本文選題：缺血性中風(fēng)　切入點(diǎn)：醒腦通督　出處：《山西中醫(yī)學(xué)院》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究將醒腦通督針法用于缺血性中風(fēng)后偏癱痙攣狀態(tài)的治療,觀察其臨床療效,從而探討醒腦通督針法治療該病的機(jī)理,進(jìn)一步規(guī)范化操作,為該針法廣泛地運(yùn)用于臨床提供理論依據(jù)和實(shí)踐基礎(chǔ)。方法本研究設(shè)立醒腦通督針法組為治療組,常規(guī)針法組為對照組,患者隨機(jī)入組后都按缺血性中風(fēng)病診療常規(guī)給予西醫(yī)基礎(chǔ)治療和康復(fù)訓(xùn)練,并在此基礎(chǔ)上接受針刺治療。醒腦通督針法組取穴:百會、四神聰、風(fēng)府、風(fēng)池、華佗夾脊穴(蛇形刺)、陶道、長強(qiáng)。常規(guī)針法組參考2010年出版的《針灸治療學(xué)》(作者:王啟才)取穴:肩毭、臂佈、曲池、手三里、合谷、環(huán)跳、風(fēng)市、陽陵泉、足三里、絕骨、丘墟、解溪、太溪。兩組均每日針刺1次,每次留針30分鐘,每治療10次后休息2天,共30次。觀察指標(biāo)采用CSS量表(評定神經(jīng)功能缺損程度)、MAS量表(評定肢體痙攣程度)、FMA量表(評定運(yùn)動功能)、ADL指數(shù)(評定日常生活能力),采用盲法評價,于治療前、后對所有患者進(jìn)行測評,通過比較患者治療前后及兩組之間各指標(biāo)的變化,觀察兩種針法對患者上述四種功能障礙的影響,并據(jù)此來對比出兩種針法對缺血性中風(fēng)后偏癱痙攣狀態(tài)治療效果的優(yōu)劣。結(jié)果1.兩種針法對臨床神經(jīng)功能缺損程度的影響治療前兩組患者CSS量表評分經(jīng)軟件分析,P0.05,認(rèn)為兩組患者神經(jīng)功能缺損程度齊同,可以進(jìn)行對比研究;治療后測評,兩組患者所得的評分與治療前自身對照均降低,P0.05,差異均不具有統(tǒng)計學(xué)意義。2.兩種針法對患肢痙攣程度的影響治療前兩組患者M(jìn)AS量表評分經(jīng)軟件分析,P0.05,認(rèn)為兩組患者患肢痙攣程度齊同,可以進(jìn)行對比研究。治療后測評,兩組患者上下肢痙攣程度評分與治療前自身對照明顯降低,P0.05,差異有統(tǒng)計學(xué)意義;治療后與常規(guī)針刺組比較,上肢P0.05,差異無統(tǒng)計學(xué)意義,說明醒腦通督組上肢評分降低程度不明顯;下肢P0.05,差異有統(tǒng)計學(xué)意義,說明醒腦通督組下肢評分降低明顯。3.兩種針法對患肢運(yùn)動能力的影響治療前兩組患者FMA量表評分經(jīng)軟件分析,P0.05,認(rèn)為兩組患者患肢運(yùn)動能力齊同,可以進(jìn)行對比研究。治療后測評,兩組患者與治療前自身對照評分均有明顯升高,P0.05,差異有統(tǒng)計學(xué)意義;治療后與常規(guī)針刺組比較,P0.05,差異有統(tǒng)計學(xué)意義,醒腦通督組評分升高明顯。4.兩種針法對患者日常生活能力的影響治療前兩組患者ADL評分經(jīng)統(tǒng)計軟件分析,P0.05,認(rèn)為兩組日常生活能力齊同,可以進(jìn)行對比研究。治療后測評,兩組患者與治療前自身對照評分均有所升高,P0.05,差異有統(tǒng)計學(xué)意義;治療后與常規(guī)針刺組比較,P0.05,差異無統(tǒng)計學(xué)意義,說明醒腦通督組評分升高不明顯。5.兩種針法對總體有效率的影響醒腦通督針法組治療后總有效27例,占87.1%,常規(guī)針法組總有效為19例,占63.3%,兩組療效相比較,P0.05,差異有統(tǒng)計學(xué)意義。結(jié)論1.醒腦通督針法與常規(guī)針法對于研究期間患者神經(jīng)功能缺損程度的改善均沒有明顯療效。2.醒腦通督針法與常規(guī)針法均能改善患者肢體的痙攣程度,醒腦通督針法改善下肢痙攣程度優(yōu)于常規(guī)針刺組,對于上肢兩種方法療效相當(dāng)。3.醒腦通督針法與常規(guī)針法對于提高患者的運(yùn)動能力均有確切療效,醒腦通督針法更為明顯。4.醒腦通督針法與常規(guī)針法對于改善患者的日常生活能力均有效,且兩種方法療效相當(dāng),不能說明哪一種方法對于改善患者日常生活能力更有效。本研究結(jié)果顯示醒腦通督針法的療效主要體現(xiàn)在改善患者患肢痙攣程度以及提高患肢運(yùn)動能力,對日常生活能力的提高與常規(guī)針刺法相當(dāng),短時期內(nèi)對于神經(jīng)功能缺損程度的改善并不明顯。醒腦通督針法組總有效率為87.1%,常規(guī)針刺組總有效率為63.3%,差異具有統(tǒng)計學(xué)意義,可以認(rèn)為醒腦通督針法治療該病總體療效優(yōu)于常規(guī)針刺法。
[Abstract]:The purpose of this study will Xingnao unblocking acupuncture for the treatment of spastic hemiplegia after ischemic stroke, to observe its clinical curative effect, so as to explore the mechanism of Xingnao unblocking acupuncture treatment of the disease, to further standardize the operation, the method is widely used to provide theoretical basis and practical basis for clinical. Methods in this study the establishment of Xingnao unblocking acupuncture group for the treatment group, conventional acupuncture group as the control group, patients were randomized into group according to diagnosis and treatment of ischemic stroke treated with western medicine foundation treatment and rehabilitation training, and on the basis of received acupuncture treatment. Xingnao unblocking acupuncture group acupoints: Baihui, Sishencong, Fengchi, Fengfu, Hua Tuo Jiaji (snake thorn), Taodao, long strong. > conventional acupuncture group acupuncture treatment reference published in 2010 "(author: Wang Qicai) acupoints: Dou shoulder, arm, hand three years, Quchi, Hegu, ring jump, wind city, Yang Ling Quan, Zusanli and juegu, Qiuxu, JieXi, too Xi. Two groups of acupuncture 1 times a day, each time the needle for 30 minutes, every 10 days after treatment 2 days off, a total of 30 times. The observation indexes by CSS scale (assessment of the degree of neural function defect scale (MAS), assessment of spasticity degree scale (FMA), assessment of motor function, ADL (index) the assessment of the ability of daily life), evaluated by blind method before treatment, after evaluation of all patients, through the comparison between changes in patients before and after treatment, two groups of each index, to observe the effect of acupuncture on two patients with the four kinds of dysfunction, and to compare the advantages and disadvantages of the two kinds of needle method for treatment of hemiplegia spasticity after ischemic stroke. Results 1. of two kinds of acupuncture effect on clinical neurological impairment of the two groups before treatment CSS score through the analysis of the software P0.05, that two groups of patients with neurological deficits can be compared with Qi, study after treatment evaluation, two groups; The score and treatment of patients with the control were lower, P0.05, the difference was not statistically significant.2. two stitches on the score by the software analysis, affected limb spasticity in the two groups before treatment MAS scale P0.05, two group patients with limb spasticity with Qi, can be treated to conduct a comparative study. After the evaluation of lower limb spasticity score before treatment were significantly decreased, P0.05 patients were divided into two groups, the difference was statistically significant; after treatment compared with the routine acupuncture group of upper limb P0.05, the difference was not statistically significant, indicating Xingnao unblocking group on limb score decreased not obviously; lower extremity P0.05, the difference was statistically significant, indicating Xingnao unblocking group of lower extremity score decreased signiifcantly.3. two kinds of acupuncture on limb movement ability of the two groups before treatment FMA score through the analysis of the software P0.05, two group patients with limb movement ability with Qi, can Comparative study. After treatment evaluation, two groups of patients before treatment and control scores were significantly increased, P0.05, the difference was statistically significant; after treatment compared with the conventional acupuncture group P0.05, the difference was statistically significant, Xingnao unblocking score of group.4. increased significantly two kinds of acupuncture effect on daily life ability of patients before treatment, two ADL score of group analysis by statistical software P0.05, two group together with the ability of daily life, can carry out comparative study. After treatment evaluation, two groups of patients before treatment and control scores were increased, P0.05, the difference was statistically significant; after treatment compared with the conventional acupuncture group P0.05, the difference was not statistically significant. Description of Xingnao unblocking group were increased significantly.5. two effect of Xingnao acupuncture methods on the overall efficiency of unblocking acupuncture group after treatment, the total effective 27 cases, accounting for 87.1%, a conventional acupuncture group total effective 19 cases, accounting for 63.3%, two Results compared to P0.05, the difference was statistically significant. Conclusion 1. Xingnao unblocking acupuncture and conventional acupuncture for spasm during the study period in patients with neurological deficits were improved without obvious curative effect.2. Xingnao unblocking acupuncture and conventional acupuncture can improve the patients' limbs, awake brain unblocking acupuncture improve lower limb spasticity is superior to conventional acupuncture for the group, with two methods of upper limb rather.3. Xingnao unblocking acupuncture and conventional acupuncture in improving exercise capacity have definite curative effect in patients, Xingnao unblocking acupuncture is more obvious.4. Xingnao unblocking acupuncture and conventional acupuncture are effective to improve the ability of daily life of patients, and the curative effect of two kinds of methods, can not explain what kind of a more effective method for improving the ability of daily life of patients. The results of this study showed that effect of Xingnao unblocking acupuncture mainly in patients with limb spasticity and Improve the limb movement ability, is to improve the ability of daily life and routine acupuncture method, a short period of time for the improvement of nerve function defect degree is not obvious. Xingnao unblocking acupuncture group total effective rate was 87.1%, conventional acupuncture group, the total effective rate was 63.3%, the difference has statistical significance, can think of Xingnao unblocking acupuncture treatment the overall effect is better than conventional acupuncture.

【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6

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