针刺治疗女性尿道综合征的治疗次数与疗效关系研究

发布时间：2018-09-10 19:08

【摘要】：目的：系统归纳现代医学与传统医学对女性尿道综合征的认识、流行病学特征、发病机制、诊断及治疗的研究概况。开展临床研究,观察针刺治疗女性尿道综合征的次数与疗效的关系。方法：本研究选取了于2013年9月-2016年1月期间在北京中医药大学东直门医院针灸科门诊就诊的患者,参照《临床诊疗指南》(人民卫生出版社,2006-06)中《泌尿外科分册》关于女性尿道综合征的诊断标准,结合本试验的纳入、排除、脱落标准,共收治女性尿道综合征患者36例。患者年龄在35-70岁之间,平均年龄为58.4岁。病程最长15年,最短2个月,平均病程3.5年。36名患者均采用传统体针疗法进行针刺治疗,穴位选取八毼、肾俞、膀胱俞、中极大赫、气海、关元、肓俞、神庭、大陵、三阴交、合谷、太冲。其中八毼、肾俞、膀胱俞行快针,得气后起针。中极、大赫、气海、关元、肓俞、神庭、大陵、三阴交、合谷、太冲,得气后留针30min,配合局部红光照射。隔天治疗一次,每周治疗三次。使用国际下尿路症状(LUTS)评分表,以问卷调查形式,分别记录患者治疗前及治疗3次、6次、9次、12次、15次后LUTS评分。采用SPSS21.0统计软件对所得数据进行分析处理,计量资料以均数±标准差(x±s)表示,统计量服从正态分布,采用配对t检验,不服从正态分布,采用非参数检验。P0.05为差异有统计学意义,得出结论。结果：LUTS评分随治疗次数增加整体呈下降趋势,并且前12次治疗,曲线下降趋势明显,第12次至第15次治疗曲线下降趋势趋于平缓。分别将治疗3次与治疗前,治疗6次与3次,治疗9次与6次,治疗12次与9次的LUTS评分进行比较,P0.05,差异有统计学意义,治疗15次与治疗12次比较,P0.05,差异无统计学意义。治疗3次后的尿频症状评分与治疗前比较,治疗15次与治疗12次比较,P0.05,差异无统计学意义,比较治疗6次与治疗3次,治疗9次与治疗6次,治疗12次与治疗9次的尿频症状评分,P0.05,差异有统计学意义。治疗3次后的尿急症状评分与治疗前比较,治疗6次与治疗3次比较,治疗9次与治疗6次比较,治疗12次与治疗9次比较,P0.05,差异有统计学意义,治疗15次与治疗12次比较,P0.05,差异无统计学意义。治疗3次后的尿无力症状评分与治疗前比较,治疗12次与9次比较,15次与12次比较,P0.05,差异无统计学意义。治疗6次、9次、12次、15次与治疗前比较,P0.05,差异有统计学意义。分别比较治疗6次与治疗3次,治疗9次与治疗6次,P0.05,差异有统计学意义。结论：针刺治疗女性尿道综合征有显著临床效果,自第1次至第12次治疗疗效随治疗次数增多有明显增加。第12次治疗后,随治疗次数增多,疗效无明显增加。故每疗程以12次为宜。其中针刺对尿频、尿急症状改善明显,对尿无力症状改善不明显。比较女性尿道综合征的主要症状,针刺治疗尿急症状起效最快,尿频次之,尿无力症状起效最慢。
[Abstract]:Objective: to summarize the knowledge, epidemiological characteristics, pathogenesis, diagnosis and treatment of female urethral syndrome in modern and traditional medicine. The clinical study was carried out to observe the relationship between the times of acupuncture and the curative effect on female urethral syndrome. Methods: this study selected patients from September 2013 to January 2016 in the Department of Acupuncture and moxibustion of Dongzhimen Hospital, Beijing University of traditional Chinese Medicine. According to the Diagnostic criteria of female urethral Syndrome in the guidelines for Clinical diagnosis and treatment (people's Health Publishing House 2006-06), 36 cases of female urethral syndrome were treated according to the criteria of inclusion, exclusion and exfoliation of this test. The age of the patients ranged from 35 to 70 years old, with an average age of 58.4 years. The longest course of disease was 15 years, the shortest period was 2 months, and the mean course of disease was 3.5 years. All the 36 patients were treated with traditional body acupuncture therapy. The acupoints were selected as Bazhou, Shenshu, Biaoshu, Zhongdahe, Qihai, Guan Yuan, Baiyu, Shenting, Daling, Sanyinjiao, Hegu, too Chong. Eight of them, Shen Yu, bladder Yu fast needle, get Qi from the needle. Middle pole, Dahe, Qihai, Guan Yuan, Huangshu, Shenting, Daling, Sanyinjiao, Hegu, Taochong, after 30 minutes, with local red light irradiation. Treatment once every other day, three times a week. The international (LUTS) scale of lower urinary tract symptoms was used to record the LUTS scores before treatment and after 3 times, 9 times and 12 times and 15 times respectively by questionnaire. SPSS21.0 statistical software was used to analyze and process the data. The measured data were expressed as mean 卤standard deviation (x 卤s). The statistical data were normal distribution, paired t test, not normal distribution. The use of non-parametric test. P0.05 as the difference has statistical significance, draw a conclusion. Results with the increase of the number of treatments, the score of the first 12 times of treatment showed a downward trend, and the curve of the first 12 times decreased obviously, and the decreasing trend of the 12th to 15th times of treatment tended to be gentle. The LUTS scores of 3 times and before treatment, 6 times and 3 times, 9 times and 6 times, 12 times of treatment and 9 times of treatment were compared respectively (P 0.05), the difference was statistically significant. There was no significant difference between 15 times of treatment and 12 times of treatment (P 0.05). The urinary frequency symptom score after 3 times of treatment was significantly higher than that before treatment (P 0.05). There was no significant difference between 15 times of treatment and 12 times of treatment (P 0.05). There was no significant difference between treatment and treatment of 6 times and 3 times, 9 times of treatment and 6 times of treatment. The urinary frequency symptom scores of 12 times and 9 times of treatment were significantly different (P 0.05). The scores of urinary symptoms after 3 times of treatment were compared with those before treatment, 6 times of treatment and 3 times of treatment, 9 times of treatment and 6 times of treatment, and 12 times of treatment compared with 9 times of treatment (P 0.05). There was no significant difference between 15 times of treatment and 12 times of treatment (P 0.05). The urinary asthenia symptom score after 3 times of treatment was compared with that before treatment, and there was no significant difference between 12 times and 9 times compared with 15 times and 12 times compared with 12 times (P 0.05). There was a significant difference between 6 times, 9 times, 12 times, 15 times and before treatment (P 0.05). The difference was statistically significant between 6 times of treatment and 3 times of treatment, 9 times of treatment and 6 times of treatment (P 0.05). Conclusion: acupuncture has a significant clinical effect in the treatment of female urethral syndrome, and the curative effect increases with the increase of treatment times from the first time to the 12th time. After the 12 th treatment, the curative effect did not increase with the increase of treatment frequency. Therefore, 12 times per course of treatment is appropriate. Acupuncture can improve urination frequency and urinal symptoms obviously, but it can not improve urine asthenia symptoms. Compared with the main symptoms of female urethral syndrome, acupuncture treatment of urinal symptoms was the fastest, followed by frequent urination, and the slowest onset of urinary asthenia.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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