本文選題：秦氏腹針 + 氣虛型便秘��； 參考：《廣州中醫(yī)藥大學》2016年碩士論文

【摘要】：目的：本研究以典型的中風后氣虛型便秘為研究對象,評價秦氏腹針對中風后氣虛型便秘患者的臨床療效,并與普通針刺療效比較,分析其療效差異,目的是以提高臨床療效,為臨床提供一種操作簡捷而療效可靠的治療途徑。方法：本研究采用隨機對照的臨床研究方法,共收集2015年5月-2016年2月在廣東省第二中醫(yī)院針灸康復(fù)科住院部和門診部的60例中風后氣虛型便秘的患者,均符合診斷標準、納入標準。利用電腦Excel軟件采取隨機化方法將入組病人分配到秦氏腹針組與普通針刺組,每組各30例。兩組均給予內(nèi)科基礎(chǔ)治療、體針及康復(fù)訓練。在此基礎(chǔ)上,秦氏腹針組采用秦氏腹針的選穴及針刺方法,腹部穴位以任脈及任脈兩側(cè)旁開0.5寸(腎經(jīng))基礎(chǔ)。以臍上2寸、4寸、6寸和臍下1.5寸、3寸各取1穴,每穴左右旁開約0.5寸各取1穴,每3穴成一橫線為一組,共五組,上下共15穴,共15針。普通針刺組選取的治療穴位為：天樞、支溝、大橫、豐隆、脾俞、氣海,均取雙側(cè)穴位。1個療程是7天,第7天、第14天休息,共治療兩個療程。分別于病例納入第1天和第14天使用便秘癥狀積分和改良Barthel指數(shù)評定便秘癥狀、日常生活活動能力的改善程度,并評估總體臨床療效。結(jié)果：1.兩組基線資料比較,分別在治療前對兩組的性別、年齡、發(fā)病時間、原發(fā)疾病、氣虛型便秘癥狀積分、改良Barthel指數(shù)評分進行比較,差異無統(tǒng)計學意義(p0.05),兩組基線具有可比性。2.兩組治療后與治療前進行組內(nèi)比較,氣虛型便秘癥狀積分、改良Barthel指數(shù)評分均有明顯差異,具有可比性(p0.01,p0.01)。分別對治療后兩組的氣虛型便秘癥狀積分、改良Barthel指數(shù)評分差值組間比較,差異有統(tǒng)計學意義(p0.01,p0.05)。說明秦氏腹針與傳統(tǒng)針刺方法均能有效改善患者便秘癥狀,提高患者日常生活活動能力,且秦氏腹針組優(yōu)于普通針刺組。3.兩組臨床效果方面,秦氏腹針組氣虛型便秘患者臨床治愈13例(43.33%),顯效7例(23.33%),有效9例(33.33%),無效1例(3.33%),總有效率96.67%,愈顯率66.67%。普通針刺組氣虛型便秘患者臨床治愈3例(10.00%),顯效5例(16.67%),有效18例(60.00%),無效4例(13.33%),總有效率86.67%,愈顯率26.67%。兩組療效比較,兩組總有效率無明顯差異,兩組愈顯率比較,秦氏腹針組療效較普通針刺組效果更佳。結(jié)論：秦氏腹針與普通針刺均能有效改善患者中風后氣虛型便秘的臨床癥狀,提高其日常生活活動能力,且優(yōu)于普通針刺,是一種行之有效的的治療方法。
[Abstract]:Objective: to evaluate the clinical efficacy of Qin's abdomen in treating patients with postapoplectic qi deficiency constipation, and to compare the curative effect with that of common acupuncture, and to analyze the difference of curative effect, in order to improve the clinical effect, the purpose of this study is to improve the clinical effect of Qi-deficiency type constipation after apoplexy, and to evaluate the clinical effect of Qi-deficiency constipation. To provide a simple and effective treatment for clinical approach. Methods: a randomized controlled clinical study was conducted to collect 60 patients with Qi-deficiency constipation from May 2015 to February 2016 in the Department of Rehabilitation of Acupuncture and moxibustion and the outpatient Department of the second Chinese Medicine Hospital of Guangdong Province, all of whom met the diagnostic criteria. Inclusion criteria The patients were randomly assigned to Qin's abdominal acupuncture group and common acupuncture group with 30 cases in each group by means of computer Excel software. Both groups were given basic medical treatment, body acupuncture and rehabilitation training. On this basis, Qin's abdominal acupuncture group adopted the method of selecting points and acupuncture of Qin's abdominal acupuncture, and the abdominal acupoints were based on the 0.5 inch (kidney meridian) of any vein and both sides of any vein. One acupoint was taken from 2 cubits of navel and 1 point from 3 cun of subumbilical cord, 1 point from 0.5 inch on the left side of each hole, and 1 point from each 3 points in a group of 5 points, 15 points were up and down, 15 needles were obtained from the top and bottom of the navel, and each of the three points was divided into five groups, each of which was divided into five groups. The treatment points of the common acupuncture group were: Tianshu, branch ditch, big transverse, Fenglong, Peshu and Qihai, all of which were taken from bilateral acupoints. One course of treatment was 7 days, 7 days, 14 days rest, and two courses of treatment. Constipation symptom score and modified Barthel index were used to evaluate constipation symptoms and improve the activity of daily living (ADL) respectively on the 1st and 14th day, and the overall clinical efficacy was evaluated. The result is 1: 1. The baseline data of two groups were compared before treatment, sex, age, onset time, primary disease, symptom score of Qi-deficiency type constipation and modified Barthel index were compared before treatment. There was no significant difference between the two groups (P 0.05). The baseline of the two groups was comparable. 2. The scores of constipation symptoms and modified Barthel index of Qi-deficiency type were significantly different between the two groups after treatment and before treatment. After treatment, there were significant differences between the two groups in the score of Qi-deficiency type constipation symptom and the difference of modified Barthel index score between the two groups. It shows that both Qin's abdominal acupuncture and traditional acupuncture can effectively improve the constipation symptoms and improve the activity of daily life of the patients, and the Qin's abdominal acupuncture group is better than the common acupuncture group. 3. In the two groups, 13 cases of Qi-deficiency type constipation were cured in Qin's abdominal acupuncture group (13 cases), 7 cases had remarkable effect (23. 33%), 9 cases were effective and 3. 33%, and 1 case was ineffective. The total effective rate was 96.6767 and the recovery rate was 66. 67%. In the common acupuncture group, 3 patients with Qi deficiency type constipation were cured, 5 patients with remarkable effect were treated with 16. 6767, 18 patients were effective, and 4 patients were ineffective. The total effective rate was 86.67 and the recovery rate was 26.67. There was no significant difference in the total effective rate between the two groups. The curative effect of Qin's abdominal acupuncture group was better than that of common acupuncture group. Conclusion: both Qin's abdominal acupuncture and common acupuncture can effectively improve the clinical symptoms of patients with Qi-deficiency type constipation after stroke, improve their daily life activities, and are superior to common acupuncture, which is an effective treatment method.
【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】：2016
【分類號】：R246.6

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