發(fā)布時(shí)間：2018-05-14 12:16

  本文選題：寒濕凝滯 + 原發(fā)性痛經(jīng)��； 參考：《廣西中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過(guò)針刺結(jié)合溫陽(yáng)灸法對(duì)比布洛芬緩釋膠囊對(duì)寒濕凝滯型原發(fā)性痛經(jīng)(Primary dysmenorrhea of cold-damp stagnation)患者治療前、后臨床癥狀、體征、疼痛改善情況,來(lái)評(píng)價(jià)針刺結(jié)合溫陽(yáng)灸法的臨床療效。方法:在臨床收集60例符合本課題納入標(biāo)準(zhǔn)的寒濕凝滯型原發(fā)性痛經(jīng)患者,采用隨機(jī)對(duì)照的方法,將針刺結(jié)合溫陽(yáng)灸法作為治療組,口服布洛芬緩釋膠囊藥物作為對(duì)照組,每組30例。治療組分別以仰臥位及俯臥位2個(gè)體位進(jìn)行治療,仰臥位:取合谷、三陰交、太沖、關(guān)元,合谷、太沖直刺15~20mm,三陰交直刺25~35mm,關(guān)元直刺25~35mm,進(jìn)針得氣后,施用提插捻轉(zhuǎn)平補(bǔ)平瀉法,每10分鐘行針一次,留針30分鐘。關(guān)元穴在針刺治療的同時(shí)進(jìn)行施灸,每次用艾條溫陽(yáng)灸30分鐘;俯臥位:取腎俞、次毼、命門(mén)。先針刺腎俞、次毼穴,直刺25~35mm,進(jìn)針得氣后,施用提插捻轉(zhuǎn)平補(bǔ)平瀉法,每10分鐘行針一次,留針30分鐘,腎俞、命門(mén)在針刺治療的同時(shí)進(jìn)行施灸,每次用艾條溫陽(yáng)灸30分鐘。在每月月經(jīng)來(lái)潮前10天開(kāi)始治療,每天1次,10次為1個(gè)療程。共治療3個(gè)療程(3個(gè)月經(jīng)周期)。對(duì)照組:疼痛出現(xiàn)就診日開(kāi)始服用布洛芬緩釋膠囊,一日2次(早、晚各1次),一次0.3~0.6g(1~2粒)。連續(xù)服用不超過(guò)5天,連續(xù)治療3個(gè)療程(3個(gè)月經(jīng)周期)。分別對(duì)兩組患者進(jìn)行治療前、后(共3個(gè)療程)記錄痛經(jīng)癥狀評(píng)分表、簡(jiǎn)化McGill疼痛量表(包括PRI、VAS)、痛經(jīng)COX癥狀量表,將所得臨床數(shù)據(jù)進(jìn)行處理(使用統(tǒng)計(jì)軟件SPSS22.0),根據(jù)相關(guān)結(jié)果來(lái)分析兩組的臨床療效。結(jié)果:⑴治療前對(duì)兩組的年齡、病程、病情程度進(jìn)行比較,均無(wú)顯著性差異(P0.05),具有可比性。⑵兩組治療前后痛經(jīng)癥狀積分均有不同程度下降(P0.01),但治療組療效優(yōu)于對(duì)照組(P0.01)。⑶兩組治療前后PRI評(píng)分、VAS評(píng)分比較均有顯著差異(P0.01),兩組間積分差比較(P0.01),治療組緩解痛經(jīng)療效優(yōu)于對(duì)照組。⑷兩組治療前后痛經(jīng)COX量表積分比較均有統(tǒng)計(jì)學(xué)意義(P0.01),組間積分差比較具有顯著性差異(P0.01),治療組優(yōu)于對(duì)照組。⑸治療組總有效率為92.85%,對(duì)照組總有效率為75.86%,治療組總有效率高于對(duì)照組,兩組療效比較P=0.001(P0.01),差異具有顯著統(tǒng)計(jì)學(xué)意義。結(jié)論:針刺結(jié)合溫陽(yáng)灸法對(duì)寒濕凝滯型原發(fā)性痛經(jīng)的臨床療效顯著,無(wú)論是即時(shí)、近期的臨床療效皆優(yōu)于布洛芬緩釋膠囊;該法對(duì)不同病情程度的患者均有較好的療效。針刺結(jié)合溫陽(yáng)灸法是一種極具推廣意義,臨床療效佳的中醫(yī)針灸療法。
[Abstract]:Objective: to evaluate the clinical effect of Acupuncture combined with Wenyang moxibustion on the clinical symptoms, signs and pain improvement of patients with primary dysmenorrhea of cold and dampness stagnation before and after treatment with ibuprofen sustained release capsule before and after treatment, and to evaluate the clinical efficacy of acupuncture combined with warming Yang moxibustion. Methods: sixty patients with primary dysmenorrhea of cold and wet stagnation were collected in clinical practice. The treatment group was treated with acupuncture combined with moxibustion of warm yang, and ibuprofen sustained release capsule was taken as control group. There were 30 cases in each group. The treatment group were treated in supine position and prone position, respectively. Supine position: take Hegu, Sanyinjiao, Taichong, Guan Yuan, Hegu, Taochong straight stab 1520mm, Sanyinjiao straight stab 255mm, Guan Yuan straight puncture 255mm. Needle every 10 minutes, keep needle 30 minutes. Guanyuan point in acupuncture treatment at the same time, moxibustion, each time with moxa warming moxibustion for 30 minutes; prone position: Shenshu, secondary, Shengmen. At first, acupuncture at Shenshu, Sui points, straight needling 255mm, after getting Qi, applying lifting twirling and reinforcing flat diarrhea method, every 10 minutes, needle retention 30 minutes, Shenshu, Shengmen in acupuncture treatment at the same time, 30 minutes moxibustion with moxa warm yang at the same time. Start treatment 10 days before menstruation, 10 times a day as a course of treatment. A total of 3 courses of treatment (3 menstrual cycles). In the control group, ibuprofen sustained release capsules were taken twice a day on the day of treatment (morning, evening, 0.3~0.6g(1~2). Continuously take not more than 5 days, continuous treatment for 3 courses (3 menstrual cycles). The scores of dysmenorrhea symptoms were recorded before and after treatment, and the McGill pain scale (PRI VASA, COX symptom scale) was simplified. The clinical data (SPSS 22.0) were used to analyze the clinical efficacy of the two groups. Results before the treatment, the two groups were compared with each other in terms of age, course of disease and severity of illness. The scores of dysmenorrhea symptoms in the two groups were decreased in varying degrees before and after treatment, but the curative effect in the treatment group was better than that in the control group before and after treatment. There were significant differences in the scores of PRI and PRI between the two groups before and after treatment. The curative effect of the treatment group on relieving dysmenorrhea was better than that of the control group before and after treatment (P 0.01). There was significant difference in the score difference between the two groups (P 0.01), and the treatment group was superior to the control group (P 0.01). The total effective rate of the treatment group was 92.85 and the total effective rate of the control group was 75.86. The total effective rate of the treatment group was higher than that of the control group. The curative effect of the two groups was significantly higher than that of P0. 001 and P0. 01. Conclusion: the clinical curative effect of acupuncture combined with warming yang moxibustion on primary dysmenorrhea of cold dampness and stagnation type is remarkable, and the recent clinical effect is better than ibuprofen sustained release capsule, and this method has better curative effect on patients with different degree of illness. Acupuncture combined with warming yang moxibustion is a kind of acupuncture and moxibustion with good clinical effect.
【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】：2016
【分類號(hào)】：R246.3

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