本文選題：納氣針法 + 風(fēng)池穴　； 參考：《大連醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:比較運用納氣針法與常規(guī)針法治療干眼癥的臨床療效差異,以期驗證納氣針法針刺風(fēng)池穴為主治療干眼癥的可行性。方法:選取2014年2月至2016年1月大連醫(yī)科大學(xué)附屬第二醫(yī)院針灸科門診和眼科門診確診為干眼癥的患者共60例(120只眼),根據(jù)治療方法的不同,隨機分為納氣針法組、常規(guī)針刺組、人工淚液組三組進行治療,每組均為20例,其中納氣針法組(A)入組20例,脫落2例,共18例(36只眼);常規(guī)針刺組(B)入組20例,脫落1例,共19例(38只眼);人工淚液組(C)入組20例,脫落4例,共16例(32只眼)。納氣針法組在風(fēng)池穴應(yīng)用納氣針法;足三里、三陰交、太溪施迎隨補法;光明、太沖施迎隨瀉法;太陽、攢竹、四白施捻轉(zhuǎn)平補平瀉法。常規(guī)針刺組取穴同納氣針法組,采用捻轉(zhuǎn)平補平瀉法。納氣針法組和常規(guī)針刺組每日一次,7天為一療程,連續(xù)治療4個療程;人工淚液組應(yīng)用人工淚液每天一次,每日4次點眼,根據(jù)患者的具體癥狀酌情增減,連續(xù)使用30天。隨訪觀察三組治療前后淚液分泌實驗(Schirmer I test,SIt)、淚膜破裂時間(breakup time of tear film,BUT)、角膜熒光素染色(fluorescien,FL)、視覺模擬評分法(Visual Analogue Scale/Score,VAS)評分、臨床總癥狀積分和干澀積分指標的變化。所有患者均符合入組標準,可耐受所有檢查和針灸治療并知情同意。將收集的數(shù)據(jù)建立數(shù)據(jù)庫,采用SPSS 20.0統(tǒng)計學(xué)軟件進行數(shù)據(jù)分析,對計量資料以均數(shù)±標準差((?)±S)表示。計數(shù)資料采用x2檢驗;三組間治療前計量資料的比較采用單因素方差分析,兩兩比較采用LSD-t檢驗;各組治療前后變量差異采用配對t檢驗;對比三組治療療效采用非參數(shù)秩和檢驗;均以P0.05為差異具有統(tǒng)計學(xué)意義,評價各參數(shù)變化。結(jié)果:1.三組治療后SIt、BUT值均較治療前增加,其中A、B組較治療前增加明顯,差異有統(tǒng)計學(xué)意義(P0.05)。A、B組均高于C組,差異有統(tǒng)計學(xué)意義(P0.05);A組SIt值高于B組,有統(tǒng)計學(xué)差異(P0.05)。2.三組治療后臨床癥狀總評分、VAS評分均較治療前降低,其中A、B組較治療前降低明顯,差異有統(tǒng)計學(xué)意義(P0.05)。A、B組均低于C組,差異有統(tǒng)計學(xué)意義(P0.05);A組總評分、VAS評分低于B組,有統(tǒng)計學(xué)差異(P0.05)。3.三組治療后FL評分、眼干澀積分均較治療前降低,其中A、B組較治療前降低明顯,差異有統(tǒng)計學(xué)意義(P0.05)。A、B組均低于C組,差異有統(tǒng)計學(xué)意義(P0.05);A組FL評分、干澀積分低于B組,無統(tǒng)計學(xué)差異(P0.05)。4.納氣針法組總有效率為91.7%;常規(guī)針刺組總有效率84.3%;人工淚液組總有效率68.7%,納氣針法組總有效率高于常規(guī)針刺組和人工淚液組,差異有統(tǒng)計學(xué)意義。結(jié)論:1.納氣針法治療干眼癥療效明顯優(yōu)于常規(guī)針刺,顯著改善了眼睛局部的干澀、不適等癥狀,改善淚液的分泌,對角膜上皮有修復(fù)作用。2.納氣針法針刺風(fēng)池穴可使局部產(chǎn)生針感以及沿足少陽膽經(jīng)的循行感傳,使眼瞼、眼球產(chǎn)生酸脹熱感,療效顯著,充分證明“氣至病所”的臨床意義。
[Abstract]:Objective: to compare the clinical curative effect of Qi-invigorating acupuncture and routine acupuncture in the treatment of xerophthalmia in order to verify the feasibility of treating xerophthalmia by acupuncture of Qi-acupuncture and Fengchi acupoint. Methods: from February 2014 to January 2016, 60 patients with xerophthalmia were selected from Department of Acupuncture, Department of Acupuncture and Ophthalmology, second affiliated Hospital of Dalian Medical University. The routine acupuncture group and artificial tear group were treated with 20 cases in each group, including 20 cases in group A), 2 cases in group A and 18 cases in group A, and 20 cases in group B in routine acupuncture group, 1 case in group A, and 1 case in group B in routine acupuncture group, and 2 cases in group A, 2 cases in group A, and 20 cases in group B in routine acupuncture group, and 1 case in group A in routine acupuncture group. There were 19 cases with 38 eyes and 20 cases with artificial tear group (C), and 4 cases with shedding, 16 cases with 32 eyes. Na-Qi acupuncture group in Fengchi acupoint, Zusanli, Sanyinjiao, Taixi Yingying with the complement method, bright, Taichongying with diarrhea method, the sun, Zanzhu, four Beshi twirling flat tonifying and reducing method. Routine acupuncture group took points with Qi acupuncture group, using twirling and tonifying and reducing method. The artificial tear group was treated with artificial tear once a day, 4 times a day, according to the specific symptoms of the patients, it was used continuously for 30 days. The changes of tear secretion test (Schirmer I test), tear film break up time of tear film, corneal fluorescein staining, visual analogue score (VAS), total clinical symptom score and dry score were observed before and after treatment. All patients meet the admission criteria, can tolerate all examinations and acupuncture treatment and informed consent. The collected data were set up and analyzed by SPSS 20.0 statistical software. The measurement data were expressed as mean 鹵standard deviation (鹵S). The counting data were analyzed by x2 test, single factor analysis of variance (ANOVA), LSD-t test were used to compare the measured data before and after treatment, and the difference of variables before and after treatment was matched t test. Comparison of three groups of therapeutic efficacy using non-parametric rank sum test; P0.05 as the difference was statistically significant to evaluate the changes of the parameters. The result is 1: 1. After treatment, the value of SItbut in group A was significantly higher than that before treatment, and the difference was statistically significant. The SIt value of group A was significantly higher than that of group C, and the difference was statistically significant (P 0.05. 05. 2). After treatment, the total clinical symptom scores and VAS scores of the three groups were all lower than those before treatment, and the VAS scores in group A were significantly lower than those in group B (P 0.05), and the VAS scores in group A were lower than those in group B (P 0.05), and the scores of VAS in group A were significantly lower than those in group B. There was statistical difference (P 0.05). The scores of FL and dry astringency in the eyes of the three groups were lower than those before treatment, and the scores of FL and dry astringency in group A were significantly lower than those in group B (P 0.05) and the scores of dry astringency in group A were lower than those in group B (P < 0.05), and the scores of FL and dry astringency in group A were significantly lower than those in group B. There was no statistical difference (P 0.05). The total effective rate was 91.7 in the acupuncture group, 84.3 in the routine acupuncture group, 68.7 in the artificial tear group, and 68.7 in the artificial tear group, which was higher than that in the conventional acupuncture group and the artificial tear group, and the difference was statistically significant. Conclusion 1. The treatment of dry eye with Qi acupuncture was better than that with routine acupuncture. It could significantly improve the dry and uncomfortable symptoms of the eyes, improve the secretion of tears, and repair corneal epithelium. Acupuncture at Fengchi point with the method of Na-Qi acupuncture can make the local sense of acupuncture and the sense of moving along the foot Shaoyang gallbladder meridian transmit, and make the eyelid and eyeball produce a sense of acid-swelling and heat. The curative effect is remarkable, which fully proves the clinical significance of "Qi to the place of disease".
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.82

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