本文關(guān)鍵詞：邱氏穴治療腎絞痛的機(jī)理探討　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 腎絞痛 邱氏穴 炎癥遞質(zhì) 機(jī)理

【摘要】：目的:腎絞痛為泌尿外科常見病之一,疾病發(fā)生時(shí)患者疼痛劇烈,并伴有惡心嘔吐,大汗淋漓、面色蒼白等癥狀,老年患者或合并其他疾病等體弱患者可能有休克的風(fēng)險(xiǎn),西醫(yī)藥物治療是目前主要的治療手段,但有時(shí)效果并不滿意,且不良反應(yīng)較多。邱氏穴是邱云橋教授發(fā)現(xiàn)并應(yīng)用于治療腎絞痛常用的穴位,在治療腎絞痛有許多優(yōu)勢(shì)。但比較缺乏對(duì)其止痛機(jī)理的研究。本研究通過(guò)觀察不同組別患者血漿中6-酮前列腺素Fla(6-KetoPGF1a),血栓素B2(TXB2)值,由此來(lái)評(píng)價(jià)前列環(huán)素(PGI2)、血栓素A2(TXA2)水平,從而初步探討邱氏穴治療腎絞痛的機(jī)理。方法:1.按納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)分別選取20例正常人、40例急性腎絞痛患者。2.根據(jù)隨機(jī)數(shù)字表法簡(jiǎn)單隨機(jī)將40例腎絞痛患者分為治療組(邱氏穴組)、對(duì)照組(肌肉注射曲馬多組)各20例。兩組分別按要求行指壓邱氏穴、肌肉注射曲馬多100mg治療。3.觀察并統(tǒng)計(jì)治療組與對(duì)照組治療前與治療后患者VAS疼痛量表評(píng)分。4.檢測(cè)正常人組,治療組治療前與治療后,對(duì)照組治療前與治療后研究對(duì)象血漿中6-KetoPGF1a,TXB2值,由此來(lái)評(píng)價(jià)PGI2、TXA2水平。5.采用統(tǒng)計(jì)軟件SPSS21.0對(duì)所收集資料進(jìn)行分析,探討邱氏穴治療腎絞痛的機(jī)理。結(jié)果:1.所有患者在試驗(yàn)過(guò)程中無(wú)脫落。患者的性別、年齡、發(fā)病到就診時(shí)間在統(tǒng)計(jì)學(xué)上無(wú)差異(P0.05),資料具有可比性。2.治療前治療組與對(duì)照組兩組VAS疼痛評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后兩組的VAS疼痛評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P0.05);同組治療前后VAS疼痛評(píng)分差異有均統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療前后疼痛積分的下降程度△P差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.治療前治療組與對(duì)照組兩組6-KetoPGF1a、TXB2水平組間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義,但兩組均較正常人組升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);治療組與對(duì)照組治療后的6-KetoPGF1a、TXB2的水平均較治療前下降,組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05);而治療組治療前后6-KetoPGF1a、TXB2水平下降幅度較對(duì)照組大,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:指壓邱氏穴與肌肉注射曲馬多相比,在療效基本相同的情況下,前者在降低腎絞痛患者血漿中炎性遞質(zhì)如TXA2、PGI2方面具有優(yōu)勢(shì)。表明邱氏穴治療腎絞痛的機(jī)理可能與降低腎絞痛患者血漿中炎癥遞質(zhì)有關(guān)。
[Abstract]:Objective: renal colic is one of the common disease in Department of Urology, disease in patients with severe pain and nausea, vomiting, sweating, pale complexion and other symptoms, the risk of elderly patients or with other disease patients may have a weak shock, western medicine is the main means of treatment, but sometimes the effect is not satisfactory, and the bad the reaction is more. Qiu Shixue is Professor Qiu Yunqiao found and applied to the acupoints commonly used in the treatment of renal colic, there are many advantages in the treatment of renal colic. But there is a lack of research on the mechanism of pain relief. This study through the observation group with different plasma 6- keto prostaglandin Fla (6-KetoPGF1a), thromboxane B2 (TXB2), thereby to evaluate the prostacyclin (PGI2), thromboxane A2 (TXA2) level, so as to explore the mechanism of Qiu Shixue in the treatment of renal colic. Methods: 1. according to the inclusion criteria and exclusion criteria, 20 cases of normal and 40 patients with acute renal colic were selected respectively. 2. according to the random digital table method, 40 patients with renal colic were divided into treatment group (Qiu Shixuezu) and control group (20 cases of intramuscular tramadol group). The two groups respectively according to the requirements for high Shixue, shiatsu intramuscular injection of tramadol 100mg treatment. 3. the score of VAS pain scale was observed between the treatment group and the control group before and after the treatment. 4. detect the normal group. Before treatment and after treatment, the plasma 6-KetoPGF1a and TXB2 values in the control group before and after the treatment were evaluated, so as to evaluate the level of PGI2 and TXA2. 5. by using the statistical software SPSS21.0 to collect data for analysis, to explore the mechanism of Qiu Shixue in the treatment of renal colic. Results: 1. all patients did not fall off during the test. There was no difference in sex, age, onset and time of treatment (P0.05), and the data were comparable. 2. before treatment between the two groups VAS pain score difference was statistically significant (P0.05); VAS was statistically significant differences in pain scores between the two groups after treatment (P0.05); there were significant differences in VAS pain score before and after treatment in the same group (P0.05); no statistical significance in two groups of patients before and after treatment of pain points decrease of delta P difference (P0.05). 3. before treatment between the treatment group and the control group two 6-KetoPGF1a group, TXB2 group, the difference was not statistically significant, but the two groups were lower than normal group increased, the difference was statistically significant (P0.05); the treatment group and control group after treatment 6-KetoPGF1a, TXB2 levels were lower than that before treatment, the two groups were significant the difference between the treatment group (P0.05); and 6-KetoPGF1a and TXB2 levels before and after treatment decreased significantly than the control group, the difference was statistically significant (P0.05). Conclusion: compared with intramuscular injection of tramadol Shixue acupressure Qiu, is basically the same in effect under the condition of the former in reducing inflammatory mediators in plasma of patients with renal colic such as TXA2, PGI2 has the advantage. That may Shixue Qiu mechanism in the treatment of renal colic and reduce inflammatory mediators in the plasma of patients with renal colic.
【學(xué)位授予單位】：廣州中醫(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

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 曾明輝;蔣東方;秦鎖炳;卜強(qiáng);;雙J管在妊娠合并腎絞痛治療中的應(yīng)用[J];淮海醫(yī)藥;2016年06期

2 王富軍;董俊強(qiáng);張忠原;王宗軍;莫曾南;;腎絞痛病程中血和尿前列腺素E_2含量的測(cè)定及其意義[J];臨床泌尿外科雜志;2016年11期

3 徐麗君;段艷萍;;電針穴位治療急性腎絞痛的效果觀察[J];中外醫(yī)學(xué)研究;2016年12期

4 張煥濤;夏昕暉;;腎絞痛臨床診斷的進(jìn)展[J];當(dāng)代醫(yī)學(xué);2016年09期

5 羅正菊;;鹽酸曲馬多聯(lián)合黃體酮治療急性腎絞痛效果研究[J];河北醫(yī)學(xué);2015年11期

6 龐志強(qiáng);王振華;相宜;李文曦;田宇;程志華;;炎癥介質(zhì)5-羥色胺與疼痛發(fā)生機(jī)理的研究進(jìn)展[J];中國(guó)實(shí)驗(yàn)診斷學(xué);2014年12期

7 鮑艷華;楊振宇;;腎三針配合耳穴針刺治療結(jié)石性腎絞痛48例臨床觀察[J];河北中醫(yī);2014年11期

8 黃清強(qiáng);;八正散加減聯(lián)合西藥治療結(jié)石性腎絞痛51例臨床療效觀察[J];中國(guó)民族民間醫(yī)藥;2014年09期

9 邱云橋;;穴位指壓治療腎絞痛臨床觀察[J];中國(guó)中醫(yī)急癥;2013年09期

10 陳雁威;;體外沖擊波碎石術(shù)急診治療輸尿管結(jié)石致腎絞痛的臨床研究[J];臨床醫(yī)學(xué)工程;2013年07期

相關(guān)博士學(xué)位論文 前1條

1 肖揚(yáng);龍虎交戰(zhàn)針刺邱氏穴治療腎絞痛的臨床研究及機(jī)制探討[D];廣州中醫(yī)藥大學(xué);2016年

相關(guān)碩士學(xué)位論文 前3條

1 李濤城;針刺邱氏穴對(duì)輸尿管結(jié)石排出的臨床觀察[D];廣州中醫(yī)藥大學(xué);2016年

2 宋太超;針刺邱氏穴治療結(jié)石性腎絞痛的臨床鎮(zhèn)痛研究[D];廣州中醫(yī)藥大學(xué);2016年

3 單琨;探討前列環(huán)素和血栓素在腎絞痛發(fā)作中的作用[D];天津醫(yī)科大學(xué);2007年

，

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