本文選題：火針　切入點(diǎn)：肩周炎　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究從臨床觀察的角度,客觀評(píng)價(jià)火針療法結(jié)合針刺治療粘連期風(fēng)寒濕型肩周炎的臨床療效,為臨床治療本病尋找有效的方法及提供必要的依據(jù),以祈更好的推廣應(yīng)用。方法本實(shí)驗(yàn)共選取病例60例,以隨機(jī)方法分成治療組和對(duì)照組,各組為30例,入選者均符合中西醫(yī)診斷標(biāo)準(zhǔn),并經(jīng)標(biāo)準(zhǔn)篩選排除不合格者。以肩關(guān)節(jié)活動(dòng)度和肩部疼痛范圍為觀察指標(biāo),并對(duì)治療結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)處理,以得出最終結(jié)論。治療組(火針結(jié)合針刺組)：在常規(guī)針刺治療的基礎(chǔ)上,尋找病灶局部最明顯的壓痛敏感點(diǎn),靠近施針部位,用中火針密集式圍刺刺激,針刺深淺以病程長(zhǎng)短,病情輕重而定,輕者1-2mm,重者不超過(guò)3mm。最后讓患者做外展、上抬等動(dòng)作2-3min。每次以刺3個(gè)痛點(diǎn)為限,交替取穴,每隔2-3天1次,每周治療2次,6次為一個(gè)療程。對(duì)照組(常規(guī)針刺組)：取穴肩毭、肩髂、肩前(肩髑前1寸)、肩貞、臂膈、曲池、合谷、后溪、阿是穴、陵下穴(陽(yáng)陵泉直下2寸凹陷處壓痛點(diǎn)上)。選用直徑0.30mm-0.32mm的1-2寸不銹鋼毫針,快速直刺進(jìn)針,進(jìn)針深度約為0.8-1.5寸,留針30min。同時(shí),肩髑宜向肩關(guān)節(jié)直刺,作捻轉(zhuǎn)手法。肩貞不宜向胸側(cè)深刺。每隔l0min行手法1次。唯獨(dú)后溪,取1寸不銹鋼毫針,直刺0.5-1寸,只留針,不作捻轉(zhuǎn)。施治完成后囑(協(xié)助)患者作肩部上臂上舉、翻臂擦背、攀對(duì)肩、外旋、內(nèi)旋等動(dòng)作十分鐘。每日1次,每周治療5次,15次為一個(gè)療程。結(jié)果1.治療組30例,男性12例,女性18例,年齡38-61歲,平均48.7±5.5歲,對(duì)照組30例,男性14例,女性16例,年齡40-64歲,平均49.4±5.8歲,兩組病例在性別、年齡、病程方面無(wú)明顯差異,具有可比性(P0.05)。2.對(duì)照組治療后的疼痛評(píng)分是51.33±7.99,而治療組的疼痛評(píng)分則是57.5±9.84兩組療法的療效具有明顯差異(P0.01),表示治療組優(yōu)于對(duì)照組。3.對(duì)照組治療后的活動(dòng)能力評(píng)分是29.40±5.49,而治療組的疼痛評(píng)分則是33·30±4.84。兩組數(shù)據(jù)具有統(tǒng)計(jì)學(xué)上的明顯差異(P0.01)。在提升肩關(guān)節(jié)活動(dòng)能力療效方面,治療組優(yōu)于對(duì)照組4.在治療總療效方面,治療組愈顯率為60%,對(duì)照組愈顯率為30%,兩組比較具有非常顯著性差異(P0.01)。結(jié)論火針結(jié)合針刺療法治療粘連期風(fēng)寒濕型肩周炎的療效優(yōu)于單純常規(guī)針刺,值得臨床推廣應(yīng)用。
[Abstract]:Objective to evaluate objectively the clinical effect of fire acupuncture combined with acupuncture on the treatment of rheumatic, cold and dampness shoulder periarthritis in the period of adhesion from the clinical observation point of view, and to find an effective method and provide necessary basis for clinical treatment of this disease. Methods A total of 60 cases were selected and randomly divided into treatment group and control group (30 cases in each group). The range of shoulder motion and shoulder pain were taken as the observation indexes, and the results of treatment were analyzed statistically. In order to reach the final conclusion, the treatment group (fire acupuncture combined with acupuncture group: on the basis of routine acupuncture treatment, looking for the most obvious local tenderness sensitive point of the focus, near the acupuncture position, using the medium fire needle dense type of circumscribed acupuncture stimulation, acupuncture depth and shallow with the course of disease, the treatment group, the treatment group (fire acupuncture combined with acupuncture group), the most obvious local tenderness sensitive point of the focus, According to the severity of the disease, the patient is light (1-2mm), and the heavy (not more than 3mm). Finally, the patient is allowed to do the outreaching and lifting for 2-3 mins. Take the acupoints alternately every 2-3 days, limited to 3 pain points at a time. Two times a week, 6 times a week as a course of treatment. The control group (routine acupuncture group: take points of shoulder, shoulder and iliac, shoulder (1 inch before shoulder resuscitation, shoulder virginity, arm diaphragm, convoluted pool, Hegu, Houxi, Ashi), Lingxia point (Yanglingquan 2 inch indentation). Choose 1-2 inch stainless steel needle with diameter 0.30mm-0.32mm, fast and straight into needle, the depth of needle is about 0.8-1.5 inch, keep needle for 30 mins. At the same time, shoulder resuscitation should be directed straight to shoulder joint. Twist manipulation. Shoulder virginity should not be pricked deep into the chest. Once every 10 minutes. Take 1 inch stainless steel millimeter needle, direct puncture 0.5-1 inch, only keep needle, do not twist. Ask (assist) the patient to do shoulder arm lift after treatment. The results were as follows: 1. There were 30 patients in the treatment group, 12 males and 18 females, aged 38-61 years, with an average age of 48.7 鹵5.5 years, and 30 patients in the control group. There were 14 males and 16 females, aged 40-64 years (mean 49.4 鹵5.8 years). There was no significant difference in sex, age and course of disease between the two groups. The pain score of the control group was 51.33 鹵7.99, while the pain score of the treatment group was 57.5 鹵9.84, which indicated that the treatment group was superior to the control group. The score of activity ability after treatment was 51.33 鹵7.99, while that of the treatment group was 57.5 鹵9.84, which indicated that the treatment group was superior to the control group. 29.40 鹵5.49, while the pain score of the treatment group was 33.30 鹵4.84.The difference between the two groups was statistically significant (P 0.01). The treatment group is superior to the control group 4. The effective rate of the treatment group was 60 and that of the control group was 30. The difference between the two groups was very significant (P 0.01). Conclusion the curative effect of fire acupuncture combined with acupuncture therapy is better than that of simple routine acupuncture in treating rheumatism and dampness type shoulder periarthritis in adhesive period, and it is worth popularizing in clinic.
【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】：2016
【分類號(hào)】：R246.9

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