麦粒灸治疗肾虚型腰痛及其临床疗效观察

发布时间：2019-02-22 14:07

【摘要】：背景：肾虚型腰痛是腰痛临床上常见病之一,随着社会的不断发展,生活压力的不断增加,肾虚型腰痛的发病率也在不断地增长。中医治疗肾虚型腰痛多采用口服中药、针灸推拿等方法,疗效尚佳。艾灸也常用在肾虚型腰痛的中医治疗当中,其中麦粒灸既有艾的温补作用,具有温补、通络、散寒止痛之功,治疗虚证的效果可。现代文献表明麦粒灸有消炎镇痛的作用。麦粒灸有刺激量大,定位准确、操作简单等优点,便于临床使用。目的：本课题采用麦粒灸治疗肾虚型腰痛,对照组采用温和灸治疗,通过观察麦粒灸治疗肾虚型腰痛的临床疗效,为麦粒灸治疗肾虚型腰痛提供临床依据。方法：将符合纳入标准的肾虚型腰痛患者共66例,采用随机对照方法分至治疗组和对照组,治疗组33例,对照组33例,对照组予温和灸治疗,治疗组予麦粒灸治疗,研究周期为1个月,从视觉模拟VAS评分、JOA腰痛症状评分两方面进行治疗前、治疗后组内和组间比较,评价两组患者临床疗效差异。结果：1.治疗前麦粒灸组和温和灸组患者年龄、性别、病程、中医证型、基线组间比较,无显著性差异(P0.05)组间存在可比性。2.VAS视觉模拟评分比较：治疗前与1个疗程后、2个疗程后两组组内前后比较,患者的VAS视觉模拟评分均减低,有显著性差异(P0.05)。治疗1个疗程后麦粒灸组和温和灸组组间比较,有显著性差异(P0.05)。治疗2个疗程后麦粒灸组和温和灸组组间比较,有显著性差异(P0.05)。3.JOA腰痛症状评分：治疗前与1个疗程后、2个疗程后两组组内前后比较,JOA腰痛症状评分均上升,有显著性差异(P0.05)。治疗1个疗程后麦粒灸组和温和灸组组间比较,无显著性差异(P0.05)。治疗2个疗程后麦粒灸组和温和灸组组间比较,有显著性差异(P0.05)。4.总体疗效比较：麦粒灸组治愈4例,显效18例,有效9例,无效2例,总有效率93.93%。温和灸组治愈2例,显效13例,有效14例,无效4例,总有效率87.89%。两组患者治疗总有效率比较,麦粒灸组优于温和灸组(P0.05)。结论：麦粒灸和温和灸对肾虚型腰痛均有疗效,都能改善患者的腰痛症状、体征和肢体受限功能。2.麦粒灸治疗肾虚型腰痛的效果对患者腰痛症状、体征等改善优于温和灸组。
[Abstract]:Background: low back pain of kidney deficiency type is one of the common diseases of low back pain. With the development of society and the increasing of life pressure, the incidence of low back pain of kidney deficiency type is also increasing. Chinese medicine treatment of kidney deficiency low back pain by oral Chinese medicine, acupuncture massage and other methods, the curative effect is good. Moxibustion is also commonly used in the treatment of kidney deficiency type of low back pain, in which wheat grain moxibustion not only has the effect of warming up, clearing the collaterals, dispersing cold and relieving pain, but also the effect of treating deficiency syndrome. Modern literature shows that grain moxibustion has anti-inflammatory and analgesic effect. Grain moxibustion has the advantages of large stimulation, accurate positioning, simple operation, and is convenient for clinical use. Objective: to treat kidney deficiency low back pain with grain moxibustion and mild moxibustion with mild moxibustion in control group, and to provide clinical basis for grain moxibustion treatment of kidney deficiency low back pain by observing the clinical effect of grain moxibustion on low back pain of kidney deficiency type. Methods: 66 patients with low back pain of kidney deficiency type were divided into treatment group (n = 33) and control group (n = 33), the control group (n = 33) were treated with mild moxibustion, the treatment group (n = 33) were treated with moxibustion, and the control group (n = 33) were treated with grain moxibustion. The study period was 1 month. The clinical efficacy of the two groups was compared before and after treatment with visual analog VAS score and JOA low back pain symptom score. Results: 1. Before treatment, there was no significant difference in age, sex, course of disease, TCM syndrome type and baseline group between the two groups (P0.05). Comparison of 2.VAS visual analogue score: before and after treatment, there was no significant difference between the two groups. After two courses of treatment, the VAS visual analogue scores of the two groups were significantly lower than those of the two groups (P0.05). After one course of treatment, there was a significant difference between grain moxibustion group and mild moxibustion group (P0.05). There was significant difference between grain moxibustion group and mild moxibustion group after 2 courses of treatment (P0.05). The score of 3.JOA low back pain symptom: before and after one course of treatment, after 2 courses of treatment, there was a significant difference between the two groups before and after treatment. JOA low back pain symptom scores were increased, there was significant difference (P0.05). There was no significant difference between grain moxibustion group and mild moxibustion group after one course of treatment (P0.05). There was significant difference between grain moxibustion group and mild moxibustion group after two courses of treatment (P0.05). Comparison of total curative effects: 4 cases were cured, 18 cases were markedly effective, 9 cases were effective, 2 cases were ineffective in the moxibustion group, the total effective rate was 93.93%. In mild moxibustion group, 2 cases were cured, 13 cases were markedly effective, 14 cases were effective and 4 cases were ineffective. The total effective rate was 87.89%. The total effective rate of the two groups was better than that of the mild moxibustion group (P0.05). Conclusion: both granulated moxibustion and mild moxibustion have curative effect on kidney deficiency low back pain, both of which can improve the symptoms, signs and limited function of limbs of patients with kidney deficiency. 2. The effect of granulated moxibustion on low back pain of kidney deficiency type was better than that of mild moxibustion group.
【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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