本文選題：慢性腰肌勞損 + 針灸與推拿結(jié)合足弓矯正療法��； 參考：《廣州中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：探討針灸與推拿結(jié)合足弓矯正療法治療慢性腰肌勞損的臨床研究。方法：將收集的病例68例,按隨機(jī)分配,1：1的比例分配為兩組。其中治療組有34例,男15例,女19例；對照組34例,男16例,女18例。治療組采用針灸與推拿結(jié)合足弓矯正療法進(jìn)行治療。足弓矯正療法采用自然拓印腳圖法,電腦設(shè)計(jì)并制造足弓矯正器,配合針炙、推拿治療,治療組成員每日穿配有矯正器的矯正鞋步行1-2小時(shí)。針刺選擇腎俞、大腸俞、環(huán)跳、風(fēng)市、委中,承山、飛揚(yáng)、陽陵泉、太沖、昆侖、阿是穴(1-2個(gè)),推拿沿脊椎兩側(cè)夾脊穴及沿膽經(jīng)、膀胱經(jīng)點(diǎn),重點(diǎn)穴位有腎俞穴、環(huán)跳穴、風(fēng)市穴、陽陵泉、委中穴、承山穴、飛揚(yáng)穴、昆侖穴,采用推、拿、點(diǎn)、按等手法,時(shí)間各約為30分鐘�？倳r(shí)間為1小時(shí),一周三次,共治療四周,四周為一個(gè)療程。對照組采用針灸與推拿療法,方法同前。一個(gè)療程之后,再進(jìn)行療效觀察,分別對兩組治療前后、治療后進(jìn)行觀察,并進(jìn)行對比。統(tǒng)計(jì)學(xué)處理：并采用SPSS20.0統(tǒng)計(jì)軟件完成統(tǒng)計(jì)分析。結(jié)果：經(jīng)統(tǒng)計(jì)分析,治療前對兩組病例的年齡、性別、病程以及臨床癥狀和體征方面進(jìn)行比較,經(jīng)統(tǒng)計(jì)分析后, P0.05,無顯著性意義,因此可以認(rèn)為兩組具有可比性。兩組經(jīng)過治療后,經(jīng)統(tǒng)計(jì)學(xué)分析,在臨床療效中治療組臨床痊愈率為52.94%,顯效率為29.41%,有效率為11.77%,總有效率為94.12%；對照組臨床痊愈率為32.35%,顯效率為20.59%,有效率為29.41%,總有效率為82.35%。治療組和對照組的總有效率均在80%以上,兩組治療慢性腰肌勞損均有效,治療組的中醫(yī)證候療效的總有效率明顯高于對照組(P0.05)。兩組治療前后的疼痛強(qiáng)度、冷痛重著或酸麻痛、隱痛或酸痛、持續(xù)固定痛、活動(dòng)不利、腰部壓痛的變化情況比較差異有顯著性意義,認(rèn)為治療組治療后這些癥狀體征的改善情況優(yōu)于對照組(P0.05)。兩組治療后主要臨床癥狀、體征的消失率比較中,兩組在治療后持續(xù)固定痛、得熱痛減或喜溫喜按、勞累、晨起、久坐加重、痛有定處、活動(dòng)不利、腰部壓痛這些癥狀體征的消失率比較差異有統(tǒng)計(jì)學(xué)意義,認(rèn)為治療組在治療后對降低持續(xù)固定痛、得熱痛減或喜溫喜按、勞累、晨起、久坐加重、痛有定處、活動(dòng)不利、腰部壓痛這些癥狀體征的發(fā)生優(yōu)于對照組(P0.05)。結(jié)論：針灸與推拿結(jié)合足弓矯正療法治能夠改善慢性腰肌勞損病患的腰部疼痛癥狀,并改善其生活質(zhì)量,效果明顯優(yōu)于單純的針灸與推拿療法。兩組治療前血、尿、大便常規(guī)、肝腎功能、心電圖正常者,治療后未見異常改變,說明針灸與推拿結(jié)合足弓矯正療法應(yīng)用安全,值得臨床推廣應(yīng)用。
[Abstract]:Objective: to explore the clinical study of acupuncture and massage combined with pedicle orthodontic therapy for chronic lumbar muscle strain. Methods: 68 cases were randomly divided into two groups according to the proportion of 1: 1. There were 34 cases in the treatment group, 15 cases in the male group and 19 cases in the female group, while 34 cases in the control group, 16 cases in males and 18 cases in females. The treatment group was treated with acupuncture and massage combined with pedicle correction therapy. The foot arch orthodontic therapy was done by using the method of natural foot drawing. The foot arch orthodontic appliance was designed and manufactured by computer, which was combined with acupuncture and massage treatment. The members of the treatment group walked 1-2 hours a day in orthodontic shoes with orthodontics. Acupuncture choice is Shenshu, Dachang Yu, Huan Ju, Feng City, Beizhong, Chengshan, Feiyang, Yanglingquan, Taichung, Kunlun, Ashi points 1-2, massage along both sides of the spine Jiaji points and along the gallbladder meridian, bladder meridian points, the key acupoints have Shenshu points, ring jump points, Fengshi acupoint, Yanglingquan, Beizhong, Chengshan, Feiyang, Kunlun, push, take, point, press and other techniques, the time is about 30 minutes each. The total time is 1 hour, three times a week, a total of four weeks, four weeks as a course of treatment. The control group was treated with acupuncture and massage. After a course of treatment, the curative effect was observed and compared before and after treatment. Statistical processing: SPSS 20.0 statistical software was used to complete the statistical analysis. Results: after statistical analysis, the age, sex, course of disease, clinical symptoms and signs of the two groups were compared before treatment. After statistical analysis, there was no significant difference between the two groups, so the two groups could be considered to be comparable. After the treatment, the clinical cure rate was 52.94 in the treatment group, the effective rate was 29.41, the effective rate was 11.7777 and the total effective rate was 94.12.The clinical cure rate was 32.355,20.599.The effective rate was 29.41 and the total effective rate was 82.35. The total effective rate of treatment group and control group were above 80%, both groups were effective in treating chronic lumbar muscle strain. The total effective rate of TCM syndrome in treatment group was significantly higher than that in control group (P 0.05). Before and after treatment, the changes of pain intensity, cold pain, severe pain, dull pain or sore pain, persistent fixation pain, unfavorable movement and lumbar tenderness were significantly different between the two groups. The improvement of these symptoms and signs in the treatment group was better than that in the control group (P 0.05). In the comparison of the rate of disappearance of the main clinical symptoms and signs after treatment between the two groups, the two groups continued to fix the pain after the treatment, got the heat pain reduced or happy to press, tired, from the morning, sedentary aggravation, the pain has fixed place, the activity is unfavorable, The disappearance rate of these symptoms and signs of lumbar tenderness is statistically significant. It is considered that the treatment group can reduce the sustained fixed pain after treatment, get heat pain, reduce heat pain or like warm press, tiredness, early morning, sedentary aggravation, pain has fixed place, and the activity is unfavorable. The occurrence of these symptoms and signs of lumbar tenderness was better than that of control group (P 0.05). Conclusion: acupuncture and massage combined with pedicle orthodontic therapy can improve the symptoms of lumbar pain and improve the quality of life of patients with chronic lumbar muscle strain, and the effect is obviously superior to that of simple acupuncture and massage therapy. There were no abnormal changes in patients with normal blood, urine, stool, liver and kidney function and normal electrocardiogram before treatment, indicating that acupuncture and massage combined with pedicle correction therapy were safe and worthy of clinical application.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R246.9;R244.1

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