本文選題：顳下頜關節(jié)紊亂病 + 中醫(yī)�。� 參考：《遼寧中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:通過針藥并用的方法治療顳下頜關節(jié)紊亂病并觀察其療效,依據(jù)中醫(yī)辯證分型來治療顳下頜關節(jié)紊亂病,針刺部位及針刺手法以及中藥處方的選取。臨床資料與方法:筆者依照該病種的診斷標準、納入標準、排除標準以及脫落標準,于遼寧中醫(yī)藥大學附屬醫(yī)院收入患者90例,依照數(shù)字表隨機原則,隨機均分每組30例并命名為針藥并用組,常規(guī)針灸組,以及中藥辯證組三組并編號。針藥并用組根據(jù)辯證分型給予針灸和中藥湯劑服用處理,針灸組給予治療顳下頜關節(jié)紊亂病常規(guī)穴位處理,中藥組根據(jù)辨證分型給予中藥湯劑服用處理。三組患者給予相同治療周期,記錄觀察項目:疼痛視覺模擬尺(VAS)疼痛評分[1],Friction顳下頜關節(jié)指數(shù)(其中包括顳下頜關節(jié)功能障礙指數(shù),肌肉壓痛指數(shù))。結(jié)果:1.針藥并用法、常規(guī)針灸法以及辯證中藥法分別用于TMD疼痛患者后疼痛程度均有緩解(p0.05),并且針藥并用法對TMD疼痛的治療作用在同一治療周期內(nèi)較其他兩法的作用較為迅速(p0.05),具有統(tǒng)計學意義。2.三種方法在治療后對緩解肌緊張,改善關節(jié)結(jié)構(gòu)等均有效果(p0.05)。同時認為針藥并用法較其他兩組的方法的作用相對有效(p0.05),具有統(tǒng)計學意義。3.與證型的相關性:針藥并用法在VAS值指標上反映出針藥并用法對瘀血阻絡、脾胃虛弱和腎陽虧虛型有明確療效(顯效率均為100%),而對于濕熱痹阻型的療效有一定的差異性。4從Friction指數(shù)是反映出針藥并用對TMD的四個證型均有治療作用,但與常規(guī)針灸組和辯證中藥組所達到的治療效果無明顯差異。結(jié)論:1.針藥并用可以用于治療顳下頜關節(jié)紊亂病中針對瘀血阻絡型,脾胃虛弱型以及腎陽虧虛型的疼痛有較好的緩解效果。2.在針灸、中藥和針藥并用中,對顳下頜關節(jié)紊亂病針對性的治療效果無明顯的差別。3.針藥并用治療顳下頜關節(jié)紊亂病是一種還尚未可作為最佳治療,但卻為有效的治療方法,尚需進一步研究,深入分析。
[Abstract]:Objective: to treat temporomandibular joint disorder with acupuncture and medicine and observe its curative effect. To treat temporomandibular joint disorder, acupuncture position, acupuncture manipulation and Chinese medicine prescription according to the dialectical classification of traditional Chinese medicine. Clinical data and methods: according to the diagnostic criteria, inclusion criteria, exclusion criteria and abscission criteria of the disease, 90 patients were enrolled in the affiliated hospital of Liaoning University of traditional Chinese Medicine, according to the random principle of digital table. There were 30 cases in each group and named as acupuncture combined group, routine acupuncture group and traditional Chinese medicine dialectical group. Acupuncture and medicine combined group according to the dialectical classification of acupuncture and traditional Chinese medicine decoction taking treatment, acupuncture and moxibustion group to treat temporomandibular joint disorder routine point treatment, traditional Chinese medicine group according to syndrome differentiation of traditional Chinese medicine decoction taking treatment. Three groups of patients were given the same treatment cycle. The observation items were as follows: pain visual analogue ulnar vas) pain score [1] Friction temporomandibular joint index (including temporomandibular joint dysfunction index, muscle tenderness index). The result is 1: 1. Acupuncture and medicine, The pain degree of patients with TMD pain was alleviated by routine acupuncture method and dialectical Chinese medicine method respectively, and the effect of acupuncture and medicine combined therapy on TMD pain was faster than that of other two methods in the same treatment cycle, which had statistical significance. The three methods can relieve muscle tension and improve joint structure after treatment. At the same time, the effect of acupuncture and medicine combined method is relatively effective compared with the other two groups, which has statistical significance. The correlation with syndrome type: the combination of acupuncture and medicine reflected the value of VAS on the blood stasis obstruction of collaterals by the combination of acupuncture and medicine, Spleen and stomach deficiency and kidney-yang deficiency have definite curative effect (obvious rate is 100g), and there is certain difference in curative effect for damp-heat arthralgia. 4 according to Friction index, acupuncture combined with medicine has therapeutic effect on all four syndrome types of TMD. However, there was no significant difference in therapeutic effect between acupuncture group and dialectical Chinese medicine group. Conclusion 1. Acupuncture and medicine can be used in the treatment of temporomandibular joint disorders in the blood stasis obstruction collaterals type, spleen and stomach weakness type and deficiency of kidney yang type pain relief effect. 2. In the combination of acupuncture, traditional Chinese medicine and acupuncture and medicine, there is no significant difference in the effect of targeted treatment of temporomandibular joint disorder. The treatment of temporomandibular joint disorder with acupuncture and medicine is not yet the best treatment, but it is an effective treatment method, which needs further study and in-depth analysis.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.83

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