本文選題：針刀 + 松解術(shù)　； 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：通過針刀松解術(shù)緩解骨質(zhì)疏松性脊柱骨折急性期疼痛,并設(shè)立電針組作為對(duì)照,觀察患者治療前后疼痛和腰背功能變化,并評(píng)價(jià)其療效,為臨床提供一種新的治療方法。方法：將納入的64例患者隨機(jī)分為針刀組和電針組各32例。兩組均給予靜滴甘露醇脫水、血塞通改善微循環(huán)及口服鈣爾奇D抗骨質(zhì)疏松作為基礎(chǔ)治療。針刀組在此基礎(chǔ)上使用針刀松解術(shù)治療,1次/日,3次/第1周,1次/第2周,1周為1個(gè)療程,共2個(gè)療程；電針組使用電針治療,1次/日,5次/周,1周為1個(gè)療程,共2個(gè)療程。于治療前、治療第7天和第14天記錄患者的VAS疼痛評(píng)分和臥床時(shí)腰背功能評(píng)分,在治療結(jié)束后1個(gè)月后行電話隨訪。結(jié)果：1、基線：兩組患者性別、年齡、發(fā)病時(shí)間、壓縮椎體分布、治療前VAS評(píng)分及臥床時(shí)腰背功能評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2、療效觀察指標(biāo)：兩組治療后的VAS評(píng)分和臥床時(shí)腰背功能評(píng)分均較治療前明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；針刀組治療后的VAS評(píng)分和臥床時(shí)腰背功能評(píng)分均低于電針組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),且針刀組治療后的VAS評(píng)分和臥床時(shí)腰背功能評(píng)分下降幅度均大于電針組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),綜合分析,針刀組優(yōu)于電針組。3、臨床療效評(píng)價(jià)：針刀組：治愈率0,顯效率68%,有效率32%,無(wú)效率0,總有效率100%；電針組：治愈率0,顯效率36%,有效率58%,無(wú)效率6%,總有效率94%。兩組總有效率組間比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),針刀組優(yōu)于電針組。4、不良事件：治療期間,兩組患者均未發(fā)生意外情況及不良事件。5、隨訪情況：治療結(jié)束后1個(gè)月隨訪,針刀組復(fù)發(fā)1例,電針組復(fù)發(fā)3例,兩組復(fù)發(fā)情況比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：1、針刀松解術(shù)和電針療法都可有效地緩解骨質(zhì)疏松性脊柱急性期疼痛,改善患者臥床時(shí)腰背功能,但在緩解疼痛和改善患者腰背功能方面,針刀松解術(shù)均優(yōu)于電針療法。2、針刀松解術(shù)具有定點(diǎn)容易、操作簡(jiǎn)便,治療時(shí)間短和頻次較少,取效快、療效好、安全性高等優(yōu)點(diǎn),患者易于接受,值得臨床推廣。
[Abstract]:Objective: to relieve the acute pain of osteoporotic spine fracture by acupotomy, and to establish an electroacupuncture group as a control group, to observe the changes of pain and back function before and after treatment, and to evaluate its curative effect, and to provide a new method of treatment. Methods: 64 patients were randomly divided into Acupotomy group and electroacupuncture group (32 cases each). Two The group was treated with dehydrated mannitol, blood Seton ameliorating microcirculation and oral calcium D anti osteoporosis as basic treatment. Needle knife group was treated with Acupotomy on this basis, 1 times / day, 3 / first weeks, 1 / second weeks, 1 weeks for 2 courses, electroacupuncture group using electroacupuncture treatment, 1 times per day, 5 / Zhou, 1 weeks for 1 courses. 2 courses of treatment. Before the treatment, the patients' VAS pain score and the bed back function score were recorded on the seventh and fourteenth days. After the treatment, the telephone followed up 1 months after the treatment. Results: 1, baseline: two groups of patients' sex, age, onset time, compression vertebral distribution, pre treatment VAS score and bed time waist back function score, the difference was no unified Study significance (P0.05), with comparability.2, effect observation index: two groups after treatment, the VAS score and the bed back function score were significantly lower than before the treatment, the difference was statistically significant (P0.05). The VAS score and the bed back function score of the needle knife group were lower than those in the electroacupuncture group, and the difference was statistically significant (P0.05). The VAS score and the lower back function score of the needle group after treatment were all greater than that in the electroacupuncture group (P0.05), and the difference was statistically significant (P0.05). The needle knife group was superior to the electroacupuncture group.3, and the clinical efficacy was evaluated: the cure rate was 0, the effective rate was 68%, the effective rate was 32%, the ineffective rate was 0, the total effective rate was 100%, the curative rate was 0 and the effective rate was 3. 6%, the effective rate was 58%, the invalid rate was 6%, the total effective rate of the total effective 94%. two groups was compared, the difference was statistically significant (P0.05), the needle knife group was better than the electroacupuncture group.4, the adverse events were not occurred in the two groups of patients and adverse events.5, followed up: 1 months after the end of the treatment, 1 cases in the needle knife group, and the recurrence 3 in the electroacupuncture group. There was no significant difference in the recurrence of the two groups (P0.05). Conclusion: 1, acupotomy and electroacupuncture can effectively relieve the acute pain of the osteoporotic spine and improve the back and back function of the patients in bed, but in alleviating pain and improving the function of the waist and back, Acupotomy is superior to the electroacupuncture therapy.2 and needle knife loosening. It is easy to operate, easy to operate, short in treatment time and frequency, quick in efficacy, good in efficacy and high in safety. It is easy for patients to accept and is worthy of clinical promotion.

【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.9

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