基于补泻手法研究一指禅推法治疗虚证便秘的疗效观察
发布时间：2018-11-07 18:10
【摘要】：目的:推拿作为一种有效、简便的传统疗法,在临床上被广泛应用于治疗各种疾病,但关于推拿手法的研究则大多停留于对疾病疗效的影响研究,而较少提及手法的基础研究,如手法的操作时间、频率、作用力等方面,从而缺乏较为系统的研究。一指禅推法作为推拿手法中较有代表性的手法之一,同样也很少提到运用手法时采取不同的刺激量(强度)对疾病的影响,如作用力这一因素,作用力的大小并没有做出明确的界定,以至于无法确定作用力对一指禅推法的疗效的影响大小。所以本次研究将从作用力着手,尝试探究作用力对一指禅推法的疗效影响,通过比较轻、重手法(自拟值域标准)的一指禅推法分别对治疗虚证便秘的疗效差别,探讨一指禅推法的补泻作用,得到一组可靠、实用的有效作用力数据,从而为一指禅推法,乃至其他推拿手法的标准化、量效化提供参考,为临床治疗所使用。方法:选用60例确诊为虚证便秘的受试者,主要来自于本校一附院推拿门诊、针灸门诊。将收入的受试者按随机分配分为两组,每组30例,在同一组穴位上分别采用轻压力、重压力一指禅推法进行治疗,每个穴位操作2分钟,两天治疗1次,一个星期治疗3次,共计治疗两个星期。所得数据运用Cleveland便秘评分系统(CCS)和便秘患者生存质量量表(PAC-QOL)进行评分。观察治疗前和治疗后患者症状的改变情况,再将两者疗效进行对比研究。选用腧穴如下:合谷(双侧),支沟(双侧),中脘,天枢(双侧),上巨虚(双侧)。结果:经过两个星期治疗后,将受试者治疗前与治疗后所得数据使用spss20.0统计学软件进行秩和检验进行统计分析。1、Cleveland便秘评分系统组内比较:轻压力组的治疗前与治疗后总分对比P0.01,提示本次研究具有统计学意义,说明经过治疗后受试者症状得到明显改善;重压力组的治疗前与治疗后总分对比P0.05,无统计学差异;组间比较:两组治疗前后差值对比P0.01,说明本次研究两组治疗效果有明显差异。2、便秘患者生存质量量表组内比较:轻压力组的治疗前与治疗后总分对比P0.01,提示本次研究具有统计学意义,说明受试者的生活质量经治疗后得到明显的提升;重压力组的治疗前与治疗后总分对比P0.05,无统计学差异;组间比较:两组治疗前后差值对比P0.01,说明本次研究两组治疗效果有明显差异。结论:通过临床试验对比,轻压力值一指禅推法治疗虚证便秘具有良好的疗效,能改善患者的各项症状及提升患者的生活质量;而重压力值一指禅推法治疗虚证便秘无明显的疗效,且有加重病情的可能。
[Abstract]:Objective: as an effective and simple traditional therapy, massage is widely used in clinical treatment of various diseases, but the study of massage manipulation is mostly focused on the effect of disease, and less mention of the basic study of manipulation. Such as manipulation time, frequency, force and so on, so lack of systematic research. As one of the more representative methods of massage, one of the most representative methods of massage is the influence of different stimuli (intensity) on diseases, such as force. The size of the action force is not clearly defined, so it is impossible to determine the effect of the action force on the curative effect of a Zen push method. Therefore, this study will try to explore the effect of the action force on the curative effect of a phalanwhere pushing method from the point of view of force, and the difference of curative effect of the one Zen push method in treating asthenia syndrome constipation by comparing the light and heavy manipulation (self-designed range standard). In order to provide reference for the standardization and quantification of massage manipulation, a group of reliable and practical effective force data were obtained by discussing the reinforcing and reducing effect of the method of one finger meditation and pushing, thus providing a reference for clinical treatment. Methods: 60 subjects diagnosed as deficiency constipation were selected, mainly from the clinic of massage and acupuncture. The subjects were randomly divided into two groups, 30 cases in each group, treated with light pressure, heavy pressure and finger meditation on the same acupoints. Each acupoint was operated for 2 minutes, treated once twice a day, 3 times a week. A total of two weeks of treatment. The data were evaluated by Cleveland constipation scoring system (CCS) and constipation quality of life scale (PAC-QOL). The changes of symptoms before and after treatment were observed and compared with each other. The selected acupoints are as follows: Hegu (bilateral), Zhigou (bilateral), Zhongwan, Tianshu (bilateral), Shangjuxu (bilateral). Results: after two weeks of treatment, the data before and after treatment were analyzed by rank sum test using spss20.0 software. Comparison of Cleveland constipation score system: the total score of mild stress group before and after treatment compared with P0.01, suggesting that this study has statistical significance, indicating that after treatment, the symptoms of the subjects were significantly improved; There was no significant difference in the total score between the two groups before and after treatment (P 0.05). Comparison between the two groups: the difference between the two groups before and after treatment P0.01, indicating that the treatment effect of the two groups is significantly different. 2, constipation patients quality of life scale group comparison: light pressure group before and after treatment of the total score compared to P0.01, The results suggested that the quality of life of the subjects was significantly improved after treatment. There was no significant difference in the total score between the two groups before and after treatment (P0.05). Comparison between the two groups: the difference between the two groups before and after treatment P0.01, indicating that there is a significant difference between the two groups. Conclusion: compared with the clinical trial, the method of light pressure value and finger meditation is effective in treating asthenia syndrome constipation, which can improve the symptoms of the patients and improve the quality of life of the patients. However, the treatment of asthenia constipation with one finger-Zen method has no obvious effect, and it is possible to aggravate the condition.
【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】：R244.1
，
本文编号：2317169
[Abstract]:Objective: as an effective and simple traditional therapy, massage is widely used in clinical treatment of various diseases, but the study of massage manipulation is mostly focused on the effect of disease, and less mention of the basic study of manipulation. Such as manipulation time, frequency, force and so on, so lack of systematic research. As one of the more representative methods of massage, one of the most representative methods of massage is the influence of different stimuli (intensity) on diseases, such as force. The size of the action force is not clearly defined, so it is impossible to determine the effect of the action force on the curative effect of a Zen push method. Therefore, this study will try to explore the effect of the action force on the curative effect of a phalanwhere pushing method from the point of view of force, and the difference of curative effect of the one Zen push method in treating asthenia syndrome constipation by comparing the light and heavy manipulation (self-designed range standard). In order to provide reference for the standardization and quantification of massage manipulation, a group of reliable and practical effective force data were obtained by discussing the reinforcing and reducing effect of the method of one finger meditation and pushing, thus providing a reference for clinical treatment. Methods: 60 subjects diagnosed as deficiency constipation were selected, mainly from the clinic of massage and acupuncture. The subjects were randomly divided into two groups, 30 cases in each group, treated with light pressure, heavy pressure and finger meditation on the same acupoints. Each acupoint was operated for 2 minutes, treated once twice a day, 3 times a week. A total of two weeks of treatment. The data were evaluated by Cleveland constipation scoring system (CCS) and constipation quality of life scale (PAC-QOL). The changes of symptoms before and after treatment were observed and compared with each other. The selected acupoints are as follows: Hegu (bilateral), Zhigou (bilateral), Zhongwan, Tianshu (bilateral), Shangjuxu (bilateral). Results: after two weeks of treatment, the data before and after treatment were analyzed by rank sum test using spss20.0 software. Comparison of Cleveland constipation score system: the total score of mild stress group before and after treatment compared with P0.01, suggesting that this study has statistical significance, indicating that after treatment, the symptoms of the subjects were significantly improved; There was no significant difference in the total score between the two groups before and after treatment (P 0.05). Comparison between the two groups: the difference between the two groups before and after treatment P0.01, indicating that the treatment effect of the two groups is significantly different. 2, constipation patients quality of life scale group comparison: light pressure group before and after treatment of the total score compared to P0.01, The results suggested that the quality of life of the subjects was significantly improved after treatment. There was no significant difference in the total score between the two groups before and after treatment (P0.05). Comparison between the two groups: the difference between the two groups before and after treatment P0.01, indicating that there is a significant difference between the two groups. Conclusion: compared with the clinical trial, the method of light pressure value and finger meditation is effective in treating asthenia syndrome constipation, which can improve the symptoms of the patients and improve the quality of life of the patients. However, the treatment of asthenia constipation with one finger-Zen method has no obvious effect, and it is possible to aggravate the condition.
【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】：R244.1
，
本文编号：2317169
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