本文選題：多發(fā)性神經(jīng)病 + 四藤通絡湯�。� 參考：《黑龍江中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:通過對針刺合四藤通絡湯外洗法治療多發(fā)性神經(jīng)病的臨床療效和對照觀察,綜合評價本方法治療多發(fā)性神經(jīng)病的臨床療效及安全性,以期進一步為針藥結(jié)合治療多發(fā)性神經(jīng)病提供新的方法和理論,且為其臨床廣泛應用提供客觀依據(jù)。方法:對60例符合多發(fā)性神經(jīng)病西醫(yī)和中醫(yī)雙重診斷標準的患者,按照就醫(yī)的先后順序進行編號,隨機分成對照組30例和治療組30例。對照組:給予維生素B1注射液100mg,日一次肌肉注射;維生素B12注射液0.5mg,日一次肌肉注射。一周為一個療程,以此方法連續(xù)治療四個療程。治療組:取穴:上肢:曲池,外關,陽池,合谷,八邪;下肢:足三里,解溪,足臨泣,太沖,八風;并且配合四藤通絡湯(青風藤、雞血藤、海風藤、絡石藤、川牛膝、紅花、海桐皮、艾葉、赤芍、五加皮、澤蘭、黃芪、元參、當歸、丹參)外洗法治療。每日一次,一周為一個療程,療程期間休息一天,以此方法連續(xù)治療四個療程。治療前后分別應用自覺癥狀分級量化標準、感覺障礙評定積分表(改良Fugl-meyer及Lindmark評價法)和神經(jīng)傳導速度(NCV)3項評價指標對兩組患者進行評分。結(jié)果:1.兩組患者經(jīng)治療后NCV均有所改善,尤以治療組改善情況顯著。治療后兩組NCV分別進行組內(nèi)對比,經(jīng)t檢驗分析,差異均具有統(tǒng)計學意義(P0.01)。治療后兩組組間進行NCV比較,經(jīng)t檢驗分析,差異具有統(tǒng)計學意義(P0.05)。2.兩組患者積分情況方面均有所改善,尤以治療組改善情況顯著。治療后兩組積分組內(nèi)對比,經(jīng)過t檢驗分析,差異均具有統(tǒng)計學的意義(P0.01)。治療之后兩組積分進行組間比較,經(jīng)過t檢驗分析,差異具有統(tǒng)計學意義(P0.05)。3.統(tǒng)計并分析數(shù)據(jù)得出結(jié)論,治療組和對照組的總有效率分別為86.67%、73.33%。兩組數(shù)據(jù)進行比較,其顯著性差異具有統(tǒng)計學意義(P0.05)。結(jié)論:1.針刺合四藤通絡湯外洗法和西藥常規(guī)治療均可以改善多發(fā)性神經(jīng)病病人之神經(jīng)傳導速度,使病人的自覺癥狀情況和感覺障礙情況均有所減輕。2.針刺合四藤通絡湯外洗法在改善多發(fā)性神經(jīng)病患者的神經(jīng)傳導速度、自覺癥狀和感覺障礙方面優(yōu)于西藥治療。3.針刺合四藤通絡湯外洗法治療多發(fā)性神經(jīng)病總有效率明顯優(yōu)于西藥治療,有一定的應用價值,值得在臨床中應用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of acupuncture combined with Siteng Tongluo decoction in the treatment of polyneuropathy. The aim is to provide a new method and theory for the treatment of polyneuropathy with acupuncture and medicine, and to provide objective basis for its wide clinical application. Methods: 60 patients with polyneuropathy were divided into control group (n = 30) and treatment group (n = 30). Control group: vitamin B1 injection 100 mg, once a day intramuscular injection, vitamin B 12 injection 0.5 mg, once a day intramuscular injection. A week as a course of treatment, this method of treatment for four consecutive courses. Treatment group: acupoints: upper limbs: Quchi, Waiguan, Yangchi, Hegu, eight evil; lower limbs: Zusanli, Jiexi, sobbing feet, Taochong, eight wind; and with Siteng Tongluo decoction (Qingfeng rattan, chicken blood vine, sea wind rattan, collateral stone rattan, Chuan Niujiao, Safflower, Paulownia Bark, leaves of Artemisia, Radix Paeoniae Alba, Radix Astragali, Radix Ginseng, Radix angelicae Sinensis, Salvia miltiorrhiza). Once a day, once a week as a course of treatment, a day off during the course, this method of treatment for four consecutive courses. Before and after treatment, the patients in the two groups were evaluated by the quantitative criteria of conscious symptom classification, sensory disturbance assessment scale (modified Fugl-meyer and Lindmark evaluation method) and nerve conduction velocity (NCVV). The result is 1: 1. After treatment, nCV was improved in both groups, especially in the treatment group. After treatment, the nCV of the two groups were compared within the group, and the difference was statistically significant by t test. After treatment, the nCV was compared between the two groups, and the difference was statistically significant by t test. The scores of both groups improved, especially in the treatment group. After treatment, the difference between the two groups was statistically significant (P 0.01). After treatment, the scores of the two groups were compared between the two groups, and the difference was statistically significant after t-test analysis. The total effective rates of the treatment group and the control group were 86.67 and 73.33, respectively. The difference between the two groups was statistically significant (P 0.05). Conclusion 1. Acupuncture combined with external washing of Siteng Tongluo decoction and routine treatment of western medicine can improve the nerve conduction velocity of patients with polyneuropathy, and reduce the conscious symptoms and sensory disorders of patients with polyneuropathy. 2. Acupuncture combined with Siteng Tongluo decoction was superior to western medicine in improving nerve conduction velocity, conscious symptoms and sensory disorders in patients with polyneuropathy. The total effective rate of acupuncture combined with Siteng Tongluo decoction in the treatment of polyneuropathy is obviously better than that of western medicine, which is worthy of clinical application.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.7

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