本文選題：電針　切入點(diǎn)：交感神經(jīng)節(jié)　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過觀察電針頸部交感神經(jīng)節(jié)治療頸源性心臟神經(jīng)癥(CN)的臨床療效,探討此方法治療頸源性心臟神經(jīng)癥的優(yōu)勢(shì),為此類型患者提供一個(gè)新的綠色的治療方法。方法:選取由交感型頸椎病所致的心臟神經(jīng)癥患者60例,隨機(jī)分成A組(交感神經(jīng)節(jié)組),B組(常規(guī)針刺組),C組(藥物組)三組,每組20例。A組主穴針對(duì)頸部交感神經(jīng)節(jié)(雙側(cè)頸上神經(jīng)節(jié)、雙側(cè)頸下神經(jīng)節(jié))針刺,兩對(duì)主穴分別通電,予連續(xù)波治療(頻率2Hz),強(qiáng)度以患者可耐受為度。配穴:心俞(雙側(cè))、厥陰俞(雙側(cè))、巨闕、膻中、神門(雙側(cè))、內(nèi)關(guān)(雙側(cè))。每次治療時(shí)間為30分鐘,每日1次,每周5日,連續(xù)治療四周。B組主穴為頸夾脊穴(頸4—頸7),選取頸4與頸7夾脊穴通電。配穴及脈沖治療儀連接方法均同A組。C組為藥物組,谷維素片20mg日三次口服,連續(xù)服用20天。治療前后均對(duì)三組患者進(jìn)行中醫(yī)癥候積分表、HAMA量表、HAMD量表的評(píng)估。治療結(jié)束后對(duì)三組的量表結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析比較。結(jié)果:1.三組中醫(yī)癥狀積分經(jīng)非參數(shù)檢驗(yàn),A組、B組、C組治療前后相比,三組治療后較治療前差異顯著(P△0.01);治療后AC組間差異顯著(P▲0.01);AB組間療效差異顯著(P°0.05)。BC組間療效差異不顯著(P▲=0.3290.05)2.三組中醫(yī)癥候療效經(jīng)秩和檢驗(yàn),P0.01,三組數(shù)據(jù)差異具有統(tǒng)計(jì)學(xué)意義,A組總有效率為95%,B組總有效率為80%,C組總有效率為55%,提示A組有效率最高,其次為B組。3.三組HAMA評(píng)分比較:經(jīng)配對(duì)t檢驗(yàn),A組、B組、C組治療前后相比,三組患者在治療后較治療前差異顯著(P[0.01);經(jīng)單因素方差分析檢驗(yàn),AC組、BC組間療效差異顯著(P▲0.01);AB組間療效差異顯著(P°0.01)。4.三組HAMD評(píng)分比較:經(jīng)配對(duì)t檢驗(yàn),A組、B組、C組治療前后相比,三組患者在治療后較治療前差異顯著(P[0.01);經(jīng)單因素方差分析檢驗(yàn),AC組、BC組間療效差異顯著(P▲0.01);AB組間療效差異顯著(P°0.01)。5、三組治療前后HAMA減分率(T)比較:三組數(shù)據(jù)經(jīng)秩和檢驗(yàn),三組的HAMA減分率(T)上具有統(tǒng)計(jì)學(xué)意義(Z=0.5917,P=0.0000.01),具有顯著性差異,三組總有效率A組(95%)B組(85%)C組(60%)。6.三組治療前后HAMD減分率(T)比較:三組數(shù)據(jù)經(jīng)秩和檢驗(yàn),三組的HAMD減分率(T)上具有統(tǒng)計(jì)學(xué)意義(Z=0.5278,P=0.0010.01),具有顯著性差異,三組總有效率A組(95%)B組(80%)C組(65%)。結(jié)論:1、電針頸部交感神經(jīng)節(jié)療法與傳統(tǒng)針刺夾脊穴療法對(duì)于頸源性心臟神經(jīng)癥均是有效的治療方法。2、在改善中醫(yī)癥狀上,電針頸部交感神經(jīng)節(jié)組最好,而針刺夾脊穴組與藥物組在改善中醫(yī)癥狀積分上基本一致。3、在改善頸源性心臟神經(jīng)癥患者焦慮、抑郁狀態(tài)上,電針頸部交感神經(jīng)節(jié)療法效果最好。
[Abstract]:Objective: to observe the clinical effect of electroacupuncture on cervical sympathetic ganglion in the treatment of cervical cardiac neurosis (CNN), and to explore the advantages of this method in the treatment of cervical cardiac neurosis. Methods: sixty patients with cardiac neurosis caused by sympathetic cervical spondylosis were randomly divided into group A (group B) (group B) and group C (drug group). The main points of group A were acupuncture for cervical sympathetic ganglion (bilateral superior cervical ganglion, bilateral inferior cervical ganglion). Continuous wave therapy (frequency 2HzD, intensity is tolerable to patient). Acupoints: Xinshu (bilateral Flower, Jueyinshu (bilateral, Giu que, Tanzhong, Shenmen), Neiguan (bilateral). Treatment time is 30 minutes, once a day, 5th per week, For four weeks, the main point of group B was cervical Jiaji point (cervical 4-neck 7jiao), and the points of cervical 4 and Jiaji of neck 7 were electrified. The methods of combination of acupoints and pulse therapy instrument were the same as group A and group C as drug group, and oryzanol tablets were taken orally three times a day, 20 mg per day. After 20 days of continuous administration, three groups of patients were evaluated with Hama scale and Hamd scale before and after treatment. After the treatment, the results of the three groups were statistically analyzed and compared. After nonparametric test, the difference between group A and group B was compared before and after treatment. There was a significant difference between the three groups after treatment than before, and there was significant difference between the AC group and the AC group after the treatment. There was no significant difference in the curative effect between the three groups (P 擄0.05) .BC group had no significant difference in the curative effect between the three groups. There was no significant difference in the curative effect between the three groups (P < 0.01). The total effective rate of group A was 95%, the total effective rate of group B was 80 and the total effective rate of group C was 55, indicating that the total effective rate of group A was the highest. The HAMA score of group B was compared with that of group B before and after treatment. After treatment, there was significant difference (P < 0.01) between the three groups compared with that before and after treatment, and there was significant difference in curative effect between the AC group and the BC group by univariate analysis of variance (ANOVA). There was a significant difference in the curative effect among the three groups (P 擄0.01g 路4.The HAMD scores of the three groups were compared with those before and after treatment in group A and group B by paired t test), and compared with those before and after treatment in group A, group B and group B were compared with each other before and after treatment. After treatment, there was significant difference (P < 0.01) between the three groups compared with that before and after treatment, and there was significant difference in the curative effect between the AC group and the BC group by univariate analysis of variance (ANOVA). There was a significant difference in the curative effect among the three groups (P 擄0.01g 路5). Comparison of the HAMA score reduction rate before and after treatment and before and after treatment in the three groups: the data of the three groups were compared with the rank sum test. There was significant difference in the HAMA reduction rate of three groups (P < 0. 5917), and there was significant difference among the three groups. The total effective rate of three groups was compared with that of group A, group B, group B, group B and group C. Comparison of the HAMD score reduction rate before and after treatment in three groups: the data of the three groups were tested by rank sum test, and the results were compared with those of the three groups before and after treatment, and the total effective rate of the three groups was compared with that of the control group before and after treatment. There was a significant difference in the HAMD reduction rate between the three groups (P < 0.05, P < 0.05, P > 0.0010.01, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05). The total effective rate of group A and B was 650.Conclusion electroacupuncture of cervical sympathetic ganglion therapy and traditional acupuncture of Jiaji point therapy are effective treatment methods for cervical cardiac neurosis, and can improve the symptoms of traditional Chinese medicine. Electroacupuncture in cervical sympathetic ganglion group was the best, while acupuncture at Jiaji point group and drug group had the same effect on improving TCM symptom score. The effect of electroacupuncture on cervical sympathetic ganglion was the best in improving anxiety and depression of patients with cervical cardiac neurosis.
【學(xué)位授予單位】：黑龍江中醫(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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