本文選題：輸尿管結(jié)石　切入點(diǎn)：邱氏穴　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：本研究的目的是通過觀察試驗(yàn)組(針刺組)、對照組(非針刺組)兩組患者治療后的總療效判定、癥狀積分、排石時(shí)間、不同癥型、不同長徑、不同位置的治愈率等差異,評價(jià)探討針刺邱氏穴對輸尿管結(jié)石排出的影響。方法：選取了廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院外科急診2015年10月至2016年3月同時(shí)符合輸尿管結(jié)石中醫(yī)、西醫(yī)診斷標(biāo)準(zhǔn)且在排出標(biāo)準(zhǔn)之外的患者72例。按照隨機(jī)化的方法將所有患者分為對照組與實(shí)驗(yàn)組,其中對照組32例、試驗(yàn)組37例。首診時(shí)詳細(xì)記錄患者基本信息、各項(xiàng)影像學(xué)及實(shí)驗(yàn)室檢查結(jié)果。兩組患者的性別、年齡、發(fā)病次數(shù)、結(jié)石長徑、結(jié)石位置、中醫(yī)癥型均行通過統(tǒng)計(jì)學(xué)行基線水平的比較,保證兩組基數(shù)水平差異無統(tǒng)計(jì)學(xué)意義,具有均衡可比性。對照組予口服鹽酸坦索羅辛膠囊(0.2mgPo. qd)治療。首診因“腎絞痛”就診的患者,需予常規(guī)解痙止痛治療。其中,合并泌尿系感染,查尿組合見白細(xì)胞升高者,給予左氧氟沙星片(0.5g Po.qd.)。試驗(yàn)組在對照組基礎(chǔ)上每日加用針刺邱氏穴一次�！暗脷狻焙�,留針15分鐘。經(jīng)急診處理后,所有患者均予生活指導(dǎo)(每日飲水1500-2000ml,適當(dāng)運(yùn)動(dòng)、忌食辛辣及影響排石的各種藥物、食物)。囑患者每5日返院復(fù)診,復(fù)查B超或腹部平片后,詳細(xì)記錄患者檢查結(jié)果、排石情況、不良反應(yīng)等。治療期間符合剔除標(biāo)準(zhǔn)者及時(shí)剔除本研究。采用SPSS22.0統(tǒng)計(jì)學(xué)軟件進(jìn)行統(tǒng)計(jì)分析,對比治療后兩組患者總療效判定、癥狀積分、排石時(shí)間、不同位置、不同長徑、不同癥型患者輸尿管結(jié)石治愈率的差異是否有統(tǒng)計(jì)學(xué)意義。結(jié)果：1、兩組患者性別、年齡、發(fā)病次數(shù)、結(jié)石長徑、患者癥型等基數(shù)水平分別采用T檢驗(yàn)和卡方檢驗(yàn),結(jié)果顯示兩組患者基數(shù)水平差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2、經(jīng)治療后兩組患者總療效判定與癥狀積分比較：治療后兩組患者總療效判定及癥狀積分采用秩和檢驗(yàn),結(jié)果顯示治療后兩組總療效判定差異有統(tǒng)計(jì)學(xué)意義(P0.05),療效總結(jié)分差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3、經(jīng)治療后兩組患者排石時(shí)間的比較：治療后兩組患者排石時(shí)間采用T檢驗(yàn),結(jié)果顯示兩組排石時(shí)間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4、治療后兩組不同位置、長徑、患者癥型結(jié)石治愈情況比較：治療后兩組同位置、長徑、癥型的患者治愈率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：試驗(yàn)組比對照組排石總療效更好、排石率更高、排石時(shí)間更短,兩組結(jié)石治愈率并不因結(jié)石位置、長徑、癥型的不同而有不同。說明針刺邱氏穴加用口服鹽酸坦索羅辛膠囊對于輸尿管結(jié)石的排出比當(dāng)用口服鹽酸坦索羅辛膠囊效果更好。針刺邱氏穴對輸尿管結(jié)石的排出療效確切,能有效促進(jìn)輸尿管結(jié)石的排出、縮短排石時(shí)間。
[Abstract]:Objective: the purpose of this study was to observe the difference of the total curative effect, symptom integral, lithotomy time, different symptom type, different length diameter, different position of cure rate between the two groups (acupuncture group and control group, non-acupuncture group) after treatment. To evaluate the effect of acupuncture at Qiu's point on the excretion of ureteral calculi methods: from October 2015 to March 2016, the emergency surgery department of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine was selected to accord with the Chinese medicine for ureteral calculi. According to the randomization method, all the patients were divided into two groups: the control group (n = 32) and the experimental group (n = 37). The results of various imaging and laboratory examinations showed that the sex, age, number of cases, length of stone, location of stone, TCM syndrome type were compared with baseline level by statistics, so as to ensure that there was no significant difference in cardinal level between the two groups. The control group was treated with oral tansoroxine hydrochloride 0.2mg Po.qd. the patients who were first diagnosed with "renal colic" should be treated with routine spasmolysis and pain relief. The experimental group was given levofloxacin tablet 0.5 g Po.qd.The experimental group was treated with acupuncture at Qiu's point once a day on the basis of the control group. After "getting qi", the needle was kept for 15 minutes. After emergency treatment, all the patients were given life guidance (1500-2000ml daily drinking water, appropriate exercise). Do not eat spicy and various drugs that affect the discharge of stones. Food. Ask patients to return to hospital every 5th. After reexamination of B-ultrasound or plain abdominal films, record the results of examination and discharge of stones in detail. Adverse reactions and so on. The patients who met the criteria of elimination were eliminated in time during the treatment. The SPSS22.0 statistical software was used to analyze the total curative effect, symptom score, lithotomy time, different position, different length and diameter of the two groups after treatment. The difference of cure rate of ureteral calculi in different types of patients was statistically significant. Results: sex, age, number of cases, length and diameter of stones, cardinal numbers of ureteral calculi of two groups were measured by T test and chi-square test, respectively. The results showed that there was no significant difference in cardinal number level between the two groups (P 0.05), which was comparable. After treatment, the total curative effect and symptom score of the two groups were compared: after treatment, the total curative effect and symptom score of the two groups were evaluated by rank sum test. The results showed that there was significant difference in the total curative effect between the two groups after treatment, and there was no significant difference in the score of summary of curative effect between the two groups. After treatment, the time of lithotomy was compared between the two groups: after treatment, T test was used in the two groups of patients. The results showed that there was a significant difference in the time of stone discharge between the two groups (P0.05. 4). After treatment, the two groups had different positions, long diameter, and cure status of symptomatic calculi: the two groups had the same position and long diameter after treatment. Conclusion: the total curative effect of the treatment group is better than that of the control group, the rate of stone removal is higher and the time of stone discharge is shorter. The cure rate of stone in the two groups is not due to the location and length of stone. The effect of acupuncture at Qiu's point and oral tamsoloxin hydrochloride capsule on ureteral calculi is better than that on ureteral calculi excretion, and acupuncture at Qiu's point is effective for ureteral calculi excretion. It can effectively promote the excretion of ureteral calculi and shorten the discharging time.
【學(xué)位授予單位】：廣州中醫(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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