本文選題：穴位貼敷 + 針刺　； 參考：《廣州中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的： 利用隨機對照的方法,觀察穴位貼敷結(jié)合針刺對婦科腹腔鏡術(shù)后胃腸道功能恢復(fù)的影響,探討中醫(yī)治療術(shù)后胃腸道功能紊亂的優(yōu)效方案。 方法： 1.選取60例術(shù)前辨證為脾陽虛證的婦科腹腔鏡手術(shù)后患者,運用隨機數(shù)字表方法分為治療組(穴位貼敷結(jié)合針刺)和對照組(針刺治療) 2.治療方法：治療組先用吳茱萸粉和生姜水調(diào)至粘稠狀,制成1cm*1cm*1cm的藥餅,貼敷于神闕穴、雙(胃俞、膈俞、脾俞),貼敷時間為3小時。穴位貼敷治療結(jié)束后進行針刺操作,針刺穴位：足三里、上巨虛、太沖、三陰交(均雙側(cè)),深度10mm-30mm,得氣后留針20min。對照組僅做針刺處理,針刺處方及操作同治療組。 3.觀察的指標：記錄患者術(shù)后首次排氣、排便的時間,并利用《中藥新藥臨床研究指導(dǎo)原則》、Prince-henry和尼莫地平法對患者治療前后腹脹、惡心嘔吐和腹痛等癥狀進行評價。 結(jié)果： 1.治療前一般資料比較 兩組受試者在年齡構(gòu)成、身高、體重、麻醉時間、手術(shù)時間和治療前癥狀積分等各方面比較上無顯著性差異(P0.05),具有可比較性,提示兩組患者在治療前臨床資料方面具有同質(zhì)性,均衡可比。 2.治療后比較 (1)兩組治療前、后自身比較 通過對治療前后總癥狀評分比較,兩組治療后癥狀積分均低于治療前,有顯著性差異(p0.05),提示兩組均可改善術(shù)后胃腸道的功能,有一定療效。 (2)治療后組間比較 .①首次排氣、排便時間比較：經(jīng)組間t檢驗,治療組的排氣、排便時間均較對照組短,二者有顯著性差異(P0.05),提示治療組在改善術(shù)后排氣、排便癥狀方面明顯優(yōu)于對照組。 ②治療后惡心、腹脹、腹痛等癥狀積分比較：經(jīng)t檢驗,治療后治療組在惡心嘔吐、腹脹、腹痛等癥狀積分比較上明顯低于對照組,二者有顯著性差異(P0.05),提示治療組在改善術(shù)后惡心嘔吐、腹脹、腹痛等方面明顯優(yōu)于對照組,有利于術(shù)后胃腸道功能的恢復(fù)。 (3)總體療效比較 經(jīng)尼莫地平法評價,結(jié)果顯示治療組痊愈2人,顯效21人,有效7人；對照組痊愈1人,顯效17人,有效12人。經(jīng)秩和檢驗Z=-2.553,p=0.0110.05,提示治療組在總體療效上明顯優(yōu)于對照組。 結(jié)論： 穴位貼敷結(jié)合針刺和單純針刺法對腹腔鏡術(shù)后患者胃腸功能恢復(fù)均有一定療效,其中穴位貼敷結(jié)合針刺法在改善術(shù)后患者的惡心嘔吐、腹脹腹痛及術(shù)后排氣排便等方面明顯優(yōu)于單純針刺組,提示穴位貼敷結(jié)合針刺有利于婦科腹腔鏡術(shù)后胃腸道功能的恢復(fù),且縮短了術(shù)后首次排氣、排便的時間,各項癥狀改善較明顯。
[Abstract]:Objective: to observe the effect of acupoint application combined with acupuncture on the recovery of gastrointestinal function after gynecological laparoscopy, and to explore the effective scheme of traditional Chinese medicine (TCM) in the treatment of postoperative gastrointestinal dysfunction. Methods: 1. Sixty patients with spleen yang deficiency syndrome were selected and randomly divided into treatment group (acupoint application combined with acupuncture) and control group (acupuncture treatment). Treatment methods: the treatment group was treated with Evodia rutaecarpa powder and ginger water to the viscous form, made of 1cm*1cm*1cm medicine cake, applied to Shenque point, double (Weishu, Geshu, Pi Yu), the application time was 3 hours. Acupuncture operation was carried out after acupoint application treatment. Acupuncture acupoints: Zusanli, Shangjuxu, Taochong, Sanyinjiao (both sides), depth 10mm-30mm, retention of acupuncture for 20 mins after getting qi. The control group was treated with acupuncture only, the acupuncture prescription and operation were the same as that in the treatment group. Outcome measures: the first time of exhaust and defecation was recorded, and the symptoms of abdominal distension, nausea, vomiting and abdominal pain were evaluated by Princeton -henry and nimodipine before and after treatment. Results: 1. There was no significant difference in age composition, height, weight, anesthetic time, operation time and symptom score before treatment between the two groups (P0.05). The results suggest that the two groups have homogeneity in the clinical data before treatment, balanced and comparable. 2. 2. Comparison after treatment (1) before and after treatment, the symptom scores of the two groups were lower than those before and after treatment by comparing the total symptom scores before and after treatment. There was significant difference (p0.05), suggesting that the two groups can improve the gastrointestinal function after operation, and have a certain curative effect. (2) the comparison of the first exhaust and defecation time between the two groups after treatment: after t test, the exhaust of the treatment group was better than that of the control group. The time of defecation was shorter than that of the control group (P0.05), suggesting that the treatment group was superior to the control group in improving postoperative exhaust and defecation symptoms. 2 comparison of symptoms such as nausea, abdominal distension and abdominal pain after treatment: t test. After treatment, the scores of nausea and vomiting, abdominal distension and abdominal pain in the treatment group were significantly lower than those in the control group (P0.05), indicating that the treatment group was superior to the control group in improving postoperative nausea and vomiting, abdominal distension, abdominal pain, etc. (3) the overall curative effect was evaluated by nimodipine method. The results showed that 2 patients were cured in the treatment group, 21 were effective and 7 were effective in the treatment group, while in the control group, 1 was cured and 17 were significantly effective. Effective 12. The rank sum test showed that the treatment group was superior to the control group in overall curative effect. Conclusion: acupoint application combined with acupuncture and simple acupuncture has certain curative effect on gastrointestinal function recovery after laparoscopic surgery, among which acupoint application combined with acupuncture can improve postoperative nausea and vomiting. The abdominal distention and abdominal pain and postoperative exhaust and defecation were better than those in the simple acupuncture group. It suggested that the combination of acupoint application and acupuncture was beneficial to the recovery of gastrointestinal function after gynecological laparoscopy, and shortened the time of first exhaust and defecation after operation. The symptoms were improved obviously.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R246.3

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