平衡针结合传统针刺治疗肩周炎的临床研究
发布时间：2019-04-27 00:07
【摘要】：目的:本研究旨在观察平衡针结合传统针刺治疗肩周炎的疗效,经过采用随机对照方法,与传统针刺相对照,以探求治疗肩周炎有效的治疗方案。方法:回顾总结近年来肩周炎的定义、中医病名、中医病因病机、流行病学、现代医学发病机理及临床临床常见治疗方法等理论研究成果,以确立本观察方案。本研究包含的研究对象是广中医一附属针灸科的病人,共收治符合本研究方案纳入标准的肩周炎患者60例,随机分为对照组30例、治疗组30例。其中,治疗组患者为暴露患侧肩部,选取坐位、侧卧位。穴位常规消毒后,将针刺入穴位,做捻转提插泻法运针,以患侧肩关节局部有较强酸胀感为度,之后主穴(肩前穴-肩贞穴,肩髁穴-肩毼穴)接G6805电针仪(上海制造),采用疏密波,刺激量以患者能耐受为度,余穴留针,每次30分钟。出针后,患者取坐位,暴露患肩对侧小腿,取肩痛穴,常规消毒后,采用华佗牌30号1.5寸针灸针快速刺入穴位,行快速地捻转提插运针,同时嘱患者尽可能做最大范围肩部环旋动作,当足面、足趾或腓浅神经出现触电样针感时,快速出针不留针。每周治疗五次,每日一次(周一至周五),两周为一疗程,共治疗一个疗程。治疗组亦选取上述肩部穴位,并采用相同的操作方法,然出针后取患肩对侧条口穴,常规消毒后,采用华佗牌30号1.5寸针灸针快速刺入穴位,使针尖向承山穴方向透刺,每周治疗五次,每日一次(周一至周五),两周为一疗程,共治疗一个疗程。治疗前后,比较治疗组和对照组患者的疼痛视觉模拟(VAS)评分表和肩关节活动度(Melle评分),以判定治疗效果,比较二者间的差异。结果:1.经查阅相关文献后,对肩周炎的病因、发病机制、症状、体征及治疗方法有了较深入和较全面的认识。2.治疗组30例,其中女性17例,男性13例,平均年龄为56.50±12.54岁,年龄范围为23-77岁;对照组30例,其中女性17例,男性13例,平均年龄为56.13±13.02,年龄范围为22-75岁。两组患者的病程均在6月内。经检验两组病例在年龄、性别、病程方面均无显著性差异,具有可比性。3.经t检验治疗组与对照组在治疗前疼痛视觉模拟(VAS)评分和肩关节活动度(Melle评分)亦均无显著性差异,具有可比性。4.治疗后对两组VAS评分进行比较,治疗组治疗前VAS评分为7.07±1.02,治疗后VAS评分为3.87± 1.04;对照组治疗前VAS评分为6.27±0.98,对照组治疗后VAS评分为3.90±0.80,两组治疗后VAS评分与治疗前VAS评分比较均有明显差异(p0.05);比较治疗后两组间VAS评分,差异显著。可知:治疗组与对照组都能降低VAS评分,并且前者降低VAS评分方面明显优于后者。5.治疗后对两组Melle评分进行比较,治疗组治疗前Melle评分为10.40±1.25,治疗后Melle评分为3.67± 1.37;对照组治疗前Melle评分为10.20± 1.61,对照组治疗后Melle评分为6.80±2.63,两组治疗后Melle评分与治疗前比较均有明显差异(P0.05)。比较治疗后两组间Melle评分,有明显差异。可知:治疗组与对照组都能降低Melle评分,并且前者降低Melle评分方面明显优于后者。6.比较治疗组与对照组疗效,治疗组未愈3例,有效7例,显效13例,治愈7例,总有效率90.00%;对照组未愈10例,有效8例,治愈3例,显效9例,总有效率63.33%。经Ridit分析,P=0.020.05,差异性显著。可知,治疗组疗效明显优于对照组。结论:平衡针结合传统针刺对肩周炎的治疗疗效好,能缓解肩关节疼痛,改善肩关节活动受限情况,从而保障肩周炎患者的生活质量。
[Abstract]:Objective: The purpose of this study is to observe the curative effect of balance needle combined with traditional acupuncture on the treatment of scapulohumeral periarthritis. Methods: The definition of scapulohumeral periarthritis in recent years, the name of traditional Chinese medicine, the etiology and pathogenesis of TCM, the epidemiology, the mechanism of the pathogenesis of modern medicine and the common treatment methods of clinical practice were reviewed in order to establish the observation plan. The study included a total of 60 cases of scapulohumeral periarthritis, which were included in the study protocol, and were randomly divided into control group (n = 30) and treatment group (30 cases). In the treatment group, the patient was exposed to the shoulder of the affected side, and the sitting position and the lateral position were selected. After the conventional disinfection of the acupuncture points, the acupuncture points are inserted, and then the needle is inserted into the acupuncture point, so that the shoulder joint of the affected side is locally provided with a strong strong acid expansion feeling, and then the main point (the shoulder-shoulder-shoulder, the shoulder-shoulder and the shoulder-shoulder point) is connected with a G6805 electro-acupuncture instrument (Shanghai manufacturing), and the sparse-dense wave is adopted, The amount of stimulation can be tolerated by the patient, and the remaining points are retained for 30 minutes each time. After the needle is out, the patient takes the sitting position, exposes the opposite leg of the affected shoulder, and takes the shoulder and pain points; after the conventional disinfection, the acupuncture needle with the size of 1.5 inches of the Chinese medicine card is used to rapidly penetrate the acupuncture points, When an electric shock-like needle is present in the toe or the superficial peroneal nerve, the needle is quickly released without leaving the needle. Treatment five times a week, once a day (from Monday to Friday), two weeks for a course of treatment, and a course of treatment. The treatment group also selects the above-mentioned shoulder points, and adopts the same operation method, and then, after the needle is taken out of the needle, the opposite side strip of the shoulder is taken out, and after the conventional disinfection, the acupuncture needle with the size of the Chinese medicine 30 is used to rapidly penetrate the acupuncture points, so that the needle point is penetrated in the direction of the bearing hill, and the acupuncture points are treated five times per week, One course per day (Monday to Friday) and two weeks for a course of treatment. The pain visual simulation (VAS) and the shoulder motion (Melle score) were compared between the treatment group and the control group before and after treatment to determine the treatment effect and to compare the difference between them. Results:1. After consulting the relevant literature, the causes, the pathogenesis, the symptoms, the signs and the treatment methods of the scapulohumeral periarthritis have been deeply and comprehensively recognized. The average age of the treatment group was 56.50 and 12.54 years. The age range was 23-77 years. The average age of the control group was 56.13-13.02, and the age ranged from 22 to 75 years. The course of the two groups was within 6 months. There was no significant difference in age, sex and course of the two groups. The pre-treatment pain visual (VAS) score and the shoulder motion (Melle score) were not significantly different between the treatment group and the control group by the t-test and control group, and were comparable. The VAS scores were 7.07 and 1.02 in the treatment group and 3.87 to 1.04 after the treatment, and the VAS score was 6.27 to 0.98 in the control group and 3.90 to 0.80 for the control group after the treatment. The VAS scores in the two groups were significantly different from the pre-treatment VAS scores (p0.05), and the difference was significant between the two groups after the treatment. It can be seen that both the treatment group and the control group can reduce the VAS score, and the former decreases the VAS score better than the latter. In the treatment group, the Melle score was 10.40-1.25, the Melle score was 3.67-1.37 after the treatment, and the Melle score was 10.20-1.61 in the control group and 6.80-2.63 in the control group. There was a significant difference between the post-treatment Melle score and the pre-treatment (P0.05). There was a significant difference in the Melle scores between the two groups after the treatment. It can be seen that the Melle score can be reduced in both the treatment group and the control group, and the former is superior to the latter in the reduction of the Melle score. The curative effect of the treatment group and the control group was compared. In the treatment group,3 cases were not recovered,7 cases were effective,13 cases were effective,7 cases were cured, the total effective rate was 90.00%,10 cases in the control group,8 cases were effective,3 cases were cured,9 cases were effective, and the total effective rate was 63.33%. After the analysis of Ridit, P = 0.020.05, the difference was significant. It was found that the curative effect of the treatment group was better than that of the control group. Conclusion: The balance needle combined with the traditional acupuncture has good curative effect on the scapulohumeral periarthritis, can relieve the pain of the shoulder joint, improve the limited condition of the shoulder joint, and thus guarantee the quality of life of the patients with scapulohumeral periarthritis.
【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】：R246.9
本文编号：2466512
[Abstract]:Objective: The purpose of this study is to observe the curative effect of balance needle combined with traditional acupuncture on the treatment of scapulohumeral periarthritis. Methods: The definition of scapulohumeral periarthritis in recent years, the name of traditional Chinese medicine, the etiology and pathogenesis of TCM, the epidemiology, the mechanism of the pathogenesis of modern medicine and the common treatment methods of clinical practice were reviewed in order to establish the observation plan. The study included a total of 60 cases of scapulohumeral periarthritis, which were included in the study protocol, and were randomly divided into control group (n = 30) and treatment group (30 cases). In the treatment group, the patient was exposed to the shoulder of the affected side, and the sitting position and the lateral position were selected. After the conventional disinfection of the acupuncture points, the acupuncture points are inserted, and then the needle is inserted into the acupuncture point, so that the shoulder joint of the affected side is locally provided with a strong strong acid expansion feeling, and then the main point (the shoulder-shoulder-shoulder, the shoulder-shoulder and the shoulder-shoulder point) is connected with a G6805 electro-acupuncture instrument (Shanghai manufacturing), and the sparse-dense wave is adopted, The amount of stimulation can be tolerated by the patient, and the remaining points are retained for 30 minutes each time. After the needle is out, the patient takes the sitting position, exposes the opposite leg of the affected shoulder, and takes the shoulder and pain points; after the conventional disinfection, the acupuncture needle with the size of 1.5 inches of the Chinese medicine card is used to rapidly penetrate the acupuncture points, When an electric shock-like needle is present in the toe or the superficial peroneal nerve, the needle is quickly released without leaving the needle. Treatment five times a week, once a day (from Monday to Friday), two weeks for a course of treatment, and a course of treatment. The treatment group also selects the above-mentioned shoulder points, and adopts the same operation method, and then, after the needle is taken out of the needle, the opposite side strip of the shoulder is taken out, and after the conventional disinfection, the acupuncture needle with the size of the Chinese medicine 30 is used to rapidly penetrate the acupuncture points, so that the needle point is penetrated in the direction of the bearing hill, and the acupuncture points are treated five times per week, One course per day (Monday to Friday) and two weeks for a course of treatment. The pain visual simulation (VAS) and the shoulder motion (Melle score) were compared between the treatment group and the control group before and after treatment to determine the treatment effect and to compare the difference between them. Results:1. After consulting the relevant literature, the causes, the pathogenesis, the symptoms, the signs and the treatment methods of the scapulohumeral periarthritis have been deeply and comprehensively recognized. The average age of the treatment group was 56.50 and 12.54 years. The age range was 23-77 years. The average age of the control group was 56.13-13.02, and the age ranged from 22 to 75 years. The course of the two groups was within 6 months. There was no significant difference in age, sex and course of the two groups. The pre-treatment pain visual (VAS) score and the shoulder motion (Melle score) were not significantly different between the treatment group and the control group by the t-test and control group, and were comparable. The VAS scores were 7.07 and 1.02 in the treatment group and 3.87 to 1.04 after the treatment, and the VAS score was 6.27 to 0.98 in the control group and 3.90 to 0.80 for the control group after the treatment. The VAS scores in the two groups were significantly different from the pre-treatment VAS scores (p0.05), and the difference was significant between the two groups after the treatment. It can be seen that both the treatment group and the control group can reduce the VAS score, and the former decreases the VAS score better than the latter. In the treatment group, the Melle score was 10.40-1.25, the Melle score was 3.67-1.37 after the treatment, and the Melle score was 10.20-1.61 in the control group and 6.80-2.63 in the control group. There was a significant difference between the post-treatment Melle score and the pre-treatment (P0.05). There was a significant difference in the Melle scores between the two groups after the treatment. It can be seen that the Melle score can be reduced in both the treatment group and the control group, and the former is superior to the latter in the reduction of the Melle score. The curative effect of the treatment group and the control group was compared. In the treatment group,3 cases were not recovered,7 cases were effective,13 cases were effective,7 cases were cured, the total effective rate was 90.00%,10 cases in the control group,8 cases were effective,3 cases were cured,9 cases were effective, and the total effective rate was 63.33%. After the analysis of Ridit, P = 0.020.05, the difference was significant. It was found that the curative effect of the treatment group was better than that of the control group. Conclusion: The balance needle combined with the traditional acupuncture has good curative effect on the scapulohumeral periarthritis, can relieve the pain of the shoulder joint, improve the limited condition of the shoulder joint, and thus guarantee the quality of life of the patients with scapulohumeral periarthritis.
【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】：R246.9
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