發(fā)布時(shí)間：2018-06-03 17:54

  本文選題：通經(jīng)散結(jié)法 + 乳癖　； 參考：《長(zhǎng)春中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察通經(jīng)散結(jié)法對(duì)肝郁氣滯型乳癖的治療效果,探討其臨床應(yīng)用價(jià)值。方法:本臨床研究所有入組患者均選取自2014年1月至2015年12月長(zhǎng)春中醫(yī)藥大學(xué)附屬醫(yī)院推拿科門診及住院患者共59例,確診為乳癖(乳腺小葉增生,肝郁氣滯型)。通經(jīng)散結(jié)推拿法的具體操作方法:(1)推按手三陰經(jīng);(2)拿揉胸大肌;(3)團(tuán)揉腹部;(4)通背部督脈、膀胱經(jīng)。通過比較乳房疼痛,乳房腫塊硬度、范圍、大小及全身伴隨癥狀評(píng)分變化,通過乳腺超聲和紅外熱像技術(shù)判定患者的恢復(fù)情況。結(jié)果:(1)臨床癥狀評(píng)價(jià)結(jié)果:經(jīng)治療,所有患者的乳房疼痛、乳房腫塊硬度、范圍、大小及全身伴隨癥狀評(píng)分均明顯優(yōu)于治療前(P0.05),差異具有統(tǒng)計(jì)學(xué)意義;(2)超聲評(píng)價(jià)結(jié)果:經(jīng)治療,所有患者中發(fā)生乳腺超聲改善19例,其中BI-RADSⅡ級(jí)、Ⅲ級(jí)改善效果明顯;(3)紅外線熱像評(píng)價(jià)結(jié)果:乳房組織灰階度0級(jí)6例,Ⅰ級(jí)38例,Ⅱ級(jí)13例,Ⅲ級(jí)2級(jí),改善程度明顯優(yōu)于治療前(P0.05),差異具有統(tǒng)計(jì)學(xué)意義;血管分型A型29例,B型30例,改善程度明顯優(yōu)于治療前(P0.05),差異具有統(tǒng)計(jì)學(xué)意義。(4)經(jīng)Pearson相關(guān)性分析,發(fā)現(xiàn)超聲評(píng)價(jià)及紅外線掃描結(jié)果與臨床癥狀變化存在相關(guān)性,結(jié)果顯示:乳房脹痛,乳房腫塊硬度、范圍、大小,患者情緒變化,兩脅脹滿呈相關(guān)性(P值均0.05),但與月經(jīng)異常和腰膝酸軟癥狀無(wú)顯著相關(guān)性。結(jié)論:(1)通經(jīng)散結(jié)法能有效治療乳癖即乳腺小葉增生癥;(2)手法明顯改善了乳房脹痛、煩躁易怒、胸脅脹痛等相關(guān)癥狀,明顯減小了乳房腫塊;(3)紅外線熱像結(jié)合乳腺超聲可作為乳癖即乳腺小葉增生癥的評(píng)價(jià)手段之一;(4)通經(jīng)散結(jié)法臨床應(yīng)用操作簡(jiǎn)便、安全,不僅提高了患者的依從性,而且更好的改善了患者的生活質(zhì)量。
[Abstract]:Objective: to observe the therapeutic effect of Tongjing Sanjie method on the type of liver depression and qi stagnation and to explore its clinical application value. Methods: from January 2014 to December 2015, 59 patients in the Department of Tuina, affiliated Hospital of Changchun University of traditional Chinese Medicine, were selected from our clinical research institute. 59 patients were diagnosed as nipple (mammary lobular hyperplasia, liver stagnation and qi stagnation). The concrete operation method of the massage method of Tongjing Sanjie massage is: 1) push the hands three yin meridians 2) take and knead the pectoralis major muscle (3) group knead the abdomen and make 4) the back jugular vein, bladder meridian. By comparing the changes of breast pain, breast mass hardness, range, size and systemic associated symptoms, the recovery of patients was evaluated by breast ultrasound and infrared thermography. Results: after treatment, all patients' breast pain, breast mass hardness, range, size and systemic associated symptom score were significantly better than those before treatment (P 0.05). The difference was statistically significant. Among all the patients, 19 cases were improved by breast ultrasound. The results of infrared thermography were as follows: the grayscale of breast tissue was 0 in 6 cases, grade 鈪，

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