针刺结合温润附葛汤治疗阳虚型干燥综合征的临床疗效观察
发布时间：2019-07-05 05:39
【摘要】：目的:通过观察针刺结合温润附葛汤对阳虚型干燥综合征(SS)的有效性,为临床治疗SS提供一种新的临床思路和辨证依据。方法:1.研究对象:全部来自于2016年3月至2017年3月老年病三门诊就诊的患者。2.分组:将符合纳入标准的90例干燥综合征患者随机分为针药组、针刺组和西药组,每组各30例。3.治疗方法:针药组予以针刺与温润附葛汤联合治疗,即针刺睛明、金津、玉液、牵正、肾俞、脾俞、命门及三阴交穴,同时配合口服温润附葛汤;针刺组采用单纯针刺治疗;西药组予以口服硫酸羟氯喹每次0.2g,日2次治疗;三种疗法皆治疗8周。4.观察指标:在治疗前后观察三组患者的临床症状,记录中医证候评分、外分泌腺检查(即Schirmer试验和唾液流率试验)、ESR、IgG、抗SSA及抗SSB实验室指标。5.统计方法:采用SPSS17.0软件进行统计分析三组治疗前后各指标变化,对比临床疗效。结果:1.临床疗效比较:针药组痊愈3例,显效12例,有效13例,无效2例,总有效率93.3%;针刺组痊愈0例,显效3例,有效17例,无效10例,总有效率66.7%;西药组痊愈0例,显效5例,有效16例,无效9例,总有效率70.0%。具有统计学意义(P0.05)。2.中医证候评分比较:三组中医证候评分较疗前均减少;治疗后针药组与针刺组、西药组比较具有统计学意义(P0.05)。3.腺体分泌量比较:三组治疗后腺体分泌量较前均增加;治疗后针药组与西药组、针刺组比较具有统计学意义(P0.05)。4.ESR、IgG比较:三组治疗后ESR、IgG较前均有所降低;治疗后针药组与西药组、针刺组比较具有统计学意义(P0.05)。5.抗SSA、抗SSB比较:三组治疗前后抗SSA、抗SSB比较P0.05,无统计学意义;但各抗体阳性率均有所下降,且针药组阳性率降低优于西药组和针刺组。结论:1.针刺结合温润附葛汤对治疗阳虚型干燥综合征有效。2.针刺结合温润附葛汤能有效减少中医证候评分、增加腺体分泌量,降低ESR、IgG水平,其疗效优于西药组和针刺组。
[Abstract]:Objective: to observe the effectiveness of acupuncture combined with Wenrun Fuge decoction in the treatment of (SS) with Yang deficiency Sjogren's syndrome (Sjogren's syndrome), and to provide a new clinical train of thought and syndrome differentiation basis for clinical treatment of SS. Method: 1. Subjects: all of them came from the third outpatient clinic of geriatrics from March 2016 to March 2017. 2. Group: 90 patients with Sjogren's syndrome who met the inclusion criteria were randomly divided into acupuncture group (n = 30), acupuncture group (n = 30) and western medicine group (n = 30). Treatment methods: acupuncture group was treated with acupuncture combined with Wenrun Fuge decoction, that is, acupuncture Jingming, Jinjin, Yu liquid, Zaizheng, Shenshu, spleen Shu, Mingmen and Sanyinjiao points, combined with oral Wenrun Fuge decoction; acupuncture group was treated with simple acupuncture; western medicine group was treated with oral hydroxychloroquine sulfate 0.2g twice a day; all three treatments were treated for 8 weeks. Outcome measures: the clinical symptoms of the three groups were observed before and after treatment, the scores of TCM syndromes, exocrine gland test (Schirmer test and saliva flow rate test), anti-SSA and anti-SSB laboratory indexes of ESR,IgG, were recorded. Statistical methods: SPSS17.0 software was used to analyze the changes of each index before and after treatment in the three groups, and the clinical efficacy was compared. Result: 1. Comparison of clinical efficacy: in acupuncture group, 3 cases were cured, 12 cases were markedly effective, 13 cases were effective, 2 cases were ineffective, the total effective rate was 93.3%, 0 cases were cured, 3 cases were markedly effective, 17 cases were effective, 10 cases were ineffective, the total effective rate was 66.7%, and 0 cases were cured, 5 cases were markedly effective, 16 cases were effective, 9 cases were ineffective, the total effective rate was 70.0%. It is statistically significant (P 0.05). 2. Comparison of TCM syndrome scores: the scores of TCM syndromes in the three groups were lower than those before treatment; after treatment, the scores of TCM syndromes in acupuncture group, acupuncture group and western medicine group were significantly lower than those before treatment (P 0.05). Comparison of gland secretion: after treatment, the secretion of gland in the three groups increased compared with that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). 4. IgG comparison: the ESR,IgG of the three groups after treatment was lower than that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). Comparison of anti-SSA, and anti-SSB: there was no significant difference in anti-SSA, and anti-SSB between the three groups before and after treatment, but the positive rate of each antibody was decreased, and the positive rate of acupuncture group was better than that of western medicine group and acupuncture group. Conclusion: 1. Acupuncture combined with Wenrun Fuge decoction is effective in the treatment of Yang deficiency Sjogren's syndrome. 2. Acupuncture combined with Wenrun Fuge decoction can effectively reduce the score of TCM syndromes, increase the secretion of gland and decrease the level of ESR,IgG. The curative effect of acupuncture is better than that of western medicine group and acupuncture group.
【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】：R246.1
[Abstract]:Objective: to observe the effectiveness of acupuncture combined with Wenrun Fuge decoction in the treatment of (SS) with Yang deficiency Sjogren's syndrome (Sjogren's syndrome), and to provide a new clinical train of thought and syndrome differentiation basis for clinical treatment of SS. Method: 1. Subjects: all of them came from the third outpatient clinic of geriatrics from March 2016 to March 2017. 2. Group: 90 patients with Sjogren's syndrome who met the inclusion criteria were randomly divided into acupuncture group (n = 30), acupuncture group (n = 30) and western medicine group (n = 30). Treatment methods: acupuncture group was treated with acupuncture combined with Wenrun Fuge decoction, that is, acupuncture Jingming, Jinjin, Yu liquid, Zaizheng, Shenshu, spleen Shu, Mingmen and Sanyinjiao points, combined with oral Wenrun Fuge decoction; acupuncture group was treated with simple acupuncture; western medicine group was treated with oral hydroxychloroquine sulfate 0.2g twice a day; all three treatments were treated for 8 weeks. Outcome measures: the clinical symptoms of the three groups were observed before and after treatment, the scores of TCM syndromes, exocrine gland test (Schirmer test and saliva flow rate test), anti-SSA and anti-SSB laboratory indexes of ESR,IgG, were recorded. Statistical methods: SPSS17.0 software was used to analyze the changes of each index before and after treatment in the three groups, and the clinical efficacy was compared. Result: 1. Comparison of clinical efficacy: in acupuncture group, 3 cases were cured, 12 cases were markedly effective, 13 cases were effective, 2 cases were ineffective, the total effective rate was 93.3%, 0 cases were cured, 3 cases were markedly effective, 17 cases were effective, 10 cases were ineffective, the total effective rate was 66.7%, and 0 cases were cured, 5 cases were markedly effective, 16 cases were effective, 9 cases were ineffective, the total effective rate was 70.0%. It is statistically significant (P 0.05). 2. Comparison of TCM syndrome scores: the scores of TCM syndromes in the three groups were lower than those before treatment; after treatment, the scores of TCM syndromes in acupuncture group, acupuncture group and western medicine group were significantly lower than those before treatment (P 0.05). Comparison of gland secretion: after treatment, the secretion of gland in the three groups increased compared with that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). 4. IgG comparison: the ESR,IgG of the three groups after treatment was lower than that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). Comparison of anti-SSA, and anti-SSB: there was no significant difference in anti-SSA, and anti-SSB between the three groups before and after treatment, but the positive rate of each antibody was decreased, and the positive rate of acupuncture group was better than that of western medicine group and acupuncture group. Conclusion: 1. Acupuncture combined with Wenrun Fuge decoction is effective in the treatment of Yang deficiency Sjogren's syndrome. 2. Acupuncture combined with Wenrun Fuge decoction can effectively reduce the score of TCM syndromes, increase the secretion of gland and decrease the level of ESR,IgG. The curative effect of acupuncture is better than that of western medicine group and acupuncture group.
【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】：R246.1
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