本文選題：中風　切入點：便秘　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:觀察電針深刺天樞穴治療中風后便秘的臨床療效,研究其對血清SP、VIP含量的影響。通過觀察電針深刺天樞穴、電針支溝上巨虛以及西藥治療對中風后便秘的臨床療效,來較大幅度的提高中風后便秘患者的生活質量,為中風后便秘提供更好的治療方法,同時研究針灸治療中風后便秘的機制。方法:從江蘇省中醫(yī)院針灸康復科住院病人中選取中風后便秘患者90例,將90例患者隨機分為天樞組、上巨虛支溝組和西藥組,每組各30例。天樞組患者選擇雙側天樞穴,局部消毒后直刺至手下有突破感,后接電針,選疏密波,患者耐受為度,每次治療30分鐘,每日一次,1周6次,2周為1療程;上巨虛支溝組選擇雙側上巨虛、雙側支溝穴,常規(guī)針刺后連接電針,選疏密波,患者耐受為度,每日1次,每次30min,1周6次,2周為一療程;西藥組口服乳果糖,每日1次,早晨頓服,一次10mg,2周為1療程。療程結束后觀察各項積分情況,檢測指標,對數(shù)據(jù)進行分析,得出結果。結果:治療前3組患者性別、年齡、中風類型、大便性狀評分、CCS評分、癥狀積分、便秘患者生存質量評分、血清SP含量、血清VIP含量均無統(tǒng)計學差異,具有可比性。治療后天樞組療效優(yōu)于上巨虛支溝組、西藥組,有統(tǒng)計學意義(p0.05);治療后3組大便性狀無顯著性差異(p0.05);治療后天樞組CCS評分、癥狀積分、便秘患者生存質量評分均低于上巨虛支溝組和西藥組,有統(tǒng)計學意義(p0.05)。天樞組患者治療后血清SP含量高于上巨虛支溝組和西藥組,VIP含量低于上巨虛支溝組和西藥組,具有統(tǒng)計學意義(p0.05)。結果還提示天樞組、上巨虛組的復發(fā)率均低于西藥組,有統(tǒng)計學意義(p0.05)。結論:電針深刺天樞穴治療中風后便秘顯著,對比電針上巨虛、支溝穴和西藥能更有效的改善臨床癥狀,且具有安全、復發(fā)率低等優(yōu)勢。電針深刺天樞通過升高SP、降低VIP含量從而改善便秘癥狀。
[Abstract]:Objective: to observe the clinical effect of electroacupuncture at Tianshu point in treating constipation after apoplexy, and to study the effect of electroacupuncture on the content of serum SPN VIP in patients with constipation after apoplexy. To greatly improve the quality of life of patients with post-stroke constipation, and to provide a better treatment for post-stroke constipation. At the same time, the mechanism of acupuncture and moxibustion in treating constipation after apoplexy was studied. Methods: 90 cases of constipation after apoplexy were selected from Department of Acupuncture and Rehabilitation, Jiangsu Provincial Hospital of traditional Chinese Medicine. 90 patients were randomly divided into Tianshu group, Shangjuxujigou group and western medicine group. There were 30 cases in each group. The patients in Tianshu group were treated with bilateral Tianshu acupoints. After local disinfection, the patients were directly punctured to have a sense of breakthrough, followed by electroacupuncture, selective dense wave, patient tolerance, 30 minutes each time, 6 times a day, 6 times a week, 2 weeks as a course of treatment. In the Shangjuxu Zhigou group, the patients were divided into two groups: bilateral superior asthenia and bilateral branchogou points. After routine acupuncture, electroacupuncture was connected with electroacupuncture to select the dense wave. The patient tolerance was one course of treatment once a day, 6 times a week for 30 mins, 6 times a week for 2 weeks, while the western medicine group took lactofructose once a day, while the patients in the western medicine group were treated with lactulose once a day. At the end of the course, the scores were observed, the indexes were measured, the data were analyzed and the results were obtained. Results: before treatment, the three groups received CCS score, including sex, age, stroke type, stool trait score and so on. There was no statistical difference in symptom score, quality of life score, serum SP content and serum VIP content in patients with constipation, but there was no significant difference between the two groups. After treatment, the curative effect of Tianshu group was better than that of Shangjuxuzhigou group and western medicine group. There was no significant difference in defecation traits among the three groups after treatment, and the scores of CCS, symptom score and quality of life of constipation patients in Tianshu group were lower than those in Shangjuxu Zhigou group and western medicine group. After treatment, the serum SP content in Tianshu group was higher than that in Shangjuxujiigou group and western medicine group, which was significantly lower than that in Shangjuxujigou group and western medicine group. The recurrence rate of Shangjuxu asthenia group was lower than that of western medicine group, which had statistical significance (P 0.05). Conclusion: the treatment of constipation after apoplexy by electroacupuncture deep needling Tianshu point is significant. Compared with Shangju deficiency, Zhigou acupoint and western medicine, the clinical symptoms can be improved more effectively and safely. Electroacupuncture can improve constipation symptoms by increasing VIP content.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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本文編號：1620341