本文選題：針刺　切入點(diǎn)：任督脈　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的研究針刺任、督脈腧穴對(duì)后循環(huán)缺血性(PCI)眩暈的臨床療效以及觀(guān)察治療前后針刺任、督腧穴對(duì)相關(guān)血管血流、搏動(dòng)指數(shù)客觀(guān)指標(biāo)的變化。旨在通過(guò)剖析針刺任、督二脈腧穴治療該病的作用機(jī)制,初步探討針刺治療后循環(huán)缺血性眩暈的有效治療方法,力求在臨床治療上為患者提供更為有效的優(yōu)化方法,為后循環(huán)缺血性眩暈患者的早期預(yù)防及治療提供一定的科學(xué)依據(jù)。方法本課題通過(guò)綜合西醫(yī)診斷和中醫(yī)診斷后循環(huán)缺血性眩暈的標(biāo)準(zhǔn)進(jìn)行診斷,采用簡(jiǎn)單隨機(jī)抽樣的方法將符合要求的研究對(duì)象(2015年2月至2016年2月以眩暈為主要癥狀就診于河南中醫(yī)藥大學(xué)第一附屬醫(yī)院腦病科的患者,全部病例均嚴(yán)格根據(jù)納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)進(jìn)行篩選)分為對(duì)照組和研究組,各30例。兩組患者年齡、性別、病程及合并癥方面均需經(jīng)統(tǒng)計(jì)學(xué)處理,若差異均無(wú)顯著性差異(P0.05),具備可比性,方可進(jìn)入治療觀(guān)察階段。所納入研究對(duì)象中醫(yī)辨證分型均屬于氣血虧虛型。其中,研究組采用:針刺任、督脈腧穴加靜脈輸注奧扎格雷鈉、丹紅注射液。對(duì)照組采用:針刺常規(guī)穴位加靜脈輸注奧扎格雷鈉、丹紅注射液。通過(guò)住院病歷收集兩組患者的年齡、性別、血壓、血糖、血脂等資料;采用經(jīng)顱多普勒超聲儀器(TCD)測(cè)患者大腦基底動(dòng)脈(BA)、左椎動(dòng)脈(LVA)和右椎動(dòng)脈(RVA)的血流峰值速度(Vp)和搏動(dòng)指數(shù)(PI)。所選腧穴每日針刺1次,每次30min(分鐘),7天為1療程,第1療程結(jié)束后休息1天,共2個(gè)療程。治療后詢(xún)問(wèn)患者的情況,有無(wú)心慌、胸悶、氣短等不適感。觀(guān)察兩組患者治療2個(gè)療程前后所記錄的中醫(yī)癥候積分、TCD相關(guān)客觀(guān)指標(biāo)及總有效率的變化,并根據(jù)中醫(yī)癥候積分、TCD客觀(guān)指標(biāo)及總有效率的變化,對(duì)兩組的臨床療效進(jìn)行分析評(píng)定。采用IBM SPSS Statistics SPSS21.0對(duì)數(shù)據(jù)進(jìn)行雙人錄入并統(tǒng)計(jì)分析:分別采用率及均數(shù)±標(biāo)準(zhǔn)差((?)±s)指標(biāo)對(duì)計(jì)數(shù)資料和計(jì)量資料進(jìn)行統(tǒng)計(jì)描述;對(duì)計(jì)量資料統(tǒng)計(jì)分析前,先對(duì)數(shù)據(jù)進(jìn)行正態(tài)分布檢驗(yàn),對(duì)于服從正態(tài)分布的計(jì)量資料進(jìn)行t檢驗(yàn),不服從正態(tài)分布的計(jì)量資料采用秩和檢驗(yàn);對(duì)于治療前后總有效率差異的比較,采用2x檢驗(yàn),作推斷性分析。結(jié)果1.本研究共納入60名患者,研究組和對(duì)照組各30人,對(duì)兩組患者治療前基線(xiàn)數(shù)據(jù)(年齡、性別、本地居住時(shí)間、眩暈臨床癥候積分、客觀(guān)指標(biāo)TCD的變化)進(jìn)行分析比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2.數(shù)據(jù)結(jié)果顯示:研究組及對(duì)照組兩組患者治療前后在中醫(yī)癥候積分、TCD所示VA、BA的血流速度及搏動(dòng)指數(shù)均有改善,將兩組治療前、后情況進(jìn)行分析比較,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.將研究組和對(duì)照組治療后的結(jié)果進(jìn)行比較,研究組在中醫(yī)癥候積分、TCD客觀(guān)指標(biāo)兩個(gè)方面較對(duì)照組改善明顯,經(jīng)分析,其差異具有統(tǒng)計(jì)學(xué)意義,在一定程度上說(shuō)明研究組治療效果優(yōu)于對(duì)照組。療效評(píng)定:兩組患者治療后臨床療效比較,研究組總有效率96.6%,對(duì)照組總有效率83.3%,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4.兩組患者復(fù)發(fā)率方面的評(píng)估無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。5.在兩組患者中均未見(jiàn)明顯不良反應(yīng)。結(jié)論本病從中醫(yī)整體辯證的觀(guān)點(diǎn)及結(jié)合經(jīng)絡(luò)學(xué)說(shuō),選用任督脈腧穴治療氣血虧虛性眩暈,證明了針刺任督脈腧穴對(duì)本病的臨床療效,并進(jìn)一步驗(yàn)證了任督脈與腦及氣血的聯(lián)系。根據(jù)統(tǒng)計(jì)學(xué)結(jié)果顯示,研究組及對(duì)照組兩組的治療方案對(duì)大腦后循環(huán)缺血性眩暈均有療效,而針刺任督脈腧穴合并常規(guī)西藥治療后循環(huán)缺血性眩暈較常規(guī)穴位合并西藥治療在眩暈癥狀及全身癥狀方面有更好的臨床療效,為本病的治療提供了一種更為有效的治療方案。
[Abstract]:Objective to study the acupuncture Ren and Du Meridians on posterior circulation ischemic vertigo (PCI) before and after the treatment and observation of clinical curative effect of acupuncture on acupoints, and blood flow changes, pulsatility index objective index. Through analysis of acupuncture, acupoint Du two veins in the treatment of this disease with acupuncture treatment mechanism, to explore the effective method of treatment pciv, in the clinical treatment for patients with a more effective optimization method for posterior circulation, to provide a scientific basis for early prevention and treatment of patients with ischemic vertigo. The criteria for the diagnosis method of this project through the comprehensive diagnosis of Western medicine and TCM diagnosis pciv, using simple random sampling method will in accordance with the requirements of the research object (from February 2015 to February 2016 by vertigo was the main symptom of brain diseases in the First Affiliated Hospital of Henan University of traditional Chinese medicine patients And all of the cases were strictly according to the inclusion and exclusion criteria) were divided into control group and study group, 30 cases each. Two groups of age, gender, disease duration and complications were statistically, if there are no significant difference (P0.05), comparable to enter observation of the treatment stage. The research object is divided into TCM syndrome type belong to deficiency of Qi and blood type. Among them, the study group using acupuncture Ren and Du Meridians, plus intravenous infusion of ozagrel sodium, Danhong injection. The control group: conventional acupuncture plus intravenous infusion of auza Grena, Danhong injection through medical records collected from two. Groups of patients with age, sex, blood pressure, blood glucose, blood lipids and other data; by transcranial Doppler ultrasound instrument (TCD) test in patients with cerebral basilar artery (BA), the left vertebral artery (LVA) and right vertebral artery (RVA) blood flow peak velocity (Vp) and pulsatility index (PI) of selected acupoints. Acupoint acupuncture 1 times a day, each time 30min (minutes), 7 days for 1 courses, first courses of treatment after 1 days of rest, a total of 2 courses. After treatment, patients were asked about, there is no palpitation, chest tightness, shortness of breath and discomfort. Observe two groups of patients before and after treatment of TCM symptoms of 2 recorded integral, TCD objective index and change the total efficiency, and according to the TCM syndrome score, TCD objective index and change the total efficiency, to assess the clinical efficacy of the two groups. The IBM SPSS Statistics SPSS21.0 the double entry of data and statistical analysis were used to rate and standard deviation ((?) + s) indicators for statistical description of count data and measurement data; analysis of measurement data statistics, the normal distribution test, to obey the normal distribution measurement data using t test, do not obey the normal distribution measurement data using the Wilcoxon rank sum test; The comparison of the total effective rate for the difference before and after treatment, the 2x test, as the analysis concluded. 1. results of this study included 60 patients, study group and control group of 30 people on the baseline data of two groups of patients (the change of age, gender, residence time, vertigo clinical symptom integral, objective index TCD) were analyzed and compared, there were no significant differences (P0.05), comparable.2. data showed: study group and control group before and after treatment in two groups of patients in TCM syndrome score, TCD shows VA, blood flow velocity and pulsatility index of BA were improved, the two groups before and after the situation the analysis and comparison, the difference was statistically significant (P0.05.3.) in study group compared with the control group after treatment results in the study group, TCM syndrome score, two TCD objective index improved significantly than the control group, after analysis, the difference was statistically significant, Research shows that the treatment group is better than the control group in a certain extent. The curative effect evaluation: To compare the clinical efficacy of two groups of patients after treatment, the total effective rate of study group 96.6%, control group total effective rate was 83.3%, the difference was statistically significant (P0.05.4.) two groups of patients with recurrence rate evaluation showed no significant difference (P0.05) in.5. two patients had no obvious adverse reactions. Conclusion the disease from the point of view of traditional Chinese medicine and the combination of holistic meridian theory, the Ren and Du Meridians to treat Qi and blood deficiency vertigo, proved that acupuncture Ren and Du Meridians clinical curative effect on this disease, and further validation of the brain and blood of the Ren and Du and according to the statistical results show that the contact., study group and control group two groups of treatment for ischemic vertigo curative effect after cerebral circulation, while acupuncture at Ren and Du Meridians combined conventional western medicine in the treatment of posterior circulation ischemic vertigo compared with conventional acupoint combination The treatment of Western medicine has a better clinical effect in vertigo and systemic symptoms, and provides a more effective treatment for the treatment of this disease.

【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R246.6

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