温针灸治疗痰湿型功能性便秘的临床疗效观察

发布时间：2018-08-17 18:30

【摘要】：目的:随着生活节奏急速,人们精神心理负担的加重、饮食结构的改变、以及社会环境因素等都能产生便秘情况。功能性便秘不单只见于老年人以及孕妇,此疾病已经慢慢趋向年轻化。因此本次课题通过随机对照法在临床上抽取小样本进行研究,治疗组采用温艾配合针刺治疗痰湿型功能性便秘,对照组单纯针刺方法,通过比较两种治疗方法的临床疗效,结合体质学科知识探寻防治疗痰湿型便秘的较优治疗方案,并从体质学方面探讨其相关之处。方法:本次研究参照设定中筛选出受试者62例,符合功能性便秘的诊断标准及中医体质分类表中的痰湿体质,签署知情同意书,再随机分成治疗组和对照组两组,各31例。拣选穴位方面,两组都针刺(天枢、大肠俞、手三里、支沟)。而治疗组在上述针刺基础上配合温针灸(丰隆、太白、脾俞)。两组针灸每周进行2次治疗,1个月为1次疗程,共3个疗程。待3个疗程结束后,观察其治疗前后的便秘症状改变,体质变化,用EXCEL记录并设立数据库,并运用SPSS 24.0统计学软件来进行分析。结果:在62例受试者中,治疗组剔除因治疗期间前往外地读书的患者1例,对照组亦剔除因治疗期间怀孕的患者1例,而不得不终止试验。最后完成各30例。两组病例对功能性便秘的效果都有显著的治疗效果,便秘严重程度均有所改善。当中治疗组的总有效率约为900%;对照组的总有效率约为800%,经过两组比较后,有统计学上的差异(P0.05)。3个疗程结束后,两组在改善便秘程度方面,较治疗前便秘积分有下降,但治疗组积分的下降程度较为明显,两者比较后的差异,具有统计学意义(P0.05),表明治疗组的总疗效较为优越。两组在痰湿体质改善方面,都比治疗前痰湿体质积分有下降,而治疗组的积分的下降程度较对照组明显,两者比较后的差异,具有统计学意义(P0.05),表明治疗组对于受试者的痰湿体质情况改善效果较对照组优越。结论:对于功能性便秘的治疗,两组都有一定的疗效,但治疗组的总有效率、便秘的改善、体质的改善皆比对照组明显优越。运用温针灸结合一般针刺的治疗组从基础上改善体质,对于基于痰湿体质便秘的治疗及痰湿体质的调理效果皆优于对照组。温针灸来调理痰湿体质的综合疗法对于便秘及其他以痰湿体质为主的疾病亦有较为深刻的指导意义,应在临床上给予高度重视,并进行全面推广。
[Abstract]:Objective: with the rapid pace of life, people's mental and psychological burden, dietary structure changes, and social environmental factors can lead to constipation. Functional constipation is not only seen in the elderly and pregnant women, the disease has gradually become younger. Therefore, this topic through the random control method in the clinical sampling small sample study, the treatment group with Wenai combined with acupuncture to treat functional constipation of phlegm-dampness type, the control group simple acupuncture method, by comparing the clinical efficacy of the two treatment methods, Combined with the knowledge of physique to explore the better treatment plan for phlegm and damp type constipation, and to discuss its correlation from the aspect of physique. Methods: in this study, 62 subjects were selected according to the criteria of functional constipation and the phlegm and dampness constitution in TCM constitution classification table. They were randomly divided into two groups: treatment group and control group with 31 cases each. Pick points, the two groups are acupuncture (Tianshu, Dachang Yu, hand Sanli, branch ditch). The treatment group on the basis of the above acupuncture combined with warm acupuncture (Fenglong, Taibai, Peshu). Acupuncture and moxibustion were treated twice a week, one month as a course of treatment for 3 courses of treatment. After three courses of treatment, the changes of constipation symptoms and physique were observed before and after treatment. EXCEL was used to record and set up a database, and SPSS 24.0 statistical software was used to analyze the changes of constipation symptoms and physique. Results: in the treatment group, one patient who went to other places to study during the treatment period was excluded, while the control group excluded one patient who was pregnant during the treatment period and had to stop the experiment. The final completion of each 30 cases. In both groups, the effect of functional constipation was significant and the severity of constipation was improved. The total effective rate of the treatment group is about 900 and the total effective rate of the control group is about 800. After comparison between the two groups, there is a statistical difference (P0.05). After three courses of treatment, the two groups have decreased in terms of improving the degree of constipation compared with the score before treatment. But the treatment group score decline is more obvious, the difference between the two after the comparison, with statistical significance (P0.05), indicating that the treatment group of the overall efficacy is superior. In the improvement of phlegm-dampness constitution, the scores of phlegm and dampness in the treatment group were lower than those in the control group. There is statistical significance (P0.05), indicating that the treatment group for the phlegm dampness of the subjects to improve the physical condition of the effect is superior to the control group. Conclusion: the treatment of functional constipation is effective in both groups, but the total effective rate, constipation improvement and physique improvement in the treatment group are better than those in the control group. The treatment group with warm acupuncture combined with general acupuncture can improve the physique on the basis of phlegm and dampness constitution constipation and the regulating effect of phlegm dampness constitution is better than that of the control group. The comprehensive therapy of warming acupuncture and moxibustion to regulate phlegm and dampness constitution also has profound guiding significance for constipation and other diseases with phlegm and dampness constitution, which should be attached great importance to in clinic and be popularized in an all-round way.
【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】：R246.1

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