本文選題：頸椎病頸痛　切入點(diǎn)：針灸　出處：《廣西中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討基于“氣傷痛”理論針灸療法對頸椎病頸痛癥狀及SF-36生活質(zhì)量量表的影響。方法:選擇符合納入標(biāo)準(zhǔn)的60例頸椎病頸痛患者,患者來自于廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院針灸科病房及門診,按1:1的比例隨機(jī)分為兩組,治療組30例,對照組30例。治療組采用針灸結(jié)合拔罐治療,對照組采用常規(guī)針灸治療。1、治療組:穴位:合谷(雙)、太沖(雙)、大椎、天柱(雙)、頸椎夾脊、后溪(雙);具體操作:(1)針刺治療:患者取舒適的俯臥位,充分暴露皮膚和穴位,對皮膚和穴位進(jìn)行常規(guī)消毒后,選用一次性的25號1.0寸、1.5寸的無菌針灸針,直刺后行小幅度的提插捻轉(zhuǎn),得氣后,每10分鐘再行針1次,留針30分鐘。(2)拔罐治療:患者取舒適的俯臥位,充分暴露頸項(xiàng)部和背部,選取大小合適的玻璃罐,迅速將玻璃罐扣在應(yīng)拔的皮膚上,留罐10-15分鐘后,迅速將罐取下。(3)艾灸治療:選取大椎穴,采用艾炷灸法,選用陳年艾絨,將艾絨搓成麥粒大小的圓錐形艾炷,在穴位皮膚涂少許凡士林,將艾炷放于皮膚穴位上,點(diǎn)燃后至患者有溫?zé)岣谢蛘咻p微的灼痛感時,將艾炷移去,每穴灸5壯,灸至局部皮膚紅暈溫?zé)釣槎取?、對照組:根據(jù)全國高等中醫(yī)藥院校規(guī)劃的教材,新世紀(jì)(第二版)《針灸治療學(xué)》中的治療,選擇穴位:大椎、天柱(雙)、頸椎夾脊、后溪(雙),針刺操作方法同治療組。3、療程及評價方法:兩組治療均以5次為一個療程,共進(jìn)行2個療程10次的治療。分別在治療前后觀察療效指標(biāo)NPQ頸痛量表、VAS評分、SF-36量表,采用統(tǒng)計(jì)軟件對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,評價其臨床療效。結(jié)果:1、治療前,對兩組的一般資料進(jìn)行比較,包括性別、年齡、病程長短等,均無顯著性差異(P0.05),具有可比性。2、治療前后比較,NPQ頸痛量表評分,兩組的評分較治療前均顯著下降(P0.05),表明兩組治療均能改善頸椎病頸痛情況;治療后組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),表明治療組的療效要優(yōu)于對照組。3、治療前后比較,VAS評分,兩組的評分較治療前均顯著下降,(P0.05);治療后組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),表明治療組的療效要優(yōu)于對照組。4、SF-36量表評分,兩組治療前各項(xiàng)指標(biāo)比較,差異無統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性;兩組治療前后組內(nèi)各項(xiàng)指標(biāo)比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);治療后,治療組在改善一般健康狀況、社會功能、情感職能、精神健康方面、生理機(jī)能、軀體疼痛、生理職能和精力方面更明顯,有顯著性差異(P0.05)。結(jié)果表明,治療組采用針灸療法治療頸椎病頸痛方案在改善生活質(zhì)量方面優(yōu)于對照組。5、對兩組的臨床療效進(jìn)行比較,結(jié)果有顯著性差異(P0.05),說明治療組的總體臨床療效要優(yōu)于對照組。結(jié)論:基于“氣傷痛”針灸治療方案和常規(guī)針灸治療方案均能改善頸椎病頸痛,但“氣傷痛”針灸方案治療在改善患者疼痛、生活質(zhì)量及總體臨床療效方面要優(yōu)于常規(guī)針灸治療。
[Abstract]:Objective: to investigate the effect of acupuncture and moxibustion therapy on cervical pain and SF-36 quality of life of cervical spondylosis based on "Qi pain" theory. Methods: sixty patients with cervical pain of cervical spondylosis were selected. The patients were from the Acupuncture ward and outpatient department of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine. According to the ratio of 1: 1, the patients were randomly divided into two groups: the treatment group (30 cases) and the control group (30 cases). The treatment group was treated with acupuncture combined with cupping. The control group was treated with routine acupuncture and moxibustion. The treatment group: acupoints: Hegu (Shuangli, Taichong (Shuangli, Dazhui, Tianzhu) (Shuangli, cervical spine, Hexi; specific operation: 1) acupuncture treatment: the patients took comfortable prone position, fully exposed their skin and acupoints, After routine disinfection of the skin and acupoints, a single sterile acupuncture needle of 25 1.0 inch or 1.5 inch was selected. After direct acupuncture, the needle was raised and twirled by a small margin. After getting qi, the needle was again used once every 10 minutes. Cupping treatment: the patient takes a comfortable prone position, fully exposes the neck and back, selects a glass can of the right size, quickly fastens the glass jar to the skin that should be pulled, and leaves the can for 10-15 minutes. Take off the pot quickly. 3) moxibustion treatment: select Dazhui acupoint, adopt moxa cone moxibustion method, use the aged moxa curd, rub it into a conical moxa stick the size of wheat grain, apply a little vaseline on the skin of the acupoint, put the moxa stick on the skin acupoint, put the moxa stick on the skin acupoint, After kindling, when the patient has a sense of warm heat or mild burning pain, remove the moxa stick, each point moxibustion 5 strong, moxibustion to local skin redness and warm heat degree of .2.Contral group: according to the teaching materials planned by the National College of traditional Chinese Medicine, Treatment in New Century (2nd Edition) Acupuncture Therapeutics, choose acupoints: Dazhui, Tianzhu (Shuangli, cervical spine), Houxi (Shuangjiao, acupuncture operation method, same as treatment group .3, course of treatment and evaluation method: 5 times as one course of treatment in both groups). Before and after treatment, the curative effect index of NPQ cervical pain scale and SF-36 scale were observed, and the data were statistically analyzed by statistical software to evaluate the clinical efficacy. Results: before and after treatment, the clinical efficacy was evaluated. The general data of the two groups were compared, including gender, age, duration of disease, etc. There was no significant difference between the two groups (P 0.05), which was comparable. The scores of NPQ cervical pain scale were compared before and after treatment. The scores of the two groups were significantly lower than those before treatment, indicating that both groups could improve the neck pain of cervical spondylosis, and the difference between the two groups was statistically significant (P 0.05), which indicated that the curative effect of the treatment group was better than that of the control group, and the VAS score was higher in the treatment group than in the control group before and after treatment. The scores of the two groups were significantly lower than those before treatment, and the difference between the two groups was statistically significant, which indicated that the curative effect of the treatment group was better than that of the control group with the score of SF-36, and the indexes before treatment were compared between the two groups. There was no statistical difference between the two groups (P 0.05), there was no statistical difference between the two groups (P 0.05), there were significant differences between the two groups before and after treatment, and after treatment, the treatment group improved general health status, social function, emotional function and mental health. The physiological function, body pain, physiological function and energy were more obvious, and there were significant differences (P 0.05). The treatment group was superior to the control group in improving the quality of life by using acupuncture and moxibustion therapy to treat cervical pain of cervical spondylosis. The clinical efficacy of the two groups was compared. The results showed that the total clinical effect of the treatment group was better than that of the control group. Conclusion: both acupuncture and moxibustion therapy based on "Qi pain" can improve cervical pain of cervical spondylosis. But "Qi pain" acupuncture treatment is superior to routine acupuncture treatment in improving patients' pain, quality of life and overall clinical effect.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.9

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