本文選題：第三腰椎橫突綜合征　切入點：中藥熏蒸　出處：《黑龍江中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的1探討局部中藥熏蒸、局部中藥熏蒸聯(lián)合蠟療對第三腰椎橫突綜合征患者的應(yīng)用效果,旨在為臨床護(hù)理干預(yù)提供參考依據(jù)和數(shù)據(jù)支持。2探尋第三腰椎橫突綜合征患者對中醫(yī)護(hù)理技術(shù)的真實體驗,尤其是其接受度、認(rèn)可度、需求性以及依從性,為進(jìn)一步完善中醫(yī)護(hù)理技術(shù)在臨床中的應(yīng)用提供借鑒。方法本研究采用量性與質(zhì)性相結(jié)合的研究方法。①量性研究：采取便利抽樣方法,選取哈爾濱市某三級甲等中醫(yī)院骨傷科、符合納入標(biāo)準(zhǔn)的第三腰椎橫突綜合征保守治療患者為研究對象。對照組給予院內(nèi)常規(guī)護(hù)理和治療,脫落后剩余32例；試驗組1在對照組基礎(chǔ)上給予局部中藥熏蒸,脫落后剩余33例；試驗組2在試驗組1基礎(chǔ)上給予蠟療,脫落后剩余33例。干預(yù)前后分別采用改良后日本骨科協(xié)會下腰痛評分量表、Oswestry功能障礙指數(shù)、生存質(zhì)量測定量表簡表進(jìn)行評價,并在干預(yù)后依據(jù)《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》評價患者療效。數(shù)據(jù)錄入SPSS19.0統(tǒng)計軟件進(jìn)行處理分析,檢驗水準(zhǔn)為a=0.05,P0.05為差異具有統(tǒng)計學(xué)意義。②質(zhì)性研究：采取立意抽樣方法,選取試驗組2(局部中藥熏蒸聯(lián)合蠟療組)中具有代表性的患者為研究對象,資料飽和時訪談11例患者,然后根據(jù)Colaizzi現(xiàn)象學(xué)七步分析法對訪談資料進(jìn)行轉(zhuǎn)錄、分析,并提煉出4個主題。結(jié)果1干預(yù)前,三組患者一般資料、JOA各維度及總分、ODI評分、生存質(zhì)量各維度及總分各項得分比較差異均無統(tǒng)計學(xué)意義(P0.05)。2干預(yù)前后組內(nèi)比較,三組患者JOA各維度及總分、ODI評分、生存質(zhì)量各維度及總分各項得分比較差異均有統(tǒng)計學(xué)意義(P0.05)。3干預(yù)后組間比較,三組患者JOA各維度及總分、ODI評分各項得分比較差異均有統(tǒng)計學(xué)意義(P0.05)。生存質(zhì)量生理領(lǐng)域和社會關(guān)系領(lǐng)域三組間兩兩比較差異均有統(tǒng)計學(xué)意義(P0.05)。但在心理領(lǐng)域和環(huán)境領(lǐng)域試驗組1與試驗組2無統(tǒng)計學(xué)意義(P0.05)；生存質(zhì)量總分方面對照組與試驗組1、試驗組1與試驗組2也無統(tǒng)計學(xué)意義(P0.05)。4質(zhì)性研究部分歸納為4個主題：(1)疾病認(rèn)知體驗：疾病認(rèn)知不足；疾病對患者影響較大；(2)中醫(yī)護(hù)理技術(shù)認(rèn)知不足；(3)接受中醫(yī)護(hù)理技術(shù)態(tài)度及行為體驗：中醫(yī)護(hù)理技術(shù)前、后患者感受差異較大；中醫(yī)護(hù)理技術(shù)的接受度和依從性較差；(4)對中醫(yī)護(hù)理技術(shù)服務(wù)需求的體驗：良好服務(wù)態(tài)度與工作熱情；強化心理干預(yù)與疏導(dǎo)；營造規(guī)�；�、人性化服務(wù)環(huán)境。結(jié)論1局部中藥熏蒸、局部中藥熏蒸聯(lián)合蠟療均有助于改善患者的癥狀和體征,提高生存質(zhì)量；2局部中藥熏蒸聯(lián)合蠟療的改善程度要優(yōu)于單純局部中藥熏蒸；3臨床工作中要提高患者疾病認(rèn)知,積極推廣中醫(yī)護(hù)理技術(shù),以提高社會認(rèn)同,從而不斷完善中醫(yī)護(hù)理技術(shù)管理。
[Abstract]:Objective 1 to investigate the effect of local Chinese medicine fumigation and local traditional Chinese medicine fumigation combined with wax therapy on the third lumbar vertebrae transverse process syndrome. In order to provide reference and data support for clinical nursing intervention, the purpose of this study was to explore the true experience of the third lumbar vertebrae transverse process syndrome in TCM nursing technology, especially its acceptance, acceptance, demand and compliance. Methods the method of combining quantity and quality was adopted in this study. 1 quantitative study was adopted. Convenience sampling method was adopted to select orthopedics department of Grade 3A traditional Chinese medicine hospital in Harbin. The conservative treatment of the third lumbar transverse process syndrome according to the inclusive criteria was studied. The control group was given routine nursing and treatment in hospital, and the remaining 32 cases were treated with local Chinese medicine fumigation on the basis of the control group. The remaining 33 cases were treated with wax therapy on the basis of trial group 1 and the remaining 33 cases after exfoliation. Oswestry dysfunction index was measured by the modified Japanese Orthopaedic Association low back pain scale before and after intervention. The quality of life (QOL) was evaluated by the summary table of quality of life (QOL). After the intervention, the patients were evaluated according to the criteria for diagnosis and treatment of TCM diseases and syndromes. The data were input into the SPSS19.0 statistical software for processing and analysis. The test level was 0.05% (P 0.05). The difference was statistically significant. 2 qualitative study: the representative patients in test group 2 (local Chinese medicine fumigation combined with wax therapy group) were selected as the study objects. 11 patients were interviewed when the data was saturated. Then the interview data were transcribed and analyzed according to the Colaizzi phenomenological seven step analysis method. Results 1 before intervention, three groups of patients' general data were divided into three groups: each dimension and total score were scored. There was no significant difference in the scores of each dimension and total score of quality of life between the three groups before and after P0.05.2 intervention. The scores of JOA in each dimension and total score of the three groups were significantly higher than those in the control group. The scores of each dimension and total score of quality of life were significantly different between groups after P0.05.3 intervention. There were significant differences in the scores of JOA dimensions and total scores among the three groups (P 0.05). There were significant differences in quality of life (QOL) physiological field and social relationship field (P 0.05) among the three groups, but there were significant differences in psychological field and environment. There was no significant difference between group 1 and group 2 in terms of quality of life (P 0.05); the total score of quality of life in control group and test group 1, and that in group 1 and group 2 had no statistical significance. Experience: lack of understanding of disease; (2) lack of cognition of nursing technology of traditional Chinese medicine (3) attitude and behavior experience of receiving nursing technology of traditional Chinese medicine: before and after nursing technology of TCM, patients' feelings were different; The experience of Chinese medicine nursing technology service demand: good service attitude and work enthusiasm; strengthen psychological intervention and guidance; create scale; Conclusion 1 Local Chinese medicine fumigation and local Chinese medicine fumigation combined with wax therapy can improve the symptoms and signs of the patients. The improvement of local Chinese medicine fumigation combined with wax therapy was better than that of local traditional Chinese medicine fumigation combined with wax therapy. In clinical work, patients' disease cognition should be improved, and traditional Chinese medicine nursing technology should be popularized actively in order to raise social identity. In order to constantly improve the management of traditional Chinese medicine nursing technology.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R248.2

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