“传统推拿配合整脊”治疗慢性功能性便秘的临床观察

发布时间：2018-08-25 15:14

【摘要】：目的：对“推拿配合整脊”治疗慢性功能性便秘患者的临床疗效进行观察,探讨其对患者排便功能恢复程度、日常活动质量的改进情况,评价其预后与不良反应率。方法：将60例符合标准的患者,按照随机数表划为人数相等的两组,一组标签为治疗组而另一组标签位对照组。在基础治疗的同时治疗组加上“推拿配合整脊”治疗,一周三次,每天治疗1次,共4周；对照组患者施进行传统的普通推拿手法治疗作为对照,一周三次,疗程安排同治疗组。使用法国Mapi Research Trust机构授权使用的便秘患者生活生存质量问卷量表、便秘程度评分表记录分值。将各项量表的分值进行治疗前后的组内、组间统计分析,以及病情的预后和治疗后不良反应分析。记录的数据输入SPSS 19.0软件进行分析。结果：1、治疗前后结果对比发现,两组患者的CSS分值组内分析差异存在显著性(P0.05)；治疗组和对照组数据在排便功能恢复者一指标上的总有效比率分别为100.00%和83.33%,而治疗后两组数据的CSS评分组间的比较分析后P=0.00(0.05),说明两者差异有显著性,表明“推拿配合整脊”在促进功能性便秘患者功能恢复方面疗效显著。2、相对于治疗前两组的数据,治疗后两组患者的PAC-QOL分值组内分析差异存在显著性(P0.05),且治疗后的分值组间分析后P0.05,提示“推拿配合整脊”能改善患者的生活活动能力,提高生存质量更优。3、治疗组总有效率为93.33%、对照组的为66.67%,经分析P0.05,说明差异有显著性；出口梗阻型的CFC患者中两组的有效率分别为94.44%和65.00%,慢传输型的CFC患者中两组的有效率分别为91.67%和70.00%,提示治疗组在治疗上疗效更显著；且相较于慢传输型,“推拿配合整脊”在出口梗阻型的患者中疗效更优。4、病情预后分析中,治疗组分值的变化,经数据分析P0.05,差异不显著；对照组中随访时的CSS评分与治疗4周的结果相比有部分增高,统计分析P0.05,有统计学意义。说明在两种治疗方法干预下,治疗组的预后更好,提示“推拿配合整脊法”在预防CFC复发方而效果显著,患者经治疗后预后更佳。5、不良反应分析中治疗组为6.67%、对照组为13.33%,经过分析P0.05,差异不显著,提示两种治疗方法都较安全易被患者接纳。结论：“推拿配合整脊法”在治疗慢性功能性便秘方面(特别在出口梗阻型患者中)疗效肯定,儿预后病情恢复良好,危险性低,操作简便。
[Abstract]:Objective: to observe the clinical effect of massage combined with chiropractic in the treatment of patients with chronic functional constipation, to explore the improvement of defecation function and the quality of daily activities, and to evaluate the prognosis and adverse reaction rate of patients with chronic functional constipation. Methods: sixty patients who met the criteria were divided into two equal groups according to the random number table, one group was labeled as treatment group and the other group was labeled as control group. In addition to basic treatment, the treatment group was treated with "massage plus chiropractic", three times a week, once a day, for a total of four weeks. The patients in the control group were treated with traditional massage manipulation as the control group, three times a week. The course of treatment was the same as the treatment group. The quality of life questionnaire (QOL) and constipation scale were used to record the scores of constipation patients. The scores of each scale were analyzed by intra-group and inter-group statistical analysis before and after treatment, as well as the prognosis and adverse reactions after treatment. The recorded data were analyzed by SPSS 19.0 software. Results: 1. The results before and after treatment showed that there was a significant difference in CSS scores between the two groups (P0.05). The total effective ratio of the data of the treatment group and the control group was 100.00% and 83.33in the index of the recovery of defecation function, respectively. The comparison of the CSS scores between the two groups after treatment showed that there was a significant difference between the two groups. The results showed that "massage combined with chiropractic" had a significant effect on promoting functional constipation in patients with functional constipation, compared with the data of the two groups before treatment. There was significant difference in PAC-QOL scores between the two groups after treatment (P0.05), and the scores after treatment were analyzed among groups (P0.05), indicating that "massage combined with chiropractic" can improve the patients' ability of life and activity. The total effective rate was 93.33 in the treatment group and 66.67 in the control group. The effective rates of the two groups were 94.44% and 65.00% in the CFC patients with outlet obstruction and 91.67% and 70.005% in the slow transit type CFC patients, respectively, indicating that the treatment group was more effective than the slow transit type. The curative effect of "massage combined with chiropractor" was better in the patients with outlet obstruction. There was no significant difference in the changes of the scores of the treatment group in the prognosis analysis of the patients with outlet obstruction (P0.05). In the control group, the CSS score at follow-up was significantly higher than that in the 4 week treatment group (P 0.05, P < 0.05). The results showed that the prognosis of the treatment group was better than that of the control group, suggesting that "massage combined with chiropractic therapy" was effective in preventing the recurrence of CFC. After treatment, the prognosis of the patients was better. The adverse reaction analysis showed that the treatment group was 6.67 and the control group was 13.33. The difference was not significant (P0.05), suggesting that the two treatment methods were safe and easy to be accepted by the patients. Conclusion: massage combined with chiropractic therapy is effective in the treatment of chronic functional constipation (especially in outlet obstructive patients). The prognosis of infants is good, the risk is low, and the operation is simple.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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