本文關鍵詞：“靳三針”理論指導針刺治療卒中后偏側肢體腫脹的臨床研究　出處：《廣州中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 靳三針 卒中后 肢體腫脹 臨床研究

【摘要】：目的：本研究通過觀察“靳三針”理論指導針刺對比常規(guī)針刺治療卒中后偏側肢體腫脹的臨床療效,探尋針刺治療腦卒中后偏癱側肢體腫脹更有效的方法。方法：本研究納入60例符合納入標準的患者,按區(qū)組隨機化分組方法分為治療組和對照組各30例。在中風偏癱治療的基礎上,治療組通過“靳三針”理論指導針刺治療(顳三針、四神針、支溝、陰陵泉),對照組為常規(guī)針刺治療(八邪、八風),每日1次,20次為1個療程,共1個療程。應用卒中肢體癱瘓程度評分表,肢體腫脹評分表及自擬患肢周徑測量表觀察臨床療效,并將數(shù)據(jù)采用SPSS19.0統(tǒng)計軟件進行分析。結果：1、基線資料評價：經(jīng)卡方檢驗分析,治療前兩組病例一般資料(性別、年齡、病程、病性、辨證分型、腫脹部位)具有可比性(P0.05)。2、臨床療效評價：治療組共完成29例,其中基本恢復10例,顯著進步17例,有效2例,無效0例,總有效率100%,顯效率93.10%,對照組共完成28例,其中基本恢復4例,顯著進步13例,有效11例,無效0例,總有效率100%,顯效率60.71%。經(jīng)Ridit分析,兩組差異顯著(P0.05),說明“靳三針”理論指導針刺組在改善患側肢體腫脹方面的臨床療效優(yōu)于常規(guī)針刺組。3、通過對肢體腫脹評分表中各項指標及總分的觀察,治療前兩組間具有可比性(P0.05),治療前后兩組組內(nèi)及治療后兩組間比較,均差異顯著(P0.05)。說明兩組均對治療肢體腫脹有效,但“靳三針”理論指導針刺組較常規(guī)針刺組改善更為顯著。4、應用患肢周徑測量表觀察掌指(跖趾)關節(jié)與腕(踝)橫紋連線中點處兩組的周徑縮小程度,治療前兩組間具有可比性(P0.05),治療前后組內(nèi)比較均差異均顯著(P0.05),治療后兩組間無明顯差異(P0.05),但兩組治療前后的差值比較差異顯著(P0.05),說明“靳三針”理論指導針刺組在消除掌指(跖趾)關節(jié)與腕(踝)橫紋連線中點處腫脹療效優(yōu)于常規(guī)針刺組。5、應用患肢周徑測量表觀察在掌指(跖趾)關節(jié)連線處兩組的周徑減小程度,治療前兩組間具有可比性(P0.05),治療前后組內(nèi)比較均差異顯著(P0.05),治療后兩組間及兩組治療前后的差值均無明顯差異(P0.05)。說明“靳三針”理論指導針刺組與常規(guī)針刺組在掌指(跖趾)關節(jié)連線處功效相當。6、通過卒中肢體癱瘓程度評分表測得治療前兩組間比較具有可比性(P0.05),治療前后,兩組組內(nèi)、組間均差異顯著(P0.05),說明“靳三針”理論指導針刺組在改善患側肢體運動功能方面優(yōu)于常規(guī)針刺組。結論：綜上所述,“靳三針”理論指導針刺組和常規(guī)針刺組均能在不同程度上改善卒中后偏側肢體腫脹情況及運動功能,“靳三針”理論指導針刺組治療效果更加顯著且全面,值得臨床推廣。
[Abstract]:Objective: to observe the clinical effect of acupuncture on hemiplegia after stroke by observing Jin's three-needle theory. To explore a more effective method of acupuncture in treating hemiplegic side limb swelling after stroke. Methods: 60 patients with hemiplegia were included in this study. Based on the treatment of apoplexy hemiplegia, the treatment group was guided by Jin's three-needle theory (temporal three-needle, four-mind acupuncture, branch-ditch). The control group was treated with routine acupuncture (Baxia, Bafeng, 20 times a day as a course of treatment, a course of treatment). The clinical efficacy was observed with the limb swelling score table and the self-made peripheral diameter scale of the affected limb, and the data were analyzed by SPSS19.0 software. Results: 1, baseline data evaluation: chi-square test analysis. Before treatment, the general data (sex, age, course of disease, disease, syndrome differentiation, swelling site) of the two groups were comparable (P0.05. 2). Evaluation of clinical efficacy: 29 cases were completed in the treatment group. There were 10 cases of basic recovery, 17 cases of significant improvement, 2 cases of effective, 0 cases of ineffectiveness, 100% of total effective rate and 93.10% of markedly effective rate. In the control group, 28 cases were completed, among which 4 cases were basically recovered. There were 13 cases of significant improvement, 11 cases of effective and 0 cases of ineffectiveness. The total effective rate was 100%, and the significant effective rate was 60.71%. According to Ridit analysis, the difference between the two groups was significant (P 0.05). The results showed that the clinical curative effect of the acupuncture group was better than that of the routine acupuncture group in improving the swelling of the affected side by the theory of Jin's three needles. The indexes and the total score in the score table of the swelling of the limbs were observed. There was significant difference between the two groups before and after treatment, which indicated that both groups were effective in treating limb swelling. However, the "Jin three-needle" theory guided the acupuncture group improved more significantly than the conventional acupuncture group. The circumference of the metacarpophalangeal (metatarsophalangeal) joint and carpal (ankle) transverse line was observed by using the Peripheral diameter Measurement scale of the affected limb. Before treatment, there were significant differences between the two groups (P 0.05). There was no significant difference between the two groups before and after treatment (P 0.05). But the difference between the two groups before and after treatment was significant (P0.05). The results showed that the curative effect of the acupuncture group was better than that of the routine acupuncture group in eliminating the swelling at the midpoint of the joint of metacarpophalangeal (metatarsophalangeal) and wrist (ankle). The circumference of the two groups at the metacarpophalangeal (metatarsophalangeal) joint line was observed by using the circumference diameters scale of the affected limbs, and the two groups were comparable before treatment (P0.05). The difference before and after treatment was significant (P0.05). There was no significant difference in the difference between the two groups after treatment and before and after treatment, indicating that the "Jin three Needles" theory guided the acupuncture group and the conventional acupuncture group in the metacarpophalangeal (metatarsophalangeal) joint line. The comparison between the two groups before treatment was comparable (P 0.05). Before and after treatment, the difference between the two groups was significant (P 0.05). It is shown that the "Jin three-needle" theory is superior to the conventional acupuncture group in improving the motor function of the affected limbs. Conclusion: in summary, the acupuncture group can improve the motor function of the affected limbs. Jin's three-needle theory guided acupuncture group and routine acupuncture group can improve the swelling of hemifacial limb and motor function in varying degrees. Jin three-needle theory guidance acupuncture group more significant and comprehensive therapeutic effect. It is worth popularizing in clinic.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.6

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