针刺治疗盆腔炎性疾病后遗症慢性盆腔痛的临床研究

发布时间：2018-09-14 13:32

【摘要】：研究背景:盆腔炎性疾病后遗症慢性盆腔痛,是多种盆腔炎性疾病反复发作迁延而成,病程长难以治愈且容易诱发,给患者身心生活工作带来严重困扰。抗生素治疗慢性盆腔痛效果不理想,但对盆腔炎急性期发作效果尚好。其多为对症治疗,治疗措施一般是物理治疗、抗菌药物和其他药物治疗,必要时手术。研究目的:通过观察针刺取穴治疗慢性盆腔痛的临床效果,对比出穴位的治疗特性,期望指导临床医生对慢性盆腔痛患者的健康指导及针刺治疗,以减轻疼痛对患者产生的影响。研究方法:本研究中对象均来源于黑龙江中医药大学附属第一医院妇科门诊及住院部,诊断为盆腔炎性疾病后遗症慢性盆腔痛(气滞血瘀型)患者45例(5例要求退出,5例脱落,3例证型错误,2例病例记录不全),最后观察30例患者。收集相关材料,对患者一般情况、治疗前后中医证候、局部体征积分及检查情况等进行记录,运用统计分析软件分析治疗前后的评分情况,间接评价临床效果及其实用性。结果:1、治疗后患者在中医证候、局部体征等方面均有所改善,通过比较,治疗后积分低于治疗前,治疗后明显优于治疗前,具有显著差异(P0.05)。2、治疗后患者痊愈率为16.67%,显效率为43.33%,有效率为26.67%,无效率为13.33%,总有效率为86.67%。结论:盆腔炎性疾病后遗症慢性盆腔痛具有复发率高、治愈率低、病程较长、缠绵难愈等特点,是育龄期妇女常见病,严重影响患者的身心健康。西医常用抗生素治疗,抗菌药物局部难吸收,疗效不佳,长期使用易造成肠道菌群失调及耐药性,故目前尚无特效治疗措施。而中医药特色治疗慢性盆腔痛目前应用比较广泛,患者乐于接受,减少了抗生素的副作用,同时也调理身体,治疗起来比较方便效果明显。本研究采用临床组内治疗前后对照试验,采用中医证候评分表及体征评分表进行评估,以及血液流变学变化的检测和监测等结果,观察慢性盆腔痛的针刺疗法,为其在临床中的实用性提供广泛依据。针刺治疗前后的中医症状及体征及综合积分,经秩和检验说明治疗前后症状、体征有显著差异,具有统计学意义。
[Abstract]:Background: the sequelae of pelvic inflammatory diseases, chronic pelvic pain, is caused by repeated attacks of many pelvic inflammatory diseases, the long course of disease is difficult to cure and easy to induce, which brings serious problems to the patients' physical and mental life and work. Antibiotic treatment of chronic pelvic pain effect is not ideal, but the acute stage of pelvic inflammatory attack effect is still good. Most of them are symptomatic therapy. The treatment measures are physical therapy, antimicrobial drugs and other drugs, and surgery if necessary. Objective: to observe the clinical effect of acupuncture in the treatment of chronic pelvic pain, compare the therapeutic characteristics of acupoints, and expect to guide the clinicians to give health guidance and acupuncture treatment to patients with chronic pelvic pain. In order to alleviate the effect of pain on patients. Methods: the subjects of this study were all from gynecological outpatient department and inpatient department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. There were 45 cases of chronic pelvic pain (Qi stagnation and blood stasis type) diagnosed as sequelae of pelvic inflammatory disease (5 cases asked to quit 5 cases of exfoliation and 3 cases of example error 2 cases of incomplete record), and 30 cases were observed at last. To collect relevant materials, to record the general situation of patients, TCM syndromes, local physical signs and examination before and after treatment, and to use statistical analysis software to analyze the scores before and after treatment, and to evaluate the clinical effect and practicability indirectly. Results: after treatment, the patients improved in TCM syndromes, local signs and so on. By comparison, the score after treatment was lower than that before treatment, and after treatment it was obviously better than before treatment. There was significant difference (P0.05) .2The cure rate of the patients after treatment was 16.677.The effective rate was 43.33. the effective rate was 26.67. the ineffective rate was 13.33.The total effective rate was 86.67. Conclusion: chronic pelvic pain has the characteristics of high recurrence rate, low cure rate, long course of disease and difficult to heal. It is a common disease in women of childbearing age and seriously affects the physical and mental health of patients. Antibiotics are commonly used in western medicine, which are difficult to absorb locally and have poor curative effect. It is easy to cause intestinal flora imbalance and drug resistance in long term use, so there are no special treatment measures at present. The traditional Chinese medicine characteristic treatment of chronic pelvic pain is widely used, patients are willing to accept, reduce the side effects of antibiotics, but also conditioning the body, treatment is more convenient effect. In this study, the clinical control test before and after treatment, the evaluation of TCM syndrome score table and sign score table, and the results of hemorheological changes were used to observe the acupuncture therapy of chronic pelvic pain. To provide a broad basis for its clinical practicability. Before and after acupuncture treatment, the symptoms and signs of traditional Chinese medicine and their integrative scores were significantly different before and after treatment by rank sum test, and there were significant differences in the symptoms and signs before and after treatment, which had statistical significance.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.3

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