本文選題：腰三橫突綜合征 + 滯動針刺療法　； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本課題通過對滯動針結(jié)合溫針灸療法治療風(fēng)寒阻絡(luò)型腰三橫突綜合征臨床研究,客觀的的評價該療法的臨床療效和安全性,為滯動針療法治病提供新的思路以及為該療法的推廣應(yīng)用提供依據(jù)。方法:將68例符合納入標準的腰三橫突綜合征患者用隨機數(shù)字表分配法分為治療組和對照組,每組各34例。治療組選取腰三橫突區(qū)域的阿是穴和夾脊穴,采用滯動針結(jié)合溫針灸療法治療,方法是:進針得氣后滯針,行提拉、搖擺、合谷刺等動針操作,時間約1分鐘,完成后在滯動針的針柄上插長約2.5cm的艾條,共1根,待艾條燃盡,皮膚紅暈潮紅,出針前再行一次滯動針操作。對照組給予口服雙氯芬酸鈉雙釋放腸溶膠囊75mg,每天一次,每次75mg。兩組患者在治療期間嚴禁服用其他對研究結(jié)果造成影響的藥品或采取治療方法,兩個組均以治療5天作為一個療程,總共治療兩個療程,療程結(jié)束當日,采用JOA日本骨科學(xué)會(Japanese Orthopaedic Association)下腰痛評分表、VAS(Visual Analogue Scale/Score)評分量表進行壓痛療效評定,研究結(jié)果采用SPSS23.0進行數(shù)據(jù)分析。結(jié)果:1.療程結(jié)束后,治療組JOA評分,對比治療前(p0.01),差異有顯著統(tǒng)計意義;對比對照組(p0.01),差異有顯著統(tǒng)計學(xué)意義,說明滯動針結(jié)合溫針灸有明顯的臨床療效,優(yōu)于口服西藥。2.療程結(jié)束后,治療組的VAS評分,對比治療前(p0.01),差異有顯著統(tǒng)計學(xué)意義;對比對照組(p0.01),差異有顯著統(tǒng)計學(xué)意義,說明滯動針結(jié)合溫針灸可以改善患者壓痛等體征,優(yōu)于口服西藥。3.治療組:痊愈率21.88%,總有效率為96.88%;對照組:痊愈率9.38%,總有效率為84.38%組,治療組的痊愈率和總有效率都高于對照組。4.治療組出針后出現(xiàn)2例局部輕微腫痛出血;對照組出現(xiàn)9例腹脹腹瀉、口干便秘等胃腸道不良反應(yīng)。出現(xiàn)不良反應(yīng)的患者經(jīng)處理后均能夠完成試驗,另有4例患者因家里有緊急事情或者臨時出差等個人原因未能完成最后試驗。結(jié)論:1.滯動針結(jié)合溫針灸具有溫通經(jīng)絡(luò)、松解粘連作用,治療風(fēng)寒阻絡(luò)型腰三橫突綜合征臨床療效顯著。2.滯動針結(jié)合溫針灸在改善患者癥狀、體征和日常生活方面的等綜合療效明顯優(yōu)于口服西藥。是具有操作安全、療效顯著、無副作用的治療方法,值得臨床推廣。
[Abstract]:Objective: to evaluate objectively the clinical efficacy and safety of hysteretic acupuncture combined with warm acupuncture in the treatment of the syndrome of lumbar three transverse process of wind-cold blocking collaterals. To provide a new idea for the treatment of stagnation acupuncture therapy and to provide the basis for the popularization and application of the therapy. Methods: 68 cases of lumbar three transverse process syndrome were divided into treatment group and control group with 34 cases in each group. The treatment group selected Ashi and Jiaji points in the area of lumbar three transverse processes, and used stagnation acupuncture combined with warm acupuncture therapy. The methods were as follows: acupuncture after getting Qi into the needle, pulling, rocking, and Hegu acupuncture for about 1 minute, and so on. After completion, insert about 2.5cm 's moxa on the needle handle of hysteretic needle, a total of 1 stick, wait for the moxa to burn out, the skin is red and flushed, the needle should be operated again before the needle is released. The control group was given oral diclofenac sodium double release enteric capsule 75 mg, once a day, each time 75 mg. During the course of treatment, patients in both groups were not allowed to take any other drugs or methods that affected the results of the study. Both groups were treated with a course of treatment of 5 days, a total of two courses of treatment, on the day of the end of the course of treatment. The JOA Japanese Orthopaedic Association was used to evaluate the curative effect of tenderness. The results were analyzed by SPSS23.0. The result is 1: 1. At the end of the course of treatment, the JOA score of the treatment group was significantly higher than that of the control group (P 0.01), and that of the control group was significantly higher than that of the control group (P 0.01), which indicated that the hysteretic acupuncture combined with warm acupuncture had obvious clinical effect and was superior to the western medicine. 2. At the end of the course of treatment, the VAS score of the treatment group was significantly higher than that of the control group before treatment, and the difference between the control group and the control group was statistically significant, indicating that the hysteretic acupuncture combined with warm acupuncture could improve the tenderness and other signs of the patients, and was superior to the western medicine. 3. In the treatment group, the cure rate was 21.88, the total effective rate was 96.88, in the control group, the cure rate was 9.38 and the total effective rate was 84.38%. The cure rate and the total effective rate in the treatment group were higher than those in the control group. There were 2 cases of local slight swelling and pain hemorrhage in the treatment group and 9 cases of abdominal distension diarrhea dry mouth constipation and other adverse reactions in the control group. The patients with adverse reactions were all able to complete the trial after treatment, and 4 patients could not complete the final trial because of emergency at home or temporary business trip. Conclusion 1. Stagnation acupuncture combined with warm acupuncture has the effect of warming the meridian and loosening the adhesion and treating the syndrome of wind cold blocking collaterals and three transverse processes. 2. The comprehensive effect of stagnation acupuncture combined with warm acupuncture in improving the symptoms, signs and daily life of patients was significantly better than that of oral western medicine. It is a safe, effective and no side effect treatment method. It is worth popularizing.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.9

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