天竺灸结合针刺治疗神经性耳鸣的临床研究

发布时间：2018-08-18 08:33

【摘要】：目的本课题旨在运用天竺灸结合针刺法治疗神经性耳鸣,并设常规针刺对照,探讨其优越性。方法根据随机数字表将符合病例纳入标准的72例患者随机分为治疗组(天竺灸结合针刺组)36例和对照组(常规针刺组)36例。两组均按照《针灸治疗学》辨证标准将其分为风邪外袭证、肝胆火盛证、痰火郁结证、肾精亏损证、脾胃虚弱证五型。治疗组取主穴:听会、颞后线、风市、肾关、外关、中渚,外耳道施天竺灸;对照组取主穴:听宫、听会、翳风、中渚、侠溪。两组均按照《针灸治疗学》配穴:风邪外袭者,加风池、外关、合谷;肝胆火盛者,加行间、丘墟、足临泣;痰火郁结者,加丰隆、内庭;肾精亏损者,加太溪、关元;脾胃虚弱者,加气海、足三里。两组病例疗程相同,每日1次,每周5次,周末休息,共治疗6周。分别观察治疗中(3周)、治疗结束后(6周)两组患者的THI得分及纯音听阈测试结果变化,以THI得分作为疗效观察指标,对治疗结果进行统计分析及疗效评定。结果(1)两组患者共72例,治疗1疗程(3周)时,治疗组临床痊愈1例,显效12例,有效18例,无效5例,总有效率为86.11%;对照组治愈0例,显效8例,好转20例,无效8例,总有效率为77.78%。治疗结束后(6周),治疗组临床痊愈3例,显效21例,有效10例,无效2例,总有效率为94.44%;对照组治愈1例,显效16例,好转14例,无效5例,总有效率为86.1%。对两组疗效进行比较,治疗3周后,差异不具有统计学意义(P0.05);治疗6周后疗效比较,差异具有统计学意义(P0.05)。(2)两组治疗中、治疗结束时,THI症状量表评分,以及THI量表评分功能性、情绪性、灾难性评分,纯音听阈测试结果与治疗前比较,差异均有高度统计学意义(P0.01)。对两组进行组间比较,两组治疗3周后差异不具有统计学意义(P0.05);治疗6周后疗效比较,差异具有统计学意义(P0.05)。结论(1)天竺灸结合针刺、常规针刺治疗神经性耳鸣均有疗效,且天竺灸结合针刺组的总有效率优于常规针刺组。(2)天竺灸结合针刺治疗神经性耳鸣,在改善THI量表情绪性、功能性评分方面优于对照组,改善THI量表灾难性评分方面两组疗效相当。
[Abstract]:Objective to use Tianzhu moxibustion combined with acupuncture in the treatment of neurotic tinnitus. Methods according to the random number table, 72 patients were randomly divided into treatment group (Tianzhu moxibustion combined with acupuncture group) and control group (routine acupuncture group). According to the standard of acupuncture and moxibustion therapy, the two groups were divided into five types: the syndrome of external attack of wind and evil, the syndrome of fire of liver and gallbladder, the syndrome of stagnation of phlegm and fire, the syndrome of deficiency of kidney and essence, and the syndrome of deficiency of spleen and stomach. In the treatment group, the main points: hearing, temporal line, Fengshi, Shenguan, Waiguan, Zhongzhu, external ear canal Shi Tianzhu moxibustion; in the control group, main points: hearing palace, hearing, Yifeng, Zhongzhu, Xiaxi. According to acupuncture and moxibustion therapy, the two groups were assigned points: those with wind evil attack, plus wind pond, Waiguan, Hegu; those with liver-gallbladder fire, add line, Qiu market, foot sobbing; those with phlegm and fire stagnation, Jia Feng long, chamber; those with deficiency of kidney essence, Jia Tai Xi, Guan Yuan; Weak spleen and stomach, aerated sea, Zusanli. The two groups had the same course of treatment, once a day, 5 times a week, rest at the weekend, and treated for 6 weeks. The changes of THI score and pure tone audiometry were observed during the treatment (3 weeks) and 6 weeks after the treatment. The THI score was taken as the therapeutic observation index and the treatment results were statistically analyzed and evaluated. Results (1) there were 72 patients in both groups. After one course of treatment (3 weeks), 1 case was cured, 12 cases were effective, 18 cases were effective, 5 cases were ineffective, and the total effective rate was 86.11% in the treatment group, while in the control group, 0 cases were cured, 8 cases were improved, 20 cases were improved, 8 cases were ineffective. The total effective rate was 77.78. In the treatment group, 3 cases were cured, 21 cases were effective, 10 cases were effective, 2 cases were ineffective, the total effective rate was 94.444.In the control group, 1 case was cured, 16 cases were markedly effective, 14 cases were improved, 5 cases were ineffective, and the total effective rate was 86.1%. After 3 weeks of treatment, the difference was not statistically significant (P0.05); after 6 weeks of treatment, the difference was statistically significant (P0.05). (2), and the scores of Thi symptom scale and THI scale were functional at the end of treatment. The scores of emotion, catastrophic score and pure tone audiometry were significantly different from those before treatment (P0.01). There was no significant difference between the two groups after 3 weeks of treatment (P0.05); after 6 weeks of treatment, the difference was statistically significant (P0.05). Conclusion (1) Tianzhu moxibustion combined with acupuncture and routine acupuncture are effective in the treatment of neurotic tinnitus, and the total effective rate of Tianzhu moxibustion combined with acupuncture group is better than that of routine acupuncture group. (2) Tianzhu moxibustion combined with acupuncture therapy can improve the emotional properties of THI scale. The functional score was better than that of the control group, and the efficacy of the two groups in improving the catastrophic score of THI scale was equal.
【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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