本文選題：瘀血阻竅型 + 后循環(huán)缺血　； 參考：《廣州中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:根據(jù)臨床經(jīng)驗,選擇背俞穴溫針灸作為本研究干預(yù)手段,初步評價背俞穴溫針灸治療瘀血阻竅型后循環(huán)缺血的臨床療效,明確其治療特點、優(yōu)勢及安全性,觀察是否具有臨床推廣價值,豐富針灸治療本疾病、證型的治療方法,為今后后循環(huán)缺血本證型的疾病提供一定的臨床、科研的思路和方法。方法:收集符合后循環(huán)缺血西醫(yī)診斷標準、符合眩暈病瘀血阻竅證中醫(yī)診斷且同意參加本次實驗的病例63例,簽署知情同意書后隨機分至治療組及對照組,按剔除標準、脫落標準等篩除,最后收集完整資料為治療組(背俞穴溫針灸)29人,對照組(常規(guī)針刺)29人。治療前收集病人基本資料并按DARS量表、眩暈癥候積分量表進行評分,記錄病人TCD檢查結(jié)果。治療組予背俞穴溫針灸進行治療,對照組予常規(guī)針刺治療,隔天治療1次,兩組均以2周為一個治療周期,有基礎(chǔ)疾病者在不影響本研究前提下可按之前醫(yī)囑服藥。療程結(jié)束后觀察并記錄兩組治療前后的臨床療效、DARS量表評分、眩暈癥候積分量表評分、TCD檢查結(jié)果的變化,同時密切注意治療時出現(xiàn)的異常情況以作為臨床安全性觀察資料。結(jié)果:按照療效評定標準,治療組痊愈9人,占32.03%,治療組顯效15人,占51.72%,治療組有效4人,占13.79%,治療組無效2人,占6.90%,總有效率93.10%;對照組痊愈4人,占13.79%,對照組顯效10人,占34.48%,對照組有效9人,占31.03%,對照組無效6人,占20.69%,總有效率79.31%。治療組在治療后循環(huán)缺血性眩暈的整體療效明顯優(yōu)于對照組(P0.01)。治療后兩組DARS評分均明顯改善(P0.01),且治療組對DARS評分改善程度優(yōu)于對照組(P0.01)。治療后兩組對眩暈癥候積分均有明顯改善(P0.01),且在總積分上,治療組改善程度要優(yōu)于對照組(P0.01)。在各個癥狀積分上,在眩暈程度、頭痛、失眠多夢三項上的P值均小于0.01,證明治療組在治療后循環(huán)缺血時對眩暈程度、頭痛、失眠多夢三方面的治療效果要明顯優(yōu)于對照組。在眩暈頻次及持續(xù)時間、神疲乏力二項上的P值均小于0.05,證明治療組在改善后循環(huán)缺血眩暈頻次及持續(xù)時間、神疲乏力二方面的效果要優(yōu)于對照組。在惡心嘔吐、耳鳴、心煩健忘、咽干口燥方面,P值均大于0.05,證明兩組在治療后循環(huán)缺血時對惡心嘔吐、耳鳴、心煩健忘、咽干口燥都有積極效果,無明顯統(tǒng)計學差異。TCD檢查結(jié)果顯示,經(jīng)過治療,兩組血流速度明顯增快(P0.01),TCD檢查結(jié)果差值相比較,治療組在改善瘀血阻竅型后循環(huán)缺血的后循環(huán)整體血流速度及左側(cè)椎動脈搏動指數(shù)方面療效明顯優(yōu)于對照組�？傮w來說,背俞穴溫針灸對于TCD檢查結(jié)果的整體改善程度要優(yōu)于常規(guī)針刺。結(jié)論:從治療總療效、DARS量表評分、眩暈癥候量表評分、TCD檢查結(jié)果的改變上看,背俞穴溫針灸對于瘀血阻竅型后循環(huán)缺血臨床癥狀的改善十分顯著,有著比常規(guī)針刺更理想的效果。同時本法安全性較高,操作無誤基本不會造成額外損傷,免去了藥物治療對肝腎功能造成傷害的可能性,具有安全、簡單、便捷、廉價、有效等特點,值得臨床推廣。
[Abstract]:Objective: according to clinical experience, we choose warm acupuncture at back Shu point as a means of intervention, and evaluate the clinical efficacy of back Yu Xuewen acupuncture and moxibustion for the treatment of posterior circulation ischemia of blood stasis and obstruct orifices, clarify its therapeutic characteristics, advantage and safety, observe whether it has clinical application value, Feng Fu acupuncture and moxibustion treatment of this disease, and the treatment method of syndrome type, for the future The disease of posterior circulation ischemia provides certain clinical, scientific research ideas and methods. Methods: 63 cases were collected in accordance with the standard of Western medicine, which conformed to the diagnosis of vertigo and blood stasis syndrome and agreed to take part in this experiment. After signing the informed consent book, the patients were randomly divided into the treatment group and the control group. The standard was screened. At last, the complete data were collected for 29 people in the treatment group (warm acupuncture at back Shu point) and 29 in the control group (conventional acupuncture). Before the treatment, the basic data of the patients were collected and the results were scored according to the DARS scale, the vertigo syndrome score scale, and the results of the patient's TCD examination. The treatment group was treated with the back Yu Xuewen acupuncture and moxibustion, the control group was given conventional acupuncture treatment and septum treatment. 1 times of day treatment, two groups were 2 weeks as a period of treatment. The patients with basic diseases could take medicine according to the previous doctor's orders without affecting the premise of this study. After the course of treatment, the clinical efficacy of the two groups before and after treatment were observed and recorded, DARS scale score, vertigo syndrome score score, TCD examination results, and close attention to the treatment. Abnormal conditions were used as clinical safety observation data. Results: according to the evaluation standard of curative effect, the treatment group recovered 9 people, accounted for 32.03%, the treatment group was 15, accounting for 51.72%, 4 in the treatment group, 13.79%, 2 in the treatment group, 6.90% and 93.10% in total, 4 in the control group, 13.79% in the control group, 34.48% in 10, 34.48%, and control group effective 9 People, accounted for 31.03%, the control group was invalid 6 people, accounting for 20.69%. The overall efficiency of the total effective 79.31%. treatment group after treatment was obviously better than the control group (P0.01). After treatment, the two groups of DARS scores were significantly improved (P0.01), and the treatment group improved the DARS score better than the control group (P0.01). After treatment, the two groups of vertigo syndrome scores were all in the treatment group. In the total integral, the improvement of the treatment group was better than the control group (P0.01). In the symptom score, the three P values on the dizziness, the headache and the insomnia were less than 0.01, which proved that the treatment group was better than the control in three aspects of the degree of vertigo, headache and insomnia. The P values on two items of vertigo frequency and duration were less than 0.05, which proved that the treatment group was better than the control group in improving the frequency and duration of ischemic vertigo in the treatment group. The effect of two aspects of fatigue and fatigue was better than the control group. The value of P was greater than 0.05 in nausea and vomiting, tinnitus, annoying forgetfulness and dry mouth dryness, which proved that the two groups were circulated after treatment. There were positive effects on nausea, vomiting, tinnitus, annoying amnesia and dry mouth dryness in the blood. The results of.TCD examination showed that the blood flow velocity in the two groups increased significantly (P0.01), and the difference between the results of TCD examination was compared. The treatment group was in the improvement of the posterior circulation velocity of the posterior circulation and the left vertebral artery of the posterior circulation ischemia in the treatment group. The effect of pulsation index was obviously better than that of the control group. Overall, the overall improvement of the results of TCD examination by back Yu Xuewen acupuncture was better than that of the conventional acupuncture. Conclusion: from the total therapeutic effect, the DARS scale, the vertigo syndrome scale, and the change of the TCD examination results, the back Yu Xuewen acupuncture and moxibustion for the posterior circulation ischemia of the stasis obstructing type. The improvement of the bed symptoms is very significant and has a better effect than the conventional acupuncture. At the same time, this method has a higher safety and no error in operation. It is safe, simple, convenient, inexpensive and effective. It is safe, simple, convenient, cheap and effective.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6
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本文編號：1993520