艾灸阿是穴治療寒濕型腰椎間盤突出癥的臨床觀察
發(fā)布時(shí)間：2018-10-29 22:48
【摘要】：目的:觀察艾灸阿是穴對(duì)于寒濕型腰椎間盤突出癥的臨床療效差異;觀察寒濕型腰椎間盤突出癥冷感區(qū)的分布趨勢(shì),在選穴、探穴方面上進(jìn)行探索;通過(guò)紅外熱成像技術(shù),觀察患肢冷感患者的冷感區(qū)溫差變化,探索其與冷感癥狀嚴(yán)重程度之間的相關(guān)性。研究方法:1.納入2016年1月至2017年2月期間于廈門市海滄醫(yī)院康復(fù)醫(yī)學(xué)科、骨科就診的腰椎間盤突出癥患者60例,隨機(jī)分為阿是穴溫灸組(治療組)30例及藥物口服組(對(duì)照組)30例;治療組采用艾條懸灸患區(qū)阿是穴,對(duì)照組予藥物口服,每日1次,5次為一個(gè)療程,共兩個(gè)療程,療程間間隔2天。治療前后對(duì)兩組患者進(jìn)行JOA評(píng)分評(píng)定,患肢冷感評(píng)分標(biāo)準(zhǔn)及患肢冷感區(qū)溫度評(píng)定,進(jìn)行統(tǒng)計(jì)學(xué)分析,評(píng)價(jià)艾灸阿是穴治療寒濕型腰椎間盤突出癥臨床療效,并觀察腰椎間盤突出癥伴患肢冷感患者的患肢紅外熱像圖,探索其冷感程度與健患側(cè)溫差變化的關(guān)系。結(jié)果:1.療效比較:兩組治療前后JOA評(píng)分對(duì)比,經(jīng)秩和檢驗(yàn),兩組病情均有改善(P0.05)。兩組各療程進(jìn)行組間比較,經(jīng)秩和檢驗(yàn),兩組治療前JOA評(píng)分無(wú)顯著性差異(P0.05),兩組治療后JOA評(píng)分有顯著性差異(P0.05)。兩組各個(gè)療程治療前后患肢冷感評(píng)分標(biāo)準(zhǔn)對(duì)比,經(jīng)秩和檢驗(yàn),兩組病情均有改善(P0.05)。兩組各療程進(jìn)行組間對(duì)比,經(jīng)秩和檢驗(yàn),治療前患肢冷感評(píng)分標(biāo)準(zhǔn)評(píng)分無(wú)顯著差異(P0.05),一療程后患肢冷感評(píng)分標(biāo)準(zhǔn)評(píng)分有顯著差異(P0.05),治療后患肢冷感評(píng)分標(biāo)準(zhǔn)評(píng)分有顯著差異(P0.05)。臨床療效比較:治療組治愈6例,顯效10例,好轉(zhuǎn)8例,總有效率80%;對(duì)照組治愈2例,顯效4例,好轉(zhuǎn)11例,總有效率57%,經(jīng)秩和檢驗(yàn),兩組療效有顯著性差異(P0.05)。2、冷感區(qū)均分布于下肢的后、外側(cè),位于足太陽(yáng)及足少陽(yáng)經(jīng)皮部上。3、患肢冷感程度、JOA評(píng)分與健患側(cè)溫差變化情況分析:對(duì)所有患者治療前后的冷感程度評(píng)分與健患側(cè)成像溫差進(jìn)行對(duì)比,經(jīng)Pearson相關(guān)性分析,兩組差值呈正相關(guān);對(duì)治療前后的JOA評(píng)分與健患側(cè)成像溫差進(jìn)行對(duì)比,經(jīng)Pearson相關(guān)性分析,兩組差值無(wú)明顯相關(guān)性。結(jié)論:1、采用循經(jīng)取穴結(jié)合阿是取穴的取穴方法,進(jìn)行艾灸治療寒濕型腰椎間盤突出癥,可以在較短的時(shí)間緩解患者的冷感癥狀,緩解腰椎間盤突出癥的癥狀與體征。2、患者所描述冷感區(qū)均分布于患側(cè)足太陽(yáng)經(jīng)與足少陽(yáng)經(jīng)的皮部上,通過(guò)紅外熱成像觀察存在健患側(cè)溫差區(qū),冷感區(qū)呈低溫區(qū)。3、患肢冷感程度與健患側(cè)溫差密切相關(guān)。
[Abstract]:Objective: to observe the difference of clinical curative effect of moxibustion on cold and wet lumbar disc herniation, to observe the distribution trend of cold feeling area of cold wet type lumbar disc herniation, to explore points selection and probe points. Infrared thermal imaging was used to observe the temperature difference in the cold zone of patients with cold sensation and to explore the correlation between the temperature difference and the severity of cold sensation. Methods: 1. From January 2016 to February 2017, 60 patients with lumbar intervertebral disc herniation in orthopedic department of Haicang Hospital, Xiamen City, were randomly divided into two groups: 30 patients in the treatment group treated with warm moxibustion at Ashi point and 30 patients in the control group. The treatment group was treated with Ashi point of moxa suspension moxibustion, while the control group was given oral medication once a day, 5 times as a course of treatment, two courses of treatment, the interval between the two courses of treatment was 2 days. Before and after treatment, the patients in the two groups were assessed with JOA score, cold sensation score standard of affected limb and temperature of affected limb cold zone. The clinical effect of moxibustion on cold and wet lumbar intervertebral disc herniation was evaluated by statistical analysis. The infrared thermography of the affected limb in patients with lumbar disc herniation and cold sensation was observed to explore the relationship between the degree of cold sensation and the temperature difference of the affected side. The result is 1: 1. Comparison of curative effects: JOA scores were compared before and after treatment in both groups, and the two groups were improved by rank sum test (P0.05). By rank sum test, there was no significant difference in JOA score between the two groups before treatment (P0.05), and there was a significant difference in JOA score between the two groups after treatment (P0.05). Before and after the treatment of each course of treatment between the two groups, the cold sensation scores were compared, the two groups were improved by rank sum test (P0.05). By rank sum test, there was no significant difference in the score of cold sensation score between the two groups before treatment (P0.05), but there was significant difference in the score of cold sensation score after one course of treatment (P0.05). There was significant difference in cold sensation score after treatment (P0.05). Comparison of clinical efficacy: in the treatment group, 6 cases were cured, 10 cases were markedly effective, 8 cases were improved, and the total effective rate was 80%; In the control group, 2 cases were cured, 4 cases were markedly effective, 11 cases were improved. The total effective rate was 57%. By rank sum test, there was a significant difference between the two groups (P0.05). Located on the transcutaneous part of foot sun and foot Shaoyang, the degree of cold sensation of affected limb, JOA score and temperature difference of healthy side were analyzed. The cold sensitivity score of all patients before and after treatment was compared with that of healthy side imaging temperature difference, and the correlation analysis was made by Pearson. The difference between the two groups was positively correlated. The JOA score before and after treatment was compared with the imaging temperature difference of the healthy side. By Pearson correlation analysis, there was no significant correlation between the difference between the two groups. Conclusion: 1. Moxibustion treatment of cold and wet lumbar intervertebral disc herniation with acupoints along meridians combined with acupoint extraction along meridians can relieve cold symptoms and signs of lumbar intervertebral disc herniation in a short period of time. The cold regions described by the patients were all distributed on the skin of the sucromeria and the Shaoyang meridians of the affected foot. The difference of temperature in the affected side was observed by infrared thermal imaging. 3. 3. The degree of cold sensation of the affected limb was closely related to the difference of the temperature of the healthy side of the affected side.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.9
本文編號(hào)：2299059
[Abstract]:Objective: to observe the difference of clinical curative effect of moxibustion on cold and wet lumbar disc herniation, to observe the distribution trend of cold feeling area of cold wet type lumbar disc herniation, to explore points selection and probe points. Infrared thermal imaging was used to observe the temperature difference in the cold zone of patients with cold sensation and to explore the correlation between the temperature difference and the severity of cold sensation. Methods: 1. From January 2016 to February 2017, 60 patients with lumbar intervertebral disc herniation in orthopedic department of Haicang Hospital, Xiamen City, were randomly divided into two groups: 30 patients in the treatment group treated with warm moxibustion at Ashi point and 30 patients in the control group. The treatment group was treated with Ashi point of moxa suspension moxibustion, while the control group was given oral medication once a day, 5 times as a course of treatment, two courses of treatment, the interval between the two courses of treatment was 2 days. Before and after treatment, the patients in the two groups were assessed with JOA score, cold sensation score standard of affected limb and temperature of affected limb cold zone. The clinical effect of moxibustion on cold and wet lumbar intervertebral disc herniation was evaluated by statistical analysis. The infrared thermography of the affected limb in patients with lumbar disc herniation and cold sensation was observed to explore the relationship between the degree of cold sensation and the temperature difference of the affected side. The result is 1: 1. Comparison of curative effects: JOA scores were compared before and after treatment in both groups, and the two groups were improved by rank sum test (P0.05). By rank sum test, there was no significant difference in JOA score between the two groups before treatment (P0.05), and there was a significant difference in JOA score between the two groups after treatment (P0.05). Before and after the treatment of each course of treatment between the two groups, the cold sensation scores were compared, the two groups were improved by rank sum test (P0.05). By rank sum test, there was no significant difference in the score of cold sensation score between the two groups before treatment (P0.05), but there was significant difference in the score of cold sensation score after one course of treatment (P0.05). There was significant difference in cold sensation score after treatment (P0.05). Comparison of clinical efficacy: in the treatment group, 6 cases were cured, 10 cases were markedly effective, 8 cases were improved, and the total effective rate was 80%; In the control group, 2 cases were cured, 4 cases were markedly effective, 11 cases were improved. The total effective rate was 57%. By rank sum test, there was a significant difference between the two groups (P0.05). Located on the transcutaneous part of foot sun and foot Shaoyang, the degree of cold sensation of affected limb, JOA score and temperature difference of healthy side were analyzed. The cold sensitivity score of all patients before and after treatment was compared with that of healthy side imaging temperature difference, and the correlation analysis was made by Pearson. The difference between the two groups was positively correlated. The JOA score before and after treatment was compared with the imaging temperature difference of the healthy side. By Pearson correlation analysis, there was no significant correlation between the difference between the two groups. Conclusion: 1. Moxibustion treatment of cold and wet lumbar intervertebral disc herniation with acupoints along meridians combined with acupoint extraction along meridians can relieve cold symptoms and signs of lumbar intervertebral disc herniation in a short period of time. The cold regions described by the patients were all distributed on the skin of the sucromeria and the Shaoyang meridians of the affected foot. The difference of temperature in the affected side was observed by infrared thermal imaging. 3. 3. The degree of cold sensation of the affected limb was closely related to the difference of the temperature of the healthy side of the affected side.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.9
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