针刺治疗盆腔炎性疾病的现代文献研究及临床疗效观察

发布时间：2019-07-09 06:47

【摘要】：目的 1、文献研究对近20年“万方”、“维普”和“中国知网”上采用针刺治疗盆腔炎性疾病(PID)的临床文献进行系统的整理和归纳,统计出该方法治疗本病的常用腧穴、主要经脉、最佳操作方法和时间等,为临床PID的针刺治疗提供理论依据,以使临床上针刺治疗本病更加规范化和系统化;2、临床观察将整理出的高频腧穴及操作方法等应用于小样本量的临床观察,以期证实其有效性及可行性。方法 1、搜集近20年针刺治疗PID的临床文献,将文献中需要收集的各要素录入Excel表格,最后从腧穴选择、腧穴归经、腧穴针刺操作和针刺时间规律四大方面进行系统整理与分析；2、收集来自妇科门诊的湿热瘀结型慢性盆腔炎(CPID)患者30例,给予单纯针刺治疗,观察治疗前后,中医证候及局部体征的改善情况,评价针刺治疗本病的临床疗效。结果 1、通过对文献各要素的统计和分析得出,针刺治疗PID的高频穴位为三阴交、关元、中极、足三里、气海、子宫、阴陵泉、归来、肾俞、水道、次毼、血海、太冲、地机、带脉、中脘、太溪、天枢、合谷、下脘,归经为任脉、足太阴脾经、足阳明胃经、足太阳膀胱经、足少阳胆经、足厥阴肝经、足少阳肾经、手阳明大肠经,手法以平补平泻法为主,常见操作方案为：连续治疗3个疗程,每疗程10天,每日针刺一次,每次留针时间30分钟,月经来潮期停止针刺;2、对比治疗前后,患者的综合疗效总有效率为86.36%,中医证候疗效总有效率为81.82%,局部体征疗效总有效率为68.18%,即治疗前后中医症状积分比较差异具有显著性(P0.01),治疗前后局部体征积分比较差异显著(P0.01)。结论 1、通过文献统计发现现代医家针刺治疗PID时在借鉴前人经验的基础上,注重配穴的选取及辨证分型论治,同时能把握好针刺时间；2、通过临床观察发现针刺能改善PID患者的临床症状及局部体征,是一种安全有效、无副作用的治疗方法,值得在临床实践中进一步推广应用。
文内图片：

图片说明：图２可Ｗ看出，采用单纯针刺治疗ＰＩＤ的文献较少，仅有１６逡逑篇，占总比例的１１．２％；在结合其他疗法的综合疗法中Ｗ针刺合并中药的逡逑方法最为常用，其文献包含４０篇，，占总比例的２７．８邋％
[Abstract]:Objective 1. The clinical literature of acupuncture treatment of pelvic inflammatory disease (PID) in recent 20 years was systematically sorted out and summarized, and the common acupoints, main meridians, best operation methods and time of this method were counted out, so as to provide theoretical basis for acupuncture treatment of clinical PID, so as to make the clinical acupuncture treatment of this disease more standardized and systematic. 2. Clinical observation applies the sorted out high frequency acupoints and operation methods to the clinical observation of small sample size in order to confirm its effectiveness and feasibility. Methods 1. The clinical literature of acupuncture treatment of PID in recent 20 years was collected, and the elements that needed to be collected in the literature were input into Excel table. Finally, the acupoint selection, acupoint meridians, acupoint acupuncture operation and acupuncture time law were systematically sorted out and analyzed. 2. 30 (CPID) patients with chronic pelvic inflammation with dampness-heat stasis type from gynecological clinic were collected and treated with acupuncture alone. The improvement of TCM syndromes and local signs before and after treatment was observed, and the clinical effect of acupuncture on this disease was evaluated. Results 1. Through the statistics and analysis of the factors in the literature, it is concluded that the high frequency acupoints of acupuncture treatment of PID are Sanyinjiao, Guan Yuan, Zhongji, Zusanli, Qi Hai, uterus, Yinling Spring, return, Shenshu, waterway, secondary, Xuehai, Taichong, Geji, belt vein, Zhongwan, Taixi, Tianshu, Hegu, Xiawan, belonging to Ren pulse, foot Taiyin spleen meridians, foot yang bladder meridians, foot Shaoyang gallbladder meridians, foot yin liver meridians, Foot Shaoyang kidney meridians, hand yang Ming large intestine meridians, the manipulation is based on the method of leveling and leveling, the common operation scheme is: continuous treatment for 3 courses of treatment, 10 days each course of treatment, once a day acupuncture, each time to stay for 30 minutes, menstruation to stop acupuncture; 2. Before and after treatment, the total effective rate of the patients was 86.36%, the total effective rate of TCM syndromes was 88.82%, and the total effective rate of local signs was 68.18%. There was significant difference in the scores of TCM symptoms before and after treatment (P01), and there was significant difference in the scores of local signs before and after treatment (P01). Conclusion 1. Through literature statistics, it is found that acupuncture treatment of PID by modern doctors pays attention to the selection of acupoints and the theory of syndrome differentiation and treatment, and can grasp the acupuncture time at the same time. 2, through clinical observation, it is found that acupuncture can improve the clinical symptoms and local signs of patients with PID, which is a safe and effective method without side effects, and is worthy of further popularization and application in clinical practice.
【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】：2016
【分类号】：R246.3

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