通督调任法针刺治疗颈性眩晕的临床研究

发布时间：2018-12-10 18:41

【摘要】：目的：以《颈性眩晕症状与功能评估量表》为主要评估手段,通过对比通督调任法针刺与常规取穴法针刺治疗颈性眩晕的临床疗效,研究通督调任法针刺治疗颈性眩晕的临床疗效,拟为颈性眩晕提供更多有效的治疗方案。方法：将60例符合该课题纳入要求的颈性眩晕患者,采取随机分组法分为治疗组30例及对照组30例。实际完成课题实验共59例,对照组29例,治疗组30例。治疗组以通督调任法为指导,通督取穴位风府、脑户、大椎、后溪(双),调任取穴位气海、中脘、列缺(双),结合辨证取穴。对照组按常规取穴法取颈椎夹脊(C4-7)、天柱(双)、风池(双)、百会、悬钟(双),辨证取穴同治疗组。两组皆留针0.5h,每隔lOmin以平补平泻捻转法运针。每天治疗1次,连续5天为一个疗程,第一疗程结束后休息2天开始第二个疗程。共进行两个疗程。采用《眩晕症状与功能评估量表》分别对治疗前及第2疗程结束时进行评分,其结果运SPSS 22.0软件进行分析比较。以验证通督调任法针刺治疗本病的临床疗效。结果：对治疗前两组患者性别、年龄、病程、中医证型及《眩晕症状与功能评估量表》评分进行组间比较,经统计学分析(P0.05),差异不具统计学意义,说明两组病例具有可比较性。1.治疗组治疗前后比较：治疗组实际完成病例数30例,治疗前《眩晕症状与功能评估量表》评分20.5分的有11例,20.5-30分的7例,30分的有2例；治疗后分别为2例、2例、26例。使用Ridit检验对治疗前后的评分进行分析,治疗后评分较治疗前提高,差异有统计学意义(P0.05),说明治疗组治疗后症状及生活心理情况较治疗前有明显改善。2.对照组治疗前后比较：对照组实际完成病例数29例,治疗前《眩晕症状与功能评估量表》评分20.5分的有9例,20.5-30分的13例,30分的有7例；治疗后分别为1例、9例、19例。使用Ridit检验对治疗前后的评分进行分析,治疗后评分较治疗前提高,差异有统计学意义(P0.05),说明对照组治疗后症状及生活心理情况较治疗前有明显改善。3.组间比较：治疗组治疗后《眩晕症状与功能评估量表》评分较治疗前提高分,其中提高7分的有5例,提高7-14分的有9例,提高14分的有16例；对照组治疗后《眩晕症状与功能评估量表》评分较治疗前提高,其中提高7分的有8例,提高7-14分的有20例,提高14分的有1例；使用Ridit检验,治疗组治疗前后评分差值较对照组大,差值具有统计学意义(P＜0.05),说明治疗组评分改善明显优于对照组。4.疗效比较：治疗2个疗程后,治疗组治愈6例,显效11例,有效10例,无效3例；对照组治愈4例,显效7例,有效12例,无效6例。经Ridit检验分析,两组总有效率无明显差异(P＞0.05)。结论：通督调任法针刺能改善颈性患者的眩晕情况及眩晕对其生活心理的影响,与常规取穴法相比,通督调任法针刺的临床疗效更为显著。
[Abstract]:Objective: to evaluate the symptoms and function of cervical vertigo by comparing the clinical effect of acupuncture with Tongdu-Ren method and conventional acupoint acupuncture in the treatment of cervical vertigo. To study the clinical effect of acupuncture on cervical vertigo by transposition of Tongdu and to provide more effective treatment for cervical vertigo. Methods: 60 patients with cervical vertigo were randomly divided into treatment group (n = 30) and control group (n = 30). There were 59 cases in the experiment, 29 cases in the control group and 30 cases in the treatment group. The treatment group was guided by Tongdu transfer method, Tongdu took acupoints Fengfu, Naohu, Dazhui, Houxi (double), transferred to take points of air sea, Zhongwan, column deficiency (double), combined with syndrome differentiation. In the control group, the cervical spine (C4-7), Tianzhu (double), Fengchi (double), Baihui, Xuanzhong (double) were collected according to the routine method. In both groups, the needle was kept for 0.5 h, and the needle was transported with the method of flat nourishing and flattening and twirling every lOmin. Once a day, 5 consecutive days as a course of treatment, the first course of rest 2 days after the start of the second course. Two courses of treatment were performed. The vertigo symptom and function evaluation scale was used to evaluate the scores before treatment and at the end of the second course of treatment. The results were analyzed and compared with SPSS 22.0 software. In order to verify the Tongdu transfer method acupuncture treatment of the clinical efficacy of this disease. Results: sex, age, course of disease, TCM syndrome type and score of < vertigo symptom and function evaluation scale > were compared between the two groups before treatment. The difference was not statistically significant (P0.05). Indicating that the two groups of cases are comparable. 1. Comparison before and after treatment in the treatment group: 30 cases were actually completed in the treatment group. Before treatment, there were 11 cases with 20.5 score of vertigo symptom and function evaluation scale, 7 cases with 20.5-30 points and 2 cases with 30 points. After treatment, there were 2 cases, 2 cases and 26 cases respectively. Ridit test was used to analyze the scores before and after treatment, the scores after treatment were higher than before treatment, the difference was statistically significant (P0.05), indicating that the treatment group after treatment symptoms and life and psychological conditions were significantly improved compared with before treatment. 2. Comparison before and after treatment in the control group: 29 cases were actually completed in the control group. Before treatment, there were 9 cases with 20.5 score of vertigo symptom and function evaluation scale, 13 cases with 20.5-30 points and 7 cases with 30 points. After treatment, there were 1 case, 9 cases and 19 cases respectively. Ridit test was used to analyze the scores before and after treatment, the scores after treatment were higher than before treatment, the difference was statistically significant (P0.05), indicating that the symptoms and psychological status of the control group were significantly improved after treatment. 3. Comparison between groups: the score of "vertigo symptom and function evaluation scale" after treatment in the treatment group was higher than that before treatment. Among them, 5 cases increased 7 points, 9 cases improved 7-14 points, and 16 cases improved 14 points. The score of vertigo symptom and function evaluation scale after treatment in control group was higher than that before treatment. Among them, 8 cases increased 7 points, 20 cases improved 7-14 points, and 1 case increased 14 points. Using Ridit test, the difference of score before and after treatment in the treatment group was larger than that in the control group (P < 0. 05), which indicated that the improvement of the score in the treatment group was obviously better than that in the control group. Comparison of therapeutic effects: 6 cases were cured, 11 cases were effective, 10 cases were effective, 3 cases were ineffective in the treatment group, 4 cases were cured, 7 cases were remarkable effect, 12 cases were effective, and 6 cases were ineffective in the control group. There was no significant difference in the total effective rate between the two groups by Ridit test (P > 0. 05). Conclusion: acupuncture can improve the condition of vertigo and the influence of vertigo on the life psychology of cervical patients. Compared with the routine method of acupoint collection, the clinical effect of acupuncture by transposition of Tongdu and Ren is more obvious.
【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】：2016
【分类号】：R246.9

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