本文選題：長蛇灸 + 改良長蛇灸　； 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：1、本研究通過對長蛇灸療法現(xiàn)代臨床文獻進行收集整理統(tǒng)計分析,總結(jié)長蛇灸療法適宜病癥和尋求長蛇灸療法的操作規(guī)律,為長蛇灸療法臨床應(yīng)用及進一步的臨床研究提供理論依據(jù)。2、通過對長蛇灸適宜病癥一慢性疲勞綜合征進行不同時間點的臨床療效觀察,研究改良長蛇灸結(jié)合針刺對慢性疲勞綜合征脾腎陽虛證候及癥狀的時效性,為臨床治療該病提供新方法、新思路。方法：1、文獻分析：計算機檢索中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫(CBM)、中國知識資源總庫即中國知網(wǎng)(CNKI)中的中國學(xué)術(shù)期刊全文數(shù)據(jù)庫、中國優(yōu)秀碩博士學(xué)位論文全文數(shù)據(jù)庫、相關(guān)會議論文,Cochrane Library, Pubmed,維普期刊全文數(shù)據(jù)庫(VIP),萬方數(shù)據(jù)資源系統(tǒng)(WF)。查找有關(guān)長蛇灸療法的臨床研究文獻,再按照文獻的納入及排除標(biāo)準(zhǔn),對文獻進行人工閱讀并進行篩選,獲得所研究的文獻。按國際疾病分類與編碼系統(tǒng)(ICD-10)及《中華人民共和國國家標(biāo)準(zhǔn)·中醫(yī)臨床診療術(shù)語·疾病部分》對長蛇灸治療的病癥進行命名和分類統(tǒng)計。并將文獻所獲得的有效信息：篇名、作者、文獻類型、期刊名稱、著作年代、疾病名稱、所屬系統(tǒng)、證型、治療組/對照組名稱、施術(shù)部位、鋪灸藥物、施灸時間、療程、療效評價、有效率等內(nèi)容錄入EXCEL,建立數(shù)據(jù)庫進行統(tǒng)計分析。2、臨床研究：選擇符合納入標(biāo)準(zhǔn)的脾腎陽虛型慢性疲勞綜合征患者39例,采用改良長蛇灸結(jié)合常規(guī)針刺治療,每周治療3次,2周為一療程,連續(xù)治療四個療程后進行療效評定,通過觀察每個療程后脾腎陽虛證候量表、疲勞嚴(yán)重程度量表(FSS)、軀體和心理健康報告(SPHERE)積分變化評估療效。結(jié)果：1、文獻分析：本次文獻分析共納入165篇合格文獻,得到了11類病癥系統(tǒng),36種病癥。排行前三的病癥系統(tǒng)及文獻構(gòu)成比依次為：其中肌肉骨骼和結(jié)締組織疾病系統(tǒng)文獻占64.85%,占絕大多數(shù),其下依次為呼吸系統(tǒng)疾病11.52%、精神和行為障礙6.06%。按病癥多少排序,肌肉骨骼系統(tǒng)和結(jié)締組織疾病病癥種數(shù)最多,占25%,其后依次為呼吸系統(tǒng)疾病16.67%、消化系統(tǒng)疾病13.89%,泌尿生殖系統(tǒng)疾病11.11%,長蛇灸優(yōu)勢病癥有5種：強直性脊柱炎、類風(fēng)濕關(guān)節(jié)炎、腰椎間盤突出癥、慢性阻塞性肺疾病、產(chǎn)后身痛。長蛇灸優(yōu)勢證型為：寒濕凝滯證、腎陽虛證、肺腎氣虛證、脾腎兩虛證、氣虛證、腎虛寒凝證、氣虛外感證。隔灸材料以姜、蒜、肉桂、麝香、丁香、細辛、川芎、斑蝥、附子、川烏為主。長蛇灸療法操作時間以2-3壯居多,分鐘數(shù)以30-60min為主。最常用的治療療程為1月1次,共3個月,其次為1周1次,共3個月。2、臨床研究：(1)各療程間比較,脾腎陽虛量表積分、疲勞嚴(yán)重程度量表積分、軀體和心理健康報告積分,P0.01,差異有顯著統(tǒng)計學(xué)意義。(2)各療程與治療前比較,脾腎陽虛量表積分、疲勞嚴(yán)重程度量表積分、軀體和心理健康報告積分,P0.01,差異有顯著統(tǒng)計學(xué)意義。(3)各療程與上一療程比較,只有2個療程與3個療程間比較軀體和心理健康報告積分T=1.476,P=0.1480.05,差異無顯著統(tǒng)計學(xué)意義,其余量表及療程間比較P均0.01,差異有顯著統(tǒng)計學(xué)意義。(4)療程間脾腎陽虛量表各癥狀積分比較：①脾腎陽虛量表各癥狀中畏寒肢冷、倦怠乏力、氣短懶言、食少納呆、腰膝酸軟、腰部冷痛、脘腹脹滿、夜尿清長積分P=0.0000.01,差異有顯著統(tǒng)計學(xué)意義。大便不實積分P=0.1630.05,差異無統(tǒng)計學(xué)意義。②治療1個療程、2個療程、3個療程、4個療程過后畏寒肢冷、倦怠乏力、氣短懶言、食少納呆、腰膝酸軟、腰部冷痛、脘腹脹滿、夜尿清長積分均P0.05,差異有統(tǒng)計學(xué)意義。大便不實到治療3個療程后積分P=0.0490.05,差異有統(tǒng)計學(xué)意義。治療4個療程后大便不實積分P=0.0710.05,差異無統(tǒng)計學(xué)意義。③治療在1個療程到2個療程之間,倦怠乏力、氣短懶言、腰部冷痛積分P0.05,差異有統(tǒng)計學(xué)意義,畏寒肢冷、食少納呆、腰膝酸軟、脘腹脹滿、大便不實、夜尿清長積分均P0.05,差異無統(tǒng)計學(xué)意義。2個療程到3個療程之間,只有腰膝酸軟積分P0.05,差異有統(tǒng)計學(xué)意義,余均無統(tǒng)計學(xué)意義。3個療程到4個療程之間,倦怠乏力、氣短懶言、食少納呆積分P0.05,差異有統(tǒng)計學(xué)意義,余均無統(tǒng)計學(xué)意義。結(jié)論：1、文獻分析：長蛇灸治療的疾病多集中在肌肉骨骼系統(tǒng)和結(jié)締組織疾病、呼吸系統(tǒng)疾病、精神和行為障礙、消化系統(tǒng)疾病、泌尿生殖系統(tǒng)疾病等系統(tǒng)。長蛇灸適宜證型以陽虛證、寒證、氣虛證為主,主要涉及臟腑為肺、脾、腎三臟。2、臨床研究：改良長蛇灸結(jié)合針刺治療脾腎陽虛型慢性疲勞綜合征在脾腎陽虛癥狀、疲勞程度及軀體和心理健康程度上有明顯的改善,起效時間為2周,療程與療效成正相關(guān),值得進一步研究和臨床推廣運用。
[Abstract]:Objective: 1, through collecting and sorting out the modern clinical literature of the long snake moxibustion therapy, this study summarizes the appropriate disease of the long snake moxibustion therapy and the operation rule of the long snake moxibustion therapy. It provides the theoretical basis for the clinical application and further clinical study of the long snake moxibustion therapy, and through the chronic fatigue syndrome, which is suitable for the disease of the long snake moxibustion, a chronic fatigue syndrome. To observe the clinical effect of different time points, study the timeliness of the modified long snake moxibustion combined with acupuncture on the syndrome and symptoms of spleen and kidney yang deficiency syndrome of chronic fatigue syndrome and provide a new method for clinical treatment of the disease. Methods: 1, literature analysis: computer retrieval of Chinese Biomedical Literature Database (CBM), China's general repository of knowledge resources: The full text database of Chinese academic journals in CNKI, the full text database of Chinese outstanding doctoral dissertations, the full text database of important Chinese Conference papers, Cochrane Library, Pubmed, VP journal full text database (VIP), and the Wanfang Data Resource System (WF). Find out the clinical literature on the long snake moxibustion therapy, and then according to the literature According to the international disease classification and coding system (ICD-10) and the national standard of People's Republic of China, the clinical diagnosis and treatment term of traditional Chinese medicine and the disease part, the disease was named and classified according to the international disease classification and coding system (the national standard for clinical diagnosis and treatment of traditional Chinese medicine). Information: the name, the author, the type of literature, the name of the journal, the name of the disease, the name of the disease, the system, the syndrome type, the name of the treatment group / control group, the site of the treatment, the moxibustion medicine, the time of moxibustion, the course of treatment, the evaluation of the curative effect, the efficiency and so on, and set up a database for the statistical analysis of the.2, and the clinical study: selecting the spleen kidney Yang that conforms to the standard of the spleen and kidney. 39 cases of asthenia chronic fatigue syndrome were treated with modified long snake moxibustion combined with conventional acupuncture, 3 times a week and 2 weeks as a course of treatment. After four courses of continuous treatment, the curative effect was evaluated. After observing the syndrome of spleen and kidney yang deficiency syndrome after each course, the fatigue severity scale (FSS), and the changes of body and mental health report (SPHERE) were evaluated. Results: the results were as follows: 1. The literature analysis: the literature analysis included 165 qualified literature, 11 kinds of disease system and 36 diseases. The first three disease system and the document composition ratio were in turn: the literature of the musculoskeletal and connective tissue disease system accounted for 64.85%, the most of them were respiratory diseases 11.52%, semen. The number of deity and behavioral disorders 6.06%. was ranked according to the number of disease, the number of musculoskeletal system and connective tissue disease was the most, accounting for 25%, followed by respiratory system disease 16.67%, digestive system disease 13.89%, urogenital system disease 11.11%, long snake moxibustion advantage disease 5 kinds: strong direct spondylitis, rheumatoid arthritis, lumbar disc herniation, Chronic obstructive pulmonary disease, postpartum body pain. The dominant syndrome of long snake moxibustion is: cold dampness stagnation syndrome, kidney yang deficiency syndrome, lung kidney qi deficiency syndrome, spleen kidney two deficiency syndrome, Qi deficiency syndrome, kidney deficiency cold setting syndrome, Qi deficiency syndrome, Qi deficiency external sensation syndrome. The partition moxibustion materials are ginger, garlic, cinnamon, musk, lilac, asarum, Rhizoma Chuanxiong, cantharis, Sichuan Wu. The time of the long snake moxibustion therapy is 2-3 strong and more than Zhuang. The number of clocks was 30-60min mainly. The most commonly used treatment course was 1 times in January, 3 months in total, followed by 1 times for 1 weeks, and a total of 3 months.2. Clinical study: (1) comparison between various courses, integral of spleen and kidney yang deficiency scale, integral of fatigue severity scale, integral of body and mental health report, P0.01, significant statistical significance. (2) comparison of various courses and before treatment, Spleen kidney yang deficiency scale integral, fatigue severity scale integral, body and mental health report score, P0.01, the difference has significant statistical significance. (3) compared with the last course of treatment, only 2 courses and 3 courses of physical and mental health report score T=1.476, P=0.1480.05, the difference is not significant statistical significance, the rest of the scale and the The difference between P was 0.01, and the difference was statistically significant. (4) the scores of the symptoms of the spleen kidney yang deficiency scale were compared: (1) the symptoms of spleen kidney yang deficiency were cold, tired, short of breath, short of breath, lack of appetite, low back and knee, cold pain in the waist, abdominal distention, and long integral P=0.0000.01 of nocturnal urine. The difference has significant statistical significance. 1 courses of treatment, 2 courses of treatment, 3 courses, 4 courses of cold limbs cold, fatigue, short sluggish, short, low back and knee, low back and knee, low back pain, abdominal distention, abdominal distention, night urine, and the difference have statistical significance. The 1 course of treatment was not true to the 3 course of treatment after 3 courses. 90.05, the difference was statistically significant. After 4 courses of treatment, the difference of P=0.0710.05 was not statistically significant. (3) the difference was statistically significant between the 1 courses and the 2 courses. The difference was statistically significant. The difference was statistically significant. The difference was statistically significant. The difference was statistically significant. The difference was statistically significant. The difference was statistically significant, the cold limbs were cold, the food was short, the waist and knees were soft, the abdominal distention was full, the stool was not true and the nocturia was long clear. The scores were all P0.05, the difference was not statistically significant between.2 courses to 3 courses of treatment, only the waist and the knee soft score P0.05, the difference was statistically significant, but there was no statistical significance between.3 courses and 4 courses, fatigue, shortness, shortness of breath and lazy words, food less than P0.05, the difference was statistically significant. Conclusion: 1, literature Analysis: the disease of long snake moxibustion is mainly concentrated in the system of musculoskeletal system and connective tissue diseases, respiratory diseases, mental and behavioral disorders, digestive system diseases, and urogenital system diseases. The suitable syndromes of long snake moxibustion are Yang deficiency syndrome, cold syndrome and Qi deficiency syndrome mainly, mainly involving the three Zang organs of the Zang Fu organs as lung, spleen and kidney,.2, clinical research: improvement The treatment of chronic fatigue syndrome of spleen kidney yang deficiency syndrome with long snake moxibustion combined with acupuncture has obviously improved in spleen and kidney yang deficiency syndrome, fatigue degree and physical and mental health. The onset time is 2 weeks, and the course of treatment is positively related to the curative effect. It is worth further research and clinical application.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246

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