本文選題：慢性頸痛 + 電針��； 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本研究旨在通過(guò)觀察穴位針刺和穴位假針刺治療慢性頸痛患者的療效差異,探討針刺的安慰劑效應(yīng)。方法：本研究已經(jīng)通過(guò)了廣東省中醫(yī)院·倫理委員會(huì)的倫理審查,并在中國(guó)臨床試驗(yàn)注冊(cè)中心登記及注冊(cè)(注冊(cè)號(hào)為：ChiCTR-IPO-15006886)。研究對(duì)象來(lái)源于廣州市各大高校、廣東省中醫(yī)院針灸門診部的慢性頸痛患者。納入患者共62例,隨機(jī)分為三組：穴位針刺組、穴位淺刺組和穴位非刺入組。針刺組的患者以毫針直刺入穴位0.5-1寸,得氣后給予加電刺激；淺刺組的患者亦是以毫針直刺入穴位1-4mmm,不要求得氣,并給予加電刺激；非刺入組則是在穴位上將安慰針具里的鈍頭針固定好,不需要刺進(jìn)皮下,連接電針儀但不予通電刺激。三組均選用雙側(cè)頸百勞穴及肩中俞穴,使用G6805-I型電針治療儀,予疏密波,強(qiáng)度以患者舒適為度。治療周期均為每周3次,2-3天一次,每次25min,共10次。觀察指標(biāo)是：(1)受試者的VAS評(píng)分和壓痛閾值：每次治療前后記錄； (2)受試者的NPQ評(píng)分及簡(jiǎn)式McGill量表：在第一次治療前、第五次治療后以及整個(gè)療程結(jié)束后予記錄。結(jié)果：本研究共完成62例,其中針刺組21例,淺刺組21例,非刺入組20例,各組受試者在治療前的基本資料及各項(xiàng)觀察指標(biāo)(包括VAS評(píng)分、壓痛閾值、NPQ評(píng)分及簡(jiǎn)式McGill量表)差異均無(wú)統(tǒng)計(jì)學(xué)意義。1.各組治療前后比較： (1)針刺組治療后McGill.NPQ.VAS值、壓痛閾值明顯下降,差異均有統(tǒng)計(jì)學(xué)意義(McGill:17.66±7.23 vs 7.43±3.37,P0.01;NPQ：33.19±13.92 vs 13.99±6.97,P0.01;VAS：5.80±1.21 vs 1.99±1.05,P0.01；壓痛閾值：161.58±29.48 vs 130.31±45.83,P0.05)； (2)淺刺組治療后的NPQ頸痛、McGill疼痛量表、VAS值下降,差異均有統(tǒng)計(jì)學(xué)意義(McGill:15.50±4.65 vs 9.81±4.04,P0.01;NPQ：25.98±9.06 vs 18.99±9.71,P0.01；VAS：4.91±1.37 vs 3.33±1.17,P0.01),壓痛閾值在針刺前后無(wú)明顯變化；(3)非刺入組的NPQ頸痛、McGill疼痛量表、VAS值下降(McGill:16.82±6.85 vs 11.73±4.70,P0.05;NPQ:25.78±7.31 vs 21.78±7.08,P0.01:VAS:5.02±0.90 vs 4.35±0.95,P0.05),差異具有統(tǒng)計(jì)學(xué)意義,壓痛閾值在針刺前后無(wú)明顯變化。2.組間比較：(1)針刺組各項(xiàng)觀察指標(biāo)與淺刺組及非刺入組比較,有顯著差異(McGill:10.24±6.52 vs 5.69±4.12,5.10±4.89,P0.01,P0.01;NPQ:19.21±8.79 vs 6.99±4.12,3.89±4.89,P0.01;P0.01;VAS:3.81±1.28vs 1.19±0.93,0.52±0.50,P0.01,P0.01:壓痛閾值：31.26±46.82 vs 10.57 ±30.75,4.14±19.24,P0.01,P0.01);(2)淺刺組與非刺入組相比：NPQ量表及VAS值較前下降,差異有統(tǒng)計(jì)學(xué)意義(NPQ:6.99±4.12 vs 3.89±4.89,P 0.01;VAS:1.19±0.93 vs 0.52±0.50,P0.01),壓痛閾值、及簡(jiǎn)式McGill量表評(píng)分的得分均無(wú)明顯變化。結(jié)論：1.穴位針刺組療效明顯優(yōu)于穴位淺刺組、穴位非刺入組,提示：電針能有效地治療慢性頸痛。2.針刺治療慢性頸痛具有安慰劑效應(yīng),且不同假針刺組間的產(chǎn)生的安慰劑效應(yīng)不一致(穴位淺刺組療效優(yōu)于穴位非刺入組)。
[Abstract]:Objective: to investigate the placebo effect of acupuncture on patients with chronic cervical pain by observing the curative effect of acupoint acupuncture and acupoint pseudo acupuncture. Methods: this study has passed the ethical examination of the Ethics Committee of Guangdong traditional Chinese Medicine Hospital, and has been registered and registered with the China Clinical trial Registry (registration number: ChiCTR-IPO-15006886). The subjects were chronic neck pain patients in the Department of Acupuncture and moxibustion of Guangdong Provincial Hospital of traditional Chinese Medicine. A total of 62 patients were randomly divided into three groups: acupoint acupuncture group, superficial acupoint acupuncture group and non-point needling group. The patients in the acupuncture group were punctured directly into the acupoint with a millimeter needle at 0.5-1 inch, and the patients in the shallow needling group were given electrical stimulation after getting qi, and the patients in the shallow needling group were also punctured directly into the acupoints at 1-4 mm ~ (m), so as not to get qi, and to give it electric stimulation. In the non-puncture group, the blunt needle in the comfort needle was fixed at the acupoint, without needling into the subcutaneous, connecting the electroacupuncture instrument but not the electric stimulation. All of the three groups were treated with G6805-I electroacupuncture apparatus, the intensity of which was based on the comfort of the patients. The treatment cycle was 3 times a week for 2-3 days, 25 min each time for 10 times. The VAS score and tenderness threshold of the subjects were recorded before and after each treatment, and the NPQ score and the simplified McGill scale were recorded before and after the first treatment, after the fifth treatment and after the whole course of treatment. Results: there were 62 cases in this study, including 21 cases in acupuncture group, 21 cases in superficial needling group and 20 cases in non-puncture group. There was no significant difference in the threshold of tenderness (NPQ) and the simple McGill scale (P < 0.01). Comparison before and after treatment: after treatment, the McGill.NPQ.VAS value and the tenderness threshold in the acupuncture group were significantly lower than those in the control group (P = 17.66 鹵7.23 vs 7.43 鹵3.37 P0.01NPQ: 33.19 鹵13.92 vs 13.99 鹵6.97 vs 5.80 鹵1.21 vs 1.99 鹵1.05P0.01; the threshold of tenderness: 161.58 鹵29.48 vs 130.31 鹵45.83 P0.05P0.01; P 0.01). 宸紓鍧囨湁緇熻瀛︽剰涔，

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