本文選題：耳鳴 + 耳穴壓丸��； 參考：《成都中醫(yī)藥大學》2016年碩士論文

【摘要】：目的：觀察耳穴壓丸配合認知行為療法對耳鳴的療效并分析其相關證型,探討耳穴壓丸配合認知行為治療耳鳴在臨床中發(fā)揮的作用,并分析耳鳴療效與相關因素的關系,尋求一種簡易、經濟、有效、低風險的耳鳴治療方式,為耳鳴的治療提供更多的臨床依據。方法：對符合納入標準的以耳鳴為第一主訴的35例患者予以耳穴壓丸配合認知行為治療。壓丸穴位以神門、交感、皮質下、內耳、外耳為主穴,辨證取穴：風邪外侵加肺、大腸；肝郁氣滯,肝火上擾者加肝、心；脾虛下陷,腎精不足者加脾、內分泌、腎；痰火郁結加三焦、大腸、脾。隨癥取穴：耳鳴忽輕忽重加耳背腎；因睡眠不佳而加重加耳背心；血脂高、血管硬化加內分泌。囑患者每日自行按壓(揉)3-5次,每次每穴50至80次,以出現(xiàn)酸、脹、熱、麻為度,每次貼患耳(單側或雙側),保留3日,休息1天,一周2次,5次為1個療程,共2個療程,在1個療程和2個療程結束后評價。治療期間同時配合認知行為療法。1個療程、2個療程分別觀察患者耳鳴積分及生存質量等,記錄相關數據,應用SPASS19.0統(tǒng)計軟件對所得數據進行統(tǒng)計學處理。結果：經過統(tǒng)計分析軟件處理,(1)總樣本中治療1個療程后的有效率為51.4%,治療2個療程后的有效率為80%,P0.05,差異具有統(tǒng)計學意義。(2)總體樣本中,THI評分在治療1個療程及2個療程后,P0.05,差異具有統(tǒng)計學意義。(3)耳鳴在肝火上擾、痰火郁結、脾胃虛弱、腎精虧損這四型中分布及療效無統(tǒng)計學差異。(4)療效與病程、年齡、性別的關系,治療1個療程、2個療程差異均無統(tǒng)計學意義。(5)經等級相關性檢驗,耳鳴嚴重程度分級與生存質量之間的關系呈正相關性,且隨治療周期增長,相關性越高。結論：(1)耳穴壓丸配合行為認知行為治療有助于耳鳴的緩解和提高相關的生活質量(尤其是情緒方面的和社會功能方面的)。(2)耳鳴的程度以及患者的耐受度與生活質量相互影響,尤其是睡眠障礙、煩躁、憤怒、抑郁方面。(3)耳鳴的宣教對患者正確認識耳鳴并接受耳鳴有極重要的作用,在排除重大疾病后,通過耳鳴的宣教及心理咨詢,有部分患者表示可以不需要治療。(4)本方案中性別、年齡、病程、證型、耳鳴能否匹配與療效的關系并不明顯。
[Abstract]:Objective: to observe the curative effect of auricular acupoint pressing pill combined with cognitive behavior therapy on tinnitus and analyze its related syndromes, explore the role of auricular acupoint pressing pill combined with cognitive behavior in the treatment of tinnitus, and analyze the relationship between the curative effect of tinnitus and related factors. To seek a simple, economical, effective and low risk tinnitus treatment, to provide more clinical basis for the treatment of tinnitus. Methods: 35 patients with tinnitus as the first complaint were treated with auricular pressing pill combined with cognitive behavior. The acupoints of pressure Pill are Shenmen, sympathetic, subcortical, inner ear and external ear. The main points are as follows: wind evil invades the lung and large intestine; liver and qi stagnation, liver fire is disturbed, liver, heart; spleen deficiency depression, kidney essence deficiency plus spleen, endocrine, kidney; Phlegm and fire stagnation plus tri-Jiao, large intestine, spleen. With the syndrome of acupoints: tinnitus light and heavy plus the back of the ear kidney; because of poor sleep aggravated plus ear vest; hyperlipidemia, vascular sclerosis plus endocrine. Patients were told to press themselves daily (kneading 3-5 times, 50 to 80 times each time) in order to appear acid, swelling, heat, hemp, sticking to the affected ears (unilateral or bilateral) for 3 days, rest for 1 day, 2 times a week for 5 times as a course of treatment, 2 courses of treatment, 2 times a week, 2 times a week for a course of treatment, 2 times a week for a course of treatment, a total of 2 courses of treatment. It was evaluated after one course of treatment and two courses of treatment. One course of treatment and two courses of treatment were used to observe the score of tinnitus and quality of life, to record the relevant data, and to use SPASS 19.0 statistical software to process the data. Results: the effective rate after one course of treatment was 51.4 in the total sample treated by statistical analysis software, and the effective rate was 80 P0.05 after two courses of treatment. The difference was statistically significant. After two courses of treatment, the difference was statistically significant (P 0.05). The tinnitus was disturbed on the liver fire. There was no significant difference in the distribution and efficacy of phlegm and fire stagnation, deficiency of spleen and stomach, deficiency of kidney essence. 4) the relationship between curative effect and course of disease, age, sex, treatment for one course of treatment, the difference of two courses of treatment were not statistically significant. There was a positive correlation between the severity of tinnitus and quality of life, and the higher the correlation was with the increase of treatment cycle. Conclusion1) combined with Behavioral Cognitive and Behavioral treatment, it is helpful to relieve tinnitus and improve the related quality of life (especially emotional and social function), as well as the influence of patient's tolerance and quality of life. In particular, sleep disorders, irritability, anger, depression and other aspects of tinnitus play a very important role in the patient's correct understanding of tinnitus and receiving tinnitus. Some patients indicated that there was no need for treatment.) the relationship between gender, age, course of disease, syndrome type, tinnitus matching and curative effect was not obvious.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R276.1

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