本文選題：“平腕立指針刺手法” + 肝陽上亢型偏頭痛��； 參考：《云南中醫(yī)學院》2017年碩士論文

【摘要】：目的本課題通過探討“平腕立指針刺手法”對肝陽上亢型偏頭痛的治療效應,旨在為臨床治療肝陽上亢型偏頭痛提供一種新方法。方法選取符合肝陽上亢型偏頭痛納入標準的有效病例60例,按隨機數(shù)字表法,分為治療組和對照組,每組均為30例。治療組采用“平腕立指針刺手法”,取百會、印堂、太陽、風池、陽陵泉、絲竹空、率谷、合谷、太沖、太溪為主穴治療;對照組采用口服阿司匹林治療,療程共28天。按照國家中醫(yī)藥管理局《頭風診斷與療效評定標準》和經(jīng)顱多普勒血流動力學,記錄患者治療前、治療后及治療結(jié)束3個月后的各項指標,以患者治療前與治療后的“視覺模擬評分(VAS)”、“頭痛發(fā)作次數(shù)評分”、“頭痛持續(xù)時間評分”、“頭痛指數(shù)”及“經(jīng)顱多普勒(TCD)檢測的大腦前動脈(ACA)、大腦中動脈(MCA)、大腦后動脈(PCA)、椎動脈(VA)及基底動脈(BA)平均血流速度”為近期療效指標;治療結(jié)束3個月后進行電話隨訪,記錄并觀察患者的“頭痛發(fā)作次數(shù)評分”、“頭痛持續(xù)時間評分”、“VAS評分”的時間效應和遠期療效;對兩組患者的數(shù)據(jù)進行比較分析并作出近期及遠期療效評價。結(jié)果(1)治療前:對治療組及對照組患者的性別、年齡、病程、病情,及兩組患者治療前的“VAS評分”、“頭痛持續(xù)時間評分”、“頭痛發(fā)作次數(shù)評分”、“頭痛指數(shù)”、“TCD檢測的MCA、ACA、PCA、VA、BA平均流速”進行組間比較,差異無統(tǒng)計學意義(P0.05)。(2)療程結(jié)束后:治療組及對照組患者的“VAS評分”、“頭痛持續(xù)時間評分”、“頭痛發(fā)作次數(shù)評分”、“頭痛指數(shù)”、“TCD檢測的MCA、ACA、PCA、VA、BA平均流速”組內(nèi)比較均有改善,差異有統(tǒng)計學意義(P0.05);組間比較治療組優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。(3)治療結(jié)束3個月后隨訪:兩組患者的“VAS評分”、“頭痛發(fā)作次數(shù)評分”組內(nèi)比較均有改善,差異有統(tǒng)計學意義(P0.05),且組間比較治療組優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05);治療組患者“頭痛持續(xù)時間評分”組內(nèi)比較有改善,差異有統(tǒng)計學意義(P0.05),但對照組患者“頭痛持續(xù)時間”組內(nèi)比較差異無統(tǒng)計學意義(P0.05),兩組間比較差異有統(tǒng)計學意義(P0.05);兩組患者“頭痛指數(shù)”組內(nèi)比較有改善,差異有統(tǒng)計學意義(P0.05),但兩組患者組間比較差異無統(tǒng)計學意義(P0.05)。(4)臨床療效:對兩組患者治療后的療效進行對比,治療組總有效率為90.00%,顯效率為66.67%;對照組總有效率為83.33%,顯效率為50.00%,兩組間差異具有統(tǒng)計學意義(P0.05);對兩組患者治療結(jié)束3個月后的療效進行對比,治療組總有效率為83.33%,顯效率為53.33%;對照組總有效率為70.00%,顯效率為26.67%,差異具有統(tǒng)計學意義(P0.05)。結(jié)論“平腕立指”針刺治療及口服阿司匹林均能改善肝陽上亢型偏頭痛患者的“頭痛發(fā)作次數(shù)評分”、“頭痛持續(xù)時間評分”、“頭痛指數(shù)”、“視覺模擬評分(VAS)”及“TCD檢測的顱內(nèi)MCA、ACA、PCA、VA、BA的平均血流速度”,但“平腕立指針刺手法”的療效優(yōu)于口服阿司匹林;治療結(jié)束3個月后隨訪,“平腕立指”針刺治療組患者的“VAS評分”、“頭痛發(fā)作次數(shù)評分”、“頭痛持續(xù)時間評分”和“頭痛指數(shù)”均有改善,口服阿司匹林組患者的“VAS評分”、“頭痛發(fā)作次數(shù)評分”及“頭痛指數(shù)”有改善,其中“平腕立指針刺手法”在改善肝陽上亢型偏頭痛患者的“頭痛發(fā)作次數(shù)”、“VAS評分”、“頭痛持續(xù)時間”方面的療效較口服阿司匹林好。
[Abstract]:Objective to explore the therapeutic effect of "flat wrist standing finger acupuncture manipulation" on migraine with hyperactivity of liver Yang, and to provide a new method for clinical treatment of migraine with hyperactivity of liver yang. Methods 60 effective cases of migraine which conforms to hyperactivity of liver Yang type are selected and divided into treatment group and control group according to random digital table method, each group is divided into each group. In the treatment group, the treatment group adopted the "flat wrist and vertical finger acupuncture manipulation", taking Baihui, printing hall, sun, wind pond, Yang Ling spring, silk and bamboo air, rate Valley, Hegu, Tai Chi, and Tai Xi as the main point treatment, and the control group was treated with oral aspirin for a total of 28 days. According to the national TCM administration of Chinese medicine administration, the standard of the diagnosis and therapeutic evaluation of the head wind and the blood flow of transcranial Doppler were in accordance with the State Administration of traditional Chinese medicine (TCM). Mechanics, records of the patients before, after treatment and 3 months after the end of the treatment of the indicators, the patient before and after the treatment of the "visual analog score (VAS)", "headache attack times score", "headache duration score", "headache index" and "transcranial Doppler (TCD) detection of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), The mean blood flow velocity of the posterior cerebral artery (PCA), the vertebral artery (VA) and the basilar artery (BA) was the short-term curative effect. After 3 months of treatment, a telephone follow-up was carried out to record and observe the patient's "scores of headache attacks", "headache duration score", the time effect and long-term effect of "VAS score", and the data of the two groups of patients. Comparative analysis and evaluation of short-term and long-term effect. Results (1) before treatment: the sex, age, course of disease, condition of the patients in the treatment group and the control group, and the "VAS score" before the treatment of two groups, "headache duration score", "headache times score", "headache index", "MCA, ACA, PCA, VA, BA mean flow velocity" The difference was not statistically significant (P0.05). (2) after the course of treatment, the "VAS score" of the treatment group and the control group, "headache duration score", "headache times score", "headache index", "MCA, ACA, PCA, VA, BA mean flow rate" in the group were improved, and the difference was statistically significant (P0). .05); the comparison group was better than the control group, the difference was statistically significant (P0.05). (3) after 3 months of treatment, the two groups of patients "VAS score", "headache times score" group were improved, the difference was statistically significant (P0.05), and the group was better than the control group, the difference was statistically significant (P0.05); There was a significant difference in the group of "headache duration score" in the treatment group (P0.05), but there was no significant difference in the control group (P0.05) in the group of "headache duration" (P0.05), and there was a significant difference between the two groups (P0.05); the comparison of the "headache index" group in the group of patients was improved, and the difference was statistically significant. Significance (P0.05), but there was no significant difference between the two groups of patients (P0.05). (4) clinical efficacy: the efficacy of the two groups after treatment was compared, the total effective rate of the treatment group was 90% and the effective rate was 66.67%; the total effective rate of the control group was 83.33%, the significant efficiency was 50%, and the difference between the two groups was statistically significant (P0.05); and the treatment of two groups of patients was treated. The curative effect of 3 months after treatment was compared, the total effective rate of the treatment group was 83.33%, the effective rate was 53.33%, the total effective rate of the control group was 70%, the significant rate was 26.67%, the difference was statistically significant (P0.05). Conclusion "the acupuncture treatment and oral aspirin" can improve the "headache attacks" in patients with hyperactive liver Yang type migraine. "Score", "headache duration score", "headache index", "visual analogue scale (VAS)" and "mean blood flow velocity of MCA, ACA, PCA, VA, BA detected by TCD", but the effect of "flat wrist upright finger acupuncture manipulation" was better than that of oral aspirin; after 3 months of treatment, the "VAS" in the treatment group of "flat wrist erect finger" was "VAS". "Score", "score of headache attacks", "headache duration score" and "headache index" were improved. The "VAS score", "score of headache attacks" and "headache index" were improved in the oral aspirin group, and the "flat wrist standing finger acupuncture manipulation" was used to improve the "headache" in patients with hyperactive liver Yang type migraine. The curative effect of "attack times", "VAS score" and "duration of headache" is better than that of oral aspirin.

【學位授予單位】：云南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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