribution difference is not significant, indicating that the two groups after treatment in the recovery of hemiplegia after stroke in different stages of the number of cases compared has no statistical significance.5. After treatment, the overall efficacy of comparison: through rank sum test analysis: Z = - 2.508, P = 0.0120.05, indicating that the two groups in the overall situation. Before treatment, there was no significant difference in gender and age between the two groups, including the degree of disease, including activity of daily living scale (Barthel index score), functional independence test (FIM score), stroke recovery six-stage assessment (Brunnstrom assessment) of hemiplegia. 2. There was no statistical difference between the two groups, which ensured the comparability of the experimental data. 2. After treatment, through the Barthel index score, FIM score of the two groups before and after treatment, the results were statistically different (P 0.01), indicating that the two treatment methods can significantly improve the patient's condition. Hel index score, FIM score were significantly different from the control group, indicating that the treatment used to improve the patient's score is better than the control group. 3. By comparing the overall efficacy of the two groups after treatment, the total effective rate of the treatment group is better than the control group, and is better than the control group in the significant effect, the two groups have not found impending. In Brunnstrom evaluation, there was no significant difference in the number of cases between the two groups before and after treatment, indicating that there was no statistical significance in the six-stage evaluation of hemiplegia recovery after stroke.
【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】：2017
【分类号】：R246.6
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