發(fā)布時(shí)間：2018-05-10 05:50

  本文選題：Behcet病 + 葡萄膜炎　； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察Behcet病性葡萄膜炎在常規(guī)治療基礎(chǔ)上,配合壯醫(yī)蓮花針拔罐逐瘀法,觀察治療前、后各項(xiàng)指標(biāo)的變化,為臨床上治療Behcet病性葡萄膜炎提供一種新的療法。方法:選擇符合濕熱瘀毒型Behcet病性葡萄膜炎的患者40名,按其先后就診順序,采用隨機(jī)對(duì)照方法,分為治療組(壯醫(yī)蓮花針拔罐逐瘀+西藥組)和對(duì)照組(西藥組),每組各20例。治療組:在常規(guī)西醫(yī)治療方案基礎(chǔ)上加用壯醫(yī)蓮花針拔罐逐瘀法,5天一次,10次為一個(gè)療程,總共2個(gè)療程,2療程之間休息1周;對(duì)照組:常規(guī)西醫(yī)治療(參考楊培增主編《葡萄膜炎診斷與治療》中對(duì)本病的治療,急性期,按公斤體重(1-1.2mg\kg)口服醋酸潑尼松片,或按外院激素用量繼續(xù)遞增\遞減,伴有虹膜睫狀體炎者,眼局部復(fù)方托吡卡胺滴眼液散瞳,妥布霉素地塞米松眼液及妥布霉素地塞米松眼膏,普拉洛芬滴眼液,隨癥狀變化加減滴眼次數(shù)。在風(fēng)濕免疫科指導(dǎo)下,口服環(huán)孢素)。分別對(duì)兩組Behcet病性葡萄膜炎患者血沉、全血粘度、眼部癥狀體征及中醫(yī)癥候積分等前后對(duì)比統(tǒng)計(jì)。計(jì)量資料以x±s表示,使用t檢驗(yàn),計(jì)數(shù)資料使用卡方檢驗(yàn),分組比較VAS評(píng)分采用單因素方差分析,組間檢測(cè)指標(biāo)的比較使用獨(dú)立樣本的t檢驗(yàn)。懫用SPSS22.0統(tǒng)計(jì)軟件進(jìn)行所有資料的統(tǒng)計(jì)學(xué)分析,得出結(jié)論。結(jié)果:通過對(duì)治療前后的組間比較,得出以下結(jié)果:1.在葡萄膜炎癥狀、體征積分方面,兩組治療后均較治療前降低,但治療組癥狀、體征積分低于對(duì)照組,且治療組對(duì)于“羞明、流淚、角膜后沉積物、玻璃體混濁、眼底改變”癥狀改善優(yōu)于對(duì)照組,P0.05,差異有統(tǒng)計(jì)學(xué)意義;2.在濕熱瘀毒中醫(yī)癥候積分方面,兩組治療前比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。經(jīng)治療后:治療組中醫(yī)癥候積分較治療前降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。治療后兩組間相比較:治療組中醫(yī)癥候積分低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),說明治療組優(yōu)于對(duì)照組。3.在全血粘度、血漿粘度方面,兩組治療后全血粘度、血漿粘度數(shù)值均較治療前降低,治療后組間相比,治療組優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);4.在血沉方面,兩組治療后全血粘度數(shù)值均較治療前降低,但P0.05,差異無統(tǒng)計(jì)學(xué)意義。5.在眼壓方面,兩組治療前雙眼眼壓比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性;兩組治療后及治療后組間比較,P0.05,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:介入壯醫(yī)蓮花針拔罐逐瘀治療不僅可以調(diào)整Behcet病性葡萄膜炎患者濕熱瘀毒的體質(zhì)偏畸,同時(shí)還可以使患者的濕熱瘀毒癥狀明顯低于對(duì)照組,壯醫(yī)蓮花針拔罐療法操作簡單,療效可靠,突出了壯醫(yī)蓮花針拔罐逐瘀法民族醫(yī)學(xué)及中西醫(yī)結(jié)合的優(yōu)勢(shì),為臨床上治療Behcet病性葡萄膜炎提供一種新的療法,同時(shí)也豐富了壯醫(yī)理論。
[Abstract]:Objective: to observe the changes of indexes before and after treatment of Behcet's disease uveitis on the basis of routine treatment, and to provide a new therapy for the treatment of Behcet's disease uveitis. Methods: forty patients with Behcet's disease uveitis of damp-heat stasis toxin type were selected. The patients were divided into two groups: treatment group (20 cases in each group) and control group (20 cases in each group). The treatment group: on the basis of routine western medicine treatment, the treatment group was treated with Lianhua needle cupping and removing blood stasis method for 5 days as a course of treatment, with a total of 2 courses of treatment and 2 courses of rest for one week; Control group: routine western medicine therapy (referring to Yang Pei-zeng 's "diagnosis and treatment of uveitis"). In the acute phase, prednisone acetate tablets were given orally according to kg body weight of 1-1.2 mg / kg, or the amount of hormone used in the external hospital continued to increase and decrease. In patients with iridocyclitis, local compound topiramine eye drops, tobramycin dexamethasone eye ointment and Prabuprofen eye drops were added and decreased with the change of symptoms. Under the guidance of Rheumatological Immunology Department, oral cyclosporine. The erythrocyte sedimentation rate (ESR), whole blood viscosity, ocular symptoms and signs, and TCM symptom scores were compared between the two groups of patients with Behcet's disease uveitis. The measurement data were expressed as x 鹵s, t test was used, chi-square test was used for counting data, VAS score for group comparison was single factor ANOVA, and t test for independent sample was used for comparison between groups. The statistical analysis of all the data was carried out by SPSS22.0 statistical software, and the conclusion was drawn. Results: by comparing the two groups before and after treatment, the following results were obtained: 1: 1. The scores of symptoms and signs of uveitis in both groups were lower than those before treatment, but the scores of symptoms and signs in the treatment group were lower than those in the control group. The improvement of symptoms was better than that of the control group (P 0.05), and the difference was statistically significant (P 0.05). In the aspect of TCM symptom integral of dampness and heat stasis toxin, the difference between the two groups before treatment was not statistically significant (P 0.05), which was comparable. After treatment, the score of TCM symptom in the treatment group was lower than that before treatment, and the difference was statistically significant (P 0.05), while the difference in the control group was not statistically significant (P 0.05). Comparison between the two groups after treatment: the score of TCM symptom in the treatment group was lower than that in the control group, the difference was statistically significant (P 0.05), which indicated that the treatment group was better than the control group. 3. In terms of whole blood viscosity and plasma viscosity, the whole blood viscosity and plasma viscosity in the two groups were lower than those before treatment. After treatment, the treatment group was superior to the control group, and the difference was statistically significant (P 0.05). In terms of erythrocyte sedimentation rate, the whole blood viscosity of the two groups after treatment was lower than that before treatment, but the difference was not statistically significant (P 0.05). In terms of intraocular pressure, the difference between the two groups before treatment was not statistically significant (P 0.05), but there was no significant difference between the two groups after treatment and after treatment (P 0.05). Conclusion: interventional therapy of Lianhua needle cupping and removing blood stasis can not only adjust the physique of Behcet disease uveitis patients with damp-heat stasis toxin, but also make the symptoms of damp-heat stasis toxin obviously lower than that of the control group. Lianhua needle cupping therapy in Zhuang medicine is simple in operation and reliable in curative effect. It highlights the advantages of traditional Chinese medicine and combination of traditional Chinese medicine and western medicine, and provides a new therapy for the treatment of Behcet's disease uveitis. At the same time, it enriches the theory of Zhuang medicine.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R276.7

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