本文選題：梅花針 + 肝腎不足型�。� 參考：《廣西中醫(yī)藥大學》2016年碩士論文

【摘要】：目的:觀察梅花針療法針對肝腎不足型斑禿的臨床療效及安全性。探討梅花針治療肝腎不足型斑禿的作用機制。為進一步研究梅花針治療肝腎不足型斑禿的現(xiàn)代作用機理及后期防治提供新的理論依據(jù)及方法,從而為臨床提供一種較好的治療方案。方法:依據(jù)患者的癥狀及體征,將89例受試者,采取隨機、對照的臨床研究方法,分為治療組30例,對照組30例,空白組29例。其中治療組給予梅花針扣刺治療,治療前用75%的醫(yī)用酒精對皮損局部進行消毒,采取螺旋式由外向內(nèi)扣刺,皮損局部采用中度扣刺手法,微出血為度,配穴處扣刺以輕度扣刺為主,局部出現(xiàn)紅暈為度,每隔3日治療一次,每周兩次;對照組使用5%米諾地爾酊外涂,并進行局部按摩5-10分鐘,每日兩次;空白組以75%的醫(yī)用酒精進行局部外涂,并進行局部按摩5-10分鐘,每日兩次,三組皆經(jīng)治療3個療程后,對其進行療效評價。通過斑禿癥狀治療前后的評分,并記錄治療過程當中出現(xiàn)的不良反應。試驗結(jié)束后,針對第3個月進行隨訪。采用SPSS17.0統(tǒng)計軟件將獲得的數(shù)據(jù)進行統(tǒng)計分析。結(jié)果:1.臨床療效:治療組30例患者,臨床治愈12例,顯效11例,有效5例,無效2例,總有效率93.33%。30例對照組,臨床治療愈3例,顯效7例,有效11例,無效9例,總有效率70.00%。空白組29例,臨床治愈1例,顯效2例,有效3例,無效23例,總有效率20.69%。經(jīng)秩和檢驗分析可知,Z=36.210,P=0.0000.50,具有顯著性差異。2.臨床皮損總積分對比:治療前,三組脫發(fā)區(qū)癥狀總積分差異無統(tǒng)計學意義(P0.05),三組具有可比性。治療組治療后脫發(fā)區(qū)癥狀積分減小,治療前后比較(P0.05),有顯著性差異,有統(tǒng)計學意義;對照組治療后脫發(fā)區(qū)癥狀積分減小,治療前后比較(P0.05),有顯著性差異;空白組治療后脫發(fā)區(qū)癥狀積分減小,治療前后比較(P0.05),有顯著性差異,三組治療后脫發(fā)區(qū)癥狀積分均減小,治療前后比較(P0.05),有顯著性差異。3.起效時間比較:經(jīng)治療,治療組和對照組、空白組起效時間比較(P0.05),有顯著性差異。4.治療后的第3個月隨訪,對治療組患者再次進行脫發(fā)區(qū)癥狀評估,治療后,第3個月隨訪,三組患者復發(fā)率比較(P0.05),有顯著性差異。結(jié)論:梅花針在治療肝腎不足型斑禿方面,其療效確切,安全性好,起效較快,復發(fā)率低,未見明顯副作用;其臨床起效和療效時間均優(yōu)于5%米諾地爾酊。梅花針療法的治療機制目前尚未明確,依據(jù)梅花針的治病原理考慮可能是其作用于皮膚,使局部氣血通暢,血液微循環(huán)擴張,血液循環(huán)速度加快,同時邪氣由腠理而出,局部的異常因子恢復平衡,陰陽調(diào)和,局部毛發(fā)得到滋養(yǎng)、生長。本試驗根據(jù)辨證論治進行取穴,從人體整體進行內(nèi)部氣機調(diào)整,促進局部頭發(fā)的生長。此方法安全,效果顯著,操作簡易,值得在臨床上推廣使用。
[Abstract]:Objective: to observe the clinical efficacy and safety of plum blossom needle therapy in treating alopecia areata with deficiency of liver and kidney. To explore the mechanism of plum blossom needle in treating alopecia areata with deficiency of liver and kidney. In order to further study the modern mechanism of the treatment of alopecia areata with deficiency of liver and kidney, and provide a new theoretical basis and method for the prevention and treatment of alopecia areata in the later stage. Methods: according to the symptoms and signs of the patients, 89 subjects were randomly divided into treatment group (n = 30), control group (n = 30) and blank group (n = 29). Before treatment, 75% of medical alcohol was used to sterilize the local lesions. The skin lesions were treated with spiral puncture from the outside to the inside. The local lesions were treated with moderate buckling technique, and the degree of slight hemorrhage was slight. The main points were mild buckling and local redness, which was treated twice a week every 3 days, while the control group was treated with 5% minodil tincture and local massage for 5-10 minutes twice a day, while the control group was treated with 5% minodil tincture for 5 to 10 minutes, twice a day, while the control group was treated with 5% minodil tincture. The blank group was treated with 75% medical alcohol and local massage for 5-10 minutes, twice a day. The curative effect of the three groups was evaluated after three courses of treatment. Symptoms of alopecia areata were evaluated before and after treatment, and adverse reactions were recorded. At the end of the trial, follow-up was conducted for the third month. SPSS17.0 statistical software will be used to obtain the data for statistical analysis. The result is 1: 1. Clinical efficacy: in the treatment group, 12 cases were cured, 11 cases were markedly effective, 5 cases were effective, 2 cases were ineffective, the total effective rate was 93.33.30 cases in the control group, 3 cases were cured, 7 cases were markedly effective, 11 cases were effective, 9 cases were ineffective, and the total effective rate was 70.003%. There were 29 cases in blank group, 1 case was cured, 2 cases were effective, 3 cases were effective, 23 cases were ineffective, the total effective rate was 20.699. The results of rank sum test showed that the results of RSR were 0.0000.50, and there was significant difference between them (0.0000.50, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05). Comparison of the total score of clinical lesions: before treatment, there was no significant difference in the total score of symptoms in the alopecia area among the three groups (P 0.05), and the three groups were comparable. The symptom score of the alopecia area in the treatment group was decreased after treatment, and there was significant difference between the two groups before and after treatment, while in the control group, the symptom score of the alopecia area decreased after treatment, and there was significant difference between the two groups before and after treatment. The symptom score of alopecia area in the blank group was decreased after treatment, and there was significant difference between before and after treatment (P 0.05). The symptom score of hair loss area in the three groups decreased after treatment, and there was significant difference between before and after treatment (P 0.05). Effect time comparison: after treatment, treatment group and control group, blank group effect time compared with P0.05, there was significant difference. 4. After 3 months follow-up, the patients in the treatment group were evaluated for the symptoms of alopecia area again. After 3 months follow-up, the recurrence rate of the three groups was significantly higher than that of the control group (P 0.05). Conclusion: plum blossom needle is effective and safe in treating alopecia areata with deficiency of liver and kidney, and its clinical effect and curative time are better than 5% minoxidil tincture. The therapeutic mechanism of plum blossom needle therapy is not clear at present. According to the principle of plum blossom needle treatment, it may be considered that it acts on the skin, makes local qi and blood flow unobstructed, blood microcirculation dilates, blood circulation speeds up, and the evil gas comes out of striae at the same time. Local abnormal factors restore balance, Yin and Yang harmony, local hair nourishment, growth. According to differentiation of symptoms and signs, the experiment takes acupoints and adjusts the internal air engine from the whole human body to promote the growth of local hair. This method is safe, effective and easy to operate. It is worth popularizing in clinic.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.7

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