本文選題：通元針法 + 腰肌勞損�。� 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過觀察通元針法治療腰肌勞損的臨床療效,探討通元針法治療腰肌勞損的作用機(jī)理,并與針刺夾脊穴方法進(jìn)行療效對比,為臨床提供治療腰肌勞損效果更好、遠(yuǎn)期療效更佳的方法,以期解決治療腰肌勞損容易復(fù)發(fā)的難題。方法:采取前瞻性隨機(jī)對照的研究方法,將符合納入標(biāo)準(zhǔn)的腰肌勞損患者通過查隨機(jī)數(shù)字表的方法分分別進(jìn)入實驗組和對照組,對兩組標(biāo)本在性別、年齡、病程、疼痛指數(shù)、功能活動指數(shù)等方面做統(tǒng)計學(xué)分析,證明兩組有可比性。實驗組、對照組各完成病例30例。實驗組采用通元針法電針治療,對照組采用針刺夾脊穴方法電針治療,兩組配穴相同。每日一次,十次為一療程,共實驗兩個療程。療程間休息兩天。采用視覺模擬標(biāo)尺法(VAS)及Oswestry Disability Index(ODI指數(shù))作為臨床療效觀察指標(biāo),參照相關(guān)標(biāo)準(zhǔn)進(jìn)行評定,分別觀察兩組患者在首次治療、療程結(jié)束時的療效和隨訪三個月、六個月時患者的復(fù)發(fā)情況,統(tǒng)計兩種方法治療腰肌勞損的效果。所有計量資料以均值加減標(biāo)準(zhǔn)差(x±s)表示,兩組間均值比較,采用獨立樣本t/t'檢驗;所有計數(shù)資料以頻數(shù)(f)、構(gòu)成比或百分率(P)和平均秩次(R)表示,小樣本計數(shù)資料構(gòu)成比和等級資料比較,采用Mann-Whitney非參數(shù)檢驗;四格表資料采用Fisher確切概率法卡方(x2)檢驗。由spss21.0醫(yī)學(xué)統(tǒng)計軟件進(jìn)行數(shù)據(jù)統(tǒng)計。結(jié)果:1、首次治療結(jié)束后①實驗組有效率90%,對照組的有效率86.67%,說明兩組治療方法首次均有效果,但兩組間比較效果無顯著性差異(Fisherx2=0.162,P=0.6880.05),無統(tǒng)計學(xué)意義;②兩組愈顯率比較,實驗組愈顯率63.33%,而對照組愈顯率30.00%,經(jīng)統(tǒng)計學(xué)檢驗,兩組間有顯著性差異(Fisher x2=6.696,P=0.0100.05),實驗組療效好于對照組。2、療程結(jié)束時:①實驗組總有效率96.67%,對照組總有效率93.33%,說明兩組方法治療腰肌勞損均有效果;但二組間總有效率無顯著性差異(Fisherx 2=0.351,P=0.5540.05),無統(tǒng)計學(xué)意義;②組間比較兩組臨床愈顯率,實驗組愈顯率90%,對照組愈顯率43.33%,兩者比較,經(jīng)統(tǒng)計學(xué)檢驗有顯著性差異(Fisherx2=14.700,P=0.0000.01),實驗組明顯高于對照組。3、治療后兩組復(fù)發(fā)率比較:①治療后三個月時隨訪,實驗組復(fù)發(fā)率為3.33%,對照組復(fù)發(fā)率為13.33%,對照組復(fù)I發(fā)率高于實驗組,但經(jīng)統(tǒng)計學(xué)檢驗,兩者無顯著性差異(Fisherx2=1.964,P=0.1610.05);②治療后半年時隨訪,實驗組的總復(fù)發(fā)率為10%,對照組的總復(fù)發(fā)率為33.33%,實驗組的復(fù)發(fā)率明顯低于對照組,兩組間經(jīng)統(tǒng)計學(xué)檢驗,有明顯差異(Fisherx 2=4.812,P=0.0280.05)。結(jié)論:用通元針法治療腰肌勞損,不僅見效快、即時止痛效果好,而且在改善患者功能障礙評分方面優(yōu)于對照組;從總療效看,不僅能治療腰肌勞損局部病癥,愈顯率高,而且對患者全身的功能狀態(tài)也有很好的調(diào)節(jié)作用,"正氣存內(nèi),邪不可干",因而遠(yuǎn)期療效好,復(fù)發(fā)率低,值得推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of Tongyuan acupuncture on lumbar muscle strain, to explore the mechanism of Tongyuan acupuncture in treating lumbar muscle strain, and to compare the therapeutic effect with Jiaji acupuncture, so as to provide a better effect for clinical treatment of lumbar muscle strain. The long-term effect is better to solve the problem of easy recurrence in the treatment of lumbar muscle strain. Methods: prospective randomized controlled study was used to divide the patients with lumbar muscle strain into experimental group and control group by means of random digital table. The sex, age, course of disease, pain index of the two groups were measured. Functional activity index and other aspects of statistical analysis, proved that the two groups are comparable. There were 30 cases in the experimental group and 30 cases in the control group. The experimental group was treated with Tongyuan needling method and the control group was treated with acupuncture at Jiaji point. Once a day, ten times as a course of treatment, a total of two courses of experiment. Take two days off from the course of treatment. Visual analogue scale (vas) and Oswestry Disability Index(ODI index were used as the clinical therapeutic index. The clinical efficacy of the two groups was evaluated according to the relevant criteria. The results of the first treatment, the end of the course of treatment and the follow-up for 3 months were observed respectively. Six months after the recurrence of patients, statistics of the two methods for the treatment of lumbar muscle strain effect. All the measurement data are expressed as the mean value plus or minus standard deviation (x 鹵s). The mean values of the two groups are compared with the independent sample t / t 'test. All counting data are expressed in terms of frequency, constitution ratio or percentage P) and average rank r). Mann-Whitney nonparametric test and Fisher exact probability chi-square x2 test are used to test the composition ratio of small sample count data and grade data. The data were collected by spss21.0 medical statistics software. Results: after the first treatment, the effective rate of the experimental group was 90 and that of the control group was 86.67, indicating that the two treatment methods had the first effect, but there was no significant difference in the comparison between the two groups. There was no significant difference between the two groups, and there was no significant difference in the effective rate between the two groups. The effective rate of the experimental group was 63.33, while the rate of the control group was 30.00. There was significant difference between the two groups. The experimental group was better than the control group. At the end of the course of treatment, the total effective rate of the experimental group was 96.67 and the total effective rate of the control group was 93.33. The results showed that the two groups were effective in the treatment of lumbar muscle strain. However, there was no significant difference in the total effective rate between the two groups. There was no statistical significance between the two groups. The effective rate of the two groups was 90% in the experimental group and 43.33 in the control group. There was a significant difference between the two groups by statistical test. The experimental group was significantly higher than the control group. The recurrence rate of the two groups was higher than that of the control group. The recurrence rate of the experimental group was 3.33 and that of the control group was 13.33. The recurrence rate of the control group was higher than that of the experimental group. However, there was no significant difference between the two groups by statistical test. The total recurrence rate was 10 in the experimental group and 33.33 in the control group, and the recurrence rate in the experimental group was significantly lower than that in the control group. There is a significant difference between Fisherx2 and 4.812Pu 0.0280.05. Conclusion: the treatment of lumbar muscle strain with Tongyuan needling method is not only effective, but also better in improving the score of patients with dysfunction than in the control group, and can not only treat the local symptoms of lumbar muscle strain, but also has a high effective rate. Moreover, it has a good regulating effect on the patients' whole body function, "good qi stored inside, evil can not dry", so the long-term effect is good, the recurrence rate is low, it is worth popularizing and applying.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.9

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