本文選題：頸椎病 + 經(jīng)筋��； 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：觀察并總結(jié)80例頸椎病患者(頸型及神經(jīng)根型各40例)壓痛點(diǎn)與經(jīng)筋之間的關(guān)系,揭示頸椎病經(jīng)筋病變及痛點(diǎn)的發(fā)病規(guī)律,豐富經(jīng)筋辨證及頸部壓痛點(diǎn)對(duì)頸椎病診療作用的整體認(rèn)識(shí),為頸椎病的臨床診療提供參考。方法：選取2014年3月至2015年7月四川省中醫(yī)院骨傷科、針推科門診診斷為頸型頸椎病患者40例,記作A組；神經(jīng)根型頸椎病患者40例,記作B組。分別提取頸椎病VAS評(píng)分4分以上的壓痛點(diǎn),根據(jù)壓痛點(diǎn)分布?xì)w納并總結(jié)其經(jīng)筋證型,采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,最終得出壓痛點(diǎn)、經(jīng)筋證型分布規(guī)律。結(jié)果：1.位于手足太陽經(jīng)筋上的壓痛點(diǎn)：A組(頸型頸椎病)共101個(gè),B組(神經(jīng)根型頸椎病)共69個(gè)；位于手少陽經(jīng)筋上的壓痛點(diǎn)：A組共87個(gè),B組共92個(gè)；位于足少陽經(jīng)筋上的壓痛點(diǎn)：A組共34個(gè),B組共19個(gè)；位于手足陽明經(jīng)筋上的壓痛點(diǎn)：A組共65個(gè),B組共24個(gè)。2.頸部壓痛點(diǎn)比值A(chǔ)組36.59%、B組53.92%,組間對(duì)照P0.01,具有統(tǒng)計(jì)學(xué)意義；肩部壓痛點(diǎn)比值A(chǔ)組62.02%、B組43.14%,組間對(duì)照P=0.0140.05,具有統(tǒng)計(jì)學(xué)意義。3.A組經(jīng)筋發(fā)病規(guī)律：手足太陽經(jīng)筋手少陽經(jīng)筋手足陽明經(jīng)足少陽經(jīng)筋,B組經(jīng)筋發(fā)病規(guī)律：手少陽經(jīng)筋手足太陽經(jīng)筋手足陽明經(jīng)筋足少陽經(jīng)筋；兩組在手足太陽經(jīng)筋上的壓痛點(diǎn)分布比較P=0.020.05,手少陽經(jīng)筋的比較P0.01,足少陽經(jīng)筋的比較P=0.020.05,具有統(tǒng)計(jì)學(xué)意義,手足陽明經(jīng)筋的比較P=0.5340.05,無統(tǒng)計(jì)學(xué)差異。4.常見壓痛點(diǎn)按比值高低排列依次為：A組(頸型頸椎病)手足陽明經(jīng)筋的肩井次10.80%、曲垣次10.80%,手少陽經(jīng)筋的天髂次10.80%、天宗次10.45%,手足太陽經(jīng)筋的C5棘突旁4.18%和足少陽經(jīng)筋的風(fēng)池次3.83%；B組(神經(jīng)根型頸椎病)手少陽經(jīng)筋的C5橫突5.88%、C6橫突5.88%、天毼次5.39%、天宗次5.39%、C4橫突4.90%,手足陽明經(jīng)筋的肩井次5.39%、曲垣次5.39%和手足太陽經(jīng)筋的肩痛點(diǎn)次4.90%、下肩痛點(diǎn)4.90%。結(jié)論：1.手足太陽、手足陽明及手少陽經(jīng)筋均是頸型頸椎病好發(fā)的經(jīng)筋；手少陽經(jīng)筋是神經(jīng)根型頸椎病發(fā)病的主要經(jīng)筋。2.若肩井次、曲垣次、天毼次有明顯壓痛,則提示為頸型頸椎��；若C5、C6有明顯壓痛,則提示為神經(jīng)根型頸椎病。3.對(duì)頸型頸椎病的治療可考慮側(cè)重針對(duì)手足太陽經(jīng)筋,著重由肩部的相關(guān)筋結(jié)點(diǎn)入手：神經(jīng)根型頸椎病的治療可考慮側(cè)重針對(duì)手少陽經(jīng)筋,著重由頸部的相關(guān)筋結(jié)點(diǎn)入手。
[Abstract]:Objective: to observe and summarize the relationship between tenderness points and meridians in 80 patients with cervical spondylosis (40 cases of cervical type and 40 cases of nerve root type), and to reveal the pathogenesis of meridian diseases and pain points of cervical spondylosis. To enrich the overall understanding of the diagnosis and treatment of cervical spondylosis by differentiation of meridians and cervical tenderness, and to provide reference for clinical diagnosis and treatment of cervical spondylosis. Methods: from March 2014 to July 2015, 40 patients with cervical spondylopathy of cervical type and 40 patients with cervical spondylopathy of nerve root type were selected from Department of Orthopedics and Trauma of Sichuan traditional Chinese Medicine Hospital of Sichuan Province from March 2014 to July 2015. The tenderness points of cervical spondylopathy (VAS) score above 4 points were extracted respectively. The distribution of tenderness points and meridians syndrome types were summarized and summarized according to the distribution of tenderness points. Finally, the distribution rules of tenderness points and meridian syndrome types were obtained by statistical analysis with SPSS17.0 software. The result is 1: 1. There were 101 tenderness points (cervical spondylosis) in group A (cervical spondylosis), 69 in group B (cervical spondylosis of nerve root type) and 92 in group B (87 points of tenderness on the meridians of Shaoyang meridian of hand and foot). There were 19 tenderness points in group A and 24 in group B, and in group B, there were 65 tenderness points in group A, and in group B, there were 65 points of tenderness on the meridian of foot and foot. The ratio of cervical tenderness point in group A (36.59) and group B (53.92) was significantly higher than that in control group (P 0.01). The ratio of shoulder tenderness point to group A is 62.02 and 43.14 in group B, and the control group is P0.0140.05, which has statistical significance. 3.The incidence rule of meridian in group A: the incidence of meridian in group B: in group B, the incidence of meridian in group B is less than that in group B: in group A, the incidence of meridian is statistically significant. Sun Meridian hand foot Yangming Meridian foot Shaoyang Meridian; The distribution of tenderness points in the two groups on the solar meridian of the hand and foot was 0.020.05, the comparison of the hand Shaoyang meridian and the foot Shaoyang meridian was P0.01 and P0.020.05 respectively, which had statistical significance. The comparison of the hand and foot Yangming meridian was not statistically significant (P0.5340.05, P < 0.05). The common tenderness points in order of ratio are as follows: group A (cervical spondylosis), the shoulder and well times of Yangming meridian of hands and feet 10.80, Quyuan 10.80, Tiangliu 10.80 of hand Shaoyang meridians, Tianzong 10.45, C5 spinous process of hand and foot 4.18% and foot Shaoyang Meridian of hand and foot. In group B (cervical spondylosis of nerve root type), there were 5.88 points in C5 transverse process, 5.39 in days, 4.90 in C4 transverse process, 5.39 in Tianzong, 5.39in shoulder well of Yangming meridian of hand and foot, 5.39% in Quyuan, 4.90 in shoulder pain point of yang meridian of hand and foot, 4.90 in shoulder pain point of hand and foot, and 4.90 in lower shoulder pain point. Conclusion 1. The sun of hand and foot, Yangming of hand and foot and Shaoyang meridian of hand are the most common meridians of cervical spondylosis of neck type, and the main meridians of cervical spondylosis of root type of cervical spondylosis of hand are Shaoyang meridian tendons of hand and foot. 2. If the shoulder well times, Quyuan times, Tianzao have obvious tenderness, then it is cervical type cervical spondylopathy, if C5C6 has obvious tenderness, it is the nerve root type cervical spondylosis. 3. The treatment of cervical spondylosis can be focused on the sun meridians of the hand and foot, and the related tendons in the shoulder. The treatment of the cervical spondylosis of the nerve root type can be considered to focus on the small yang meridians of the hands and the related tendons in the neck.
【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)】：R274.9

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