本文選題：子午流注　切入點：大黃穴位貼敷　出處：《山東大學》2017年碩士論文

【摘要】：研究目的探索"子午流注"理論指導下大黃穴位貼敷治療危重患者便秘的有效性及安全性,繼而為該治療方案在臨床治療工作中推廣使用提供理論依據(jù)。以期向危重患者提供更加優(yōu)質(zhì)的臨床醫(yī)療服務,促使其病情得到控制,在較短時間內(nèi)改善便秘癥狀。研究方法選取2015年3月至2016年3月入住萊蕪市中醫(yī)院ICU的危重患者60例,利用隨機數(shù)字表法分為對照組和觀察組各30例。對照組采取口服莫沙必利治療,1片/次,3次/d。觀察組給予"子午流注"理論指導下大黃穴位貼敷治療,每日6:00,用生理鹽水清理穴位,將藥貼固定于神闕穴,每日1次,每次6 h。兩組患者均持續(xù)治療4個療程,7 d為一個療程。比較兩組患者臨床治療總有效率、不良反應發(fā)生率、便秘癥狀積分、肛管運動功能、直腸肛管協(xié)調(diào)運動功能、直腸感覺功能等。結(jié)果1.觀察組治療總有效率93.3%,同期對照組治療總有效率80%。觀察組臨床療效優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。2.治療后,觀察組排便間隔時間(0.64±0.15)分,排便速度(1.23±0.78)分,排便性狀(1.01 ±0.50)分,排便難度(0.92士0.35)分,便意(0-85±0.70)分。同期對照組排便間隔時間(1-15±0.13)分,排便速度(2.02±0.80)分,排便性狀(1.75±0.48)分,排便難度(1.53±0.34)分,便意(1.51±0.67)分。觀察組各指標均明顯優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。3.治療后,觀察組 RP(65.38±1.52)mmHg,HPZ(4.47±0.32)cm,MSP(194.37±1.50)mmHg,DSS(14.10±1.25)s。同期對照組RP(61.20±1.45)mmHg,HPZ(4.22±0.30)cm,MSP(185.69±1.41)mmHg,DSS(12.65±1.24)s。觀察組各指標均明顯優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。4.治療后,觀察組IRP(35.79±1.11)mmHg,RAP(46.90±1.41)mmHg,ARR(33.85±1.3)%,RAPG(-11.44±1.33)mmHg。同期對照組 IRP(33.08±1.20)mmHg,RAP(53.33± 1.45)mmHg,ARR(29.48± 1.35)%,RAPG(—15.24± 1.26)mmHg。觀察組各指標均明顯優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。5.治療后,觀察組直腸初始感覺閾值(25.10±0.85)ml,直腸初始排便感覺閾值(52.10±1.35)ml,直腸最大耐受量(141.73±4.25)ml。同期對照組直腸初始感覺閾值(22.37±0.90)ml,直腸初始排便感覺閾值(46.48±1.32)ml,直腸最大耐受量(134.99±4.11)ml。觀察組各指標均明顯優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。結(jié)論1."子午流注"理論指導下大黃穴位貼敷治療危重患者便秘效果更佳、安全性更高,可滿足當前患者臨床治療需求。2.在緩解便秘癥狀、改善肛管運動功能、直腸肛管協(xié)調(diào)運動功能、直腸感覺功能方面,"子午流注"理論指導下大黃穴位貼敷取得的效果更加明顯。3."子午流注"理論指導下大黃穴位貼敷治療可作為臨床治療危重患者便秘的優(yōu)選方案推廣使用。
[Abstract]:Objective to explore the efficacy and safety of rhubarb acupoint application in the treatment of severe constipation under the guidance of "Meridian flow" theory. Then it provides a theoretical basis for popularizing and using the treatment scheme in clinical treatment, in order to provide more high-quality clinical medical services to critically ill patients and to bring their condition under control. To improve constipation symptoms in a short period of time. Methods 60 critically ill patients admitted to ICU in Laiwu traditional Chinese Medicine Hospital from March 2015 to March 2016 were selected. The control group was divided into control group (n = 30) and observation group (n = 30). The control group was treated with oral mosapride for 3 times / d. The observation group was treated with "meridian flow" theory under the guidance of "rhubarb" acupoint application. At 6: 00 daily, the acupoints were cleaned with normal saline, and the drug was fixed at Shenque point once a day for 6 hours. The patients in both groups were treated continuously for 4 courses and 7 days as a course of treatment. The total effective rate of clinical treatment and the incidence of adverse reactions were compared between the two groups. Results 1. The total effective rate of treatment in the observation group was 93.3, and the total effective rate in the control group was 80 percent. The clinical efficacy of the observation group was better than that of the control group, and the clinical efficacy of the observation group was better than that of the control group. After treatment, the defecation interval time was 0.64 鹵0.15, the defecation rate was 1.23 鹵0.78, the defecation character was 1.01 鹵0.50, the defecation difficulty was 0.92 鹵0.35), the mean defecation time was 1-15 鹵0.13), the defecation velocity was 2.02 鹵0.80). The score of defecation character was 1.75 鹵0.48, the defecation difficulty was 1.53 鹵0.34, the defecation meaning was 1.51 鹵0.67). The indexes in the observation group were significantly better than those in the control group, and the difference was statistically significant (P0.05 .3.After the treatment, the RP(65.38 鹵1.52 mm HgPZ4.47 鹵0.32 cm ~ (-1) HgPZ) in the observation group was significantly higher than that in the control group (14.10 鹵1.25 / s). In the same period, the control group's RP(61.20 鹵1.45 mm HgHPZL 4.22 鹵0.30mm HHPZL was significantly superior to the control group (P < 0.01 鹵1.41 鹵1.41 mm HgDSS 12.65 鹵1.24s-1). After treatment, the IRP(35.79 of the observation group was 46.90 鹵1.41 鹵1.41 鹵1.41 鹵1.41 鹵1.31 鹵1.31 鹵3.85 鹵1.33 鹵1.33 鹵11.44 鹵1.33 鹵1.33 mm Hg / g respectively. After treatment, the IRP(33.08 鹵1.20 mm IRP(33.08 of the observation group was 29.48 鹵1.35 鹵1.35 鹵1.26 mm Hg.After the treatment, all the indexes in the observation group were significantly better than those in the control group (P 0.05. 5). In the observation group, the initial rectal sensory threshold was 25.10 鹵0.85ml, the rectal initial defecation threshold was 52.10 鹵1.35ml, the rectal maximum tolerance dose was 141.73 鹵4.25ml. In the control group, the rectal initial sensory threshold was 22.37 鹵0.90ml, the rectal initial defecation threshold was 46.48 鹵1.32ml, and the maximum rectal tolerance dose was 134.99 鹵4.11ml / ml. All of them were significantly superior to the control group. Conclusion 1. Under the guidance of "Meridian flow" theory, the application of rhubarb acupoint to treat severe constipation is more effective and safe, which can meet the current clinical treatment needs of patients with constipation. 2. In relieving constipation symptoms, Improve anal motor function, rectoanal coordination motor function, In rectal sensory function, under the guidance of "Meridian flow" theory, the effect of rhubarb acupoint application was more obvious. 3. Under the guidance of "Meridian flow" theory, rhubarb acupoint application therapy could be used as an excellent scheme for clinical treatment of constipation in critically ill patients.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R248.9

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