本文選題：腰椎間盤(pán)突出癥 + 丁桂散��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過(guò)運(yùn)用丁桂散外敷聯(lián)合推拿對(duì)寒濕型腰椎間盤(pán)突出癥患者進(jìn)行治療,并與吡羅昔康貼片進(jìn)行對(duì)照比較,觀察患者治療前后量表評(píng)分的變化,探討丁桂散治療腰椎間盤(pán)突出癥在減輕疼痛、提高生活質(zhì)量和恢復(fù)腰部活動(dòng)方面的療效及安全性,以期為臨床治療腰椎間盤(pán)突出癥提供更多有效的手段和方法。方法:根據(jù)納入標(biāo)準(zhǔn)從本院門(mén)診選擇80例寒濕型腰椎間盤(pán)突出癥患者進(jìn)行臨床研究,用隨機(jī)方法分為兩組,試驗(yàn)組和對(duì)照組各40例。試驗(yàn)組患者予外敷丁桂散,對(duì)照組予外敷吡羅昔康貼片,兩組均聯(lián)合相同的推拿手法治療。治療前,兩組均記錄患者的基線參數(shù)如性別、年齡、病程、患肢等。觀察治療前、兩周及隨訪兩個(gè)月并記錄治療前后量表的VAS、0DI評(píng)分,測(cè)量SLR、Cobb角的數(shù)值,觀察并記錄藥物的不良反應(yīng)。收集數(shù)據(jù)后,用SPSS20.0軟件進(jìn)行統(tǒng)計(jì),比較和分析兩組治療前后的臨床療效。結(jié)果:1.治療前兩組之間患者的一般資料如性別、年齡、病程、患肢等,以及VAS、0DI評(píng)分、SLR和Cobb角度統(tǒng)計(jì)(P0.05)均無(wú)顯著性差異。2.治療兩周后,兩組與治療前相比較,有統(tǒng)計(jì)學(xué)差異,VAS、ODI、Cobb角比治療前出現(xiàn)了顯著下降,SLR明顯高于治療前。兩組之間VAS評(píng)分比較,有統(tǒng)計(jì)學(xué)差異,且總體評(píng)分均數(shù)對(duì)照組低于試驗(yàn)組,顯示對(duì)照組在短期內(nèi)減輕疼痛的效果方面優(yōu)于試驗(yàn)組。兩組間的0DI評(píng)分、SLR、Cobb角及0DI改善率方面比較,無(wú)明顯差異。3.治療兩個(gè)月后,兩組與治療前相比較,患者的VAS、ODI、Cobb比治療前呈更顯著下降,SLR提高較前面明顯,有統(tǒng)計(jì)學(xué)差異。兩組間的VAS、ODI、SLR角數(shù)值比較,無(wú)明顯差異。Cobb方面對(duì)比,試驗(yàn)組低于對(duì)照組,有顯著性的差異。0DI的改善率方面比較,兩組變化相當(dāng),但均高于治療前和治療后兩周。結(jié)論:1.丁桂散、吡羅昔康貼片外敷聯(lián)合推拿,這兩種方法治療寒濕型LDH在短期和中期都能取得一定療效。2.在治療兩周,吡羅昔康貼片較丁桂散外敷治療寒濕型LDH在緩解疼痛的效果更明顯;在提高生活質(zhì)量、改善脊柱側(cè)彎和恢復(fù)患側(cè)下肢活動(dòng)角度方面效果相當(dāng)。3.在治療兩個(gè)月,丁桂散較吡羅昔康貼片外敷治療寒濕型LDH在改善脊柱側(cè)彎的療效更理想,在減輕疼痛、提高生活質(zhì)量和恢復(fù)患側(cè)下肢活動(dòng)角度方面效果相當(dāng)。4.丁桂散外敷聯(lián)合推拿治療LDH具有安全有效、方便價(jià)廉的優(yōu)勢(shì),在臨床上值得推廣和使用。
[Abstract]:Objective: the purpose of this study was to treat the patients with cold and wet lumbar intervertebral disc herniation by using Dinggui Powder and massage, and compare with Piroxicam patch to observe the change of scale before and after treatment. To explore the efficacy and safety of Ding Gui San in the treatment of lumbar disc herniation in alleviating pain, improving quality of life and restoring lumbar movement, in order to provide more effective means and methods for clinical treatment of lumbar disc herniation. Methods: 80 patients with cold and wet lumbar disc herniation were selected from our outpatient clinic according to the inclusion criteria. The patients were randomly divided into two groups: the experimental group (n = 40) and the control group (n = 40). The patients in the test group were treated with Dinggui Powder and the control group were treated with Piroxicam patch. The two groups were treated with the same massage manipulation. Before treatment, the baseline parameters such as gender, age, course of disease and affected limbs were recorded in both groups. Before treatment, two weeks and two months follow-up, VAS-0DI scores of the scale before and after treatment were recorded, the values of SLR Cobb angle were measured, and adverse drug reactions were observed and recorded. After collecting data, SPSS20.0 software was used to compare and analyze the clinical efficacy of the two groups before and after treatment. The result is 1: 1. There was no significant difference in general data between the two groups before treatment, such as sex, age, course of disease, affected limb, and VAS-0DI score and Cobb angle (P 0.05). After two weeks of treatment, there was a significant difference between the two groups and before treatment, there was a significant decrease in the angle of VASA ODI Cobb and the SLR was significantly higher than that before treatment. There was significant difference in VAS score between the two groups, and the average of total score in the control group was lower than that in the experimental group, which indicated that the control group was superior to the experimental group in alleviating pain in a short period of time. There was no significant difference between the two groups in the 0DI score and the improvement rate of 0DI. After two months of treatment, the VAS-ODI Cobb in the two groups was significantly lower than that before treatment, and the SLR was significantly higher than that before treatment, and there was significant difference between the two groups. There was no significant difference between the two groups in the value of VAS-ODII SLR, but there was no significant difference between the two groups. The improvement rate of the two groups was lower than that of the control group. There was a significant difference in the improvement rate of .0DI between the two groups. The changes in the two groups were similar, but both were higher than those before treatment and two weeks after treatment. Conclusion 1. Ding Gui San, Piroxicam patch combined with massage, these two methods in the treatment of cold and wet type LDH in the short and medium can achieve a certain curative effect. 2. In two weeks of treatment, Piroxicam patch was more effective than Dinggui Powder in relieving pain of cold and wet LDH, and had the same effect in improving quality of life, improving scoliosis and recovering lower extremity movement angle of affected side. After two months of treatment, Dinggui Powder was more effective than Piroxicam patch in improving scoliosis of cold and wet type of LDH, and had the same effect in relieving pain, improving quality of life and recovering lower extremity movement angle of affected side. Dinggui Powder combined with massage therapy has the advantages of safe, effective, convenient and cheap, and is worth popularizing and using in clinic.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R274.9
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本文編號(hào)：1790554