發(fā)布時(shí)間：2018-06-20 17:22

  本文選題：瀉熱逐瘀 + 刺絡(luò)放血��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察“瀉熱逐瘀刺絡(luò)放血療法”(以取病灶局部阿是穴,大椎穴、委中穴進(jìn)行刺絡(luò)放血)與“口服普瑞巴林膠囊、甲鈷胺片”對(duì)瘀血阻絡(luò)型帶狀皰疹后遺神經(jīng)痛的臨床療效對(duì)照觀察。充分驗(yàn)證瀉熱逐瘀刺絡(luò)放血療法對(duì)治療瘀血阻絡(luò)型帶狀皰疹后遺神經(jīng)痛是一種高治愈率、安全、優(yōu)效的方法。方法:將60例患者用隨機(jī)數(shù)字表法分為治療組、對(duì)照組,每組30例。治療組:采用“瀉熱逐瘀刺絡(luò)放血療法”,取病灶局部阿是穴,大椎穴、委中穴進(jìn)行刺絡(luò)放血,(周一、周三、周五選擇病灶局部刺絡(luò)放血,則周二、周四選擇大椎、委中刺絡(luò)放血)。每周為一療程,治療五天,周末休息兩天。共治療2個(gè)療程;對(duì)照組采用口服藥物:“普瑞巴林膠囊和甲鈷胺片”同時(shí)服用。普瑞巴林膠囊,口服劑量為:150m bid;甲鈷胺片,口服劑量為:0.5mg Tid。維持劑量,服用連續(xù)服藥14天。(1)兩組均在治療前、治療中(既第一療程結(jié)束后,第二療程開始前)、治療后(既總療程治療結(jié)束后第二天),分別用VAS進(jìn)行疼痛程度測(cè)評(píng)評(píng)分,用McGill疼痛綜合積分表進(jìn)行疼痛綜合癥狀積分測(cè)評(píng),用QS進(jìn)行睡眠質(zhì)量評(píng)分。(2)兩組均在總療程治療前,治療結(jié)束時(shí)分別用副反應(yīng)量表測(cè)評(píng),分別作為兩組副作用的觀察。從總體療效、起效速率,治愈率,有效率,副反應(yīng)的有無來評(píng)價(jià)瀉熱逐瘀法刺絡(luò)放血治療瘀血阻絡(luò)型帶狀皰疹后遺神經(jīng)痛的效果。結(jié)果:1.療效比較:兩組治療結(jié)束后療比較,刺絡(luò)放血組總有效率為100%,其中治愈率60%,顯效率30%;藥物組總有效率為83.33%,其中治愈率23%,顯效率20%差異有統(tǒng)計(jì)學(xué)意義(p0.05)。刺絡(luò)放血組總有效率、治愈率、顯效率高于對(duì)照組。2.疼痛程度VAS評(píng)分比較:兩組治療中(一療程結(jié)束后)比較,刺絡(luò)放血組與藥物組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后(總療程結(jié)束后)比較,刺絡(luò)放血組與藥物組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。刺絡(luò)放血組止痛療效、止痛速率優(yōu)于藥物組,隨著治療時(shí)間增加優(yōu)效性更加突出。3.QS睡眠質(zhì)量評(píng)分比較:兩組治療中(一療程結(jié)束后)比較,刺絡(luò)放血組與藥物組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后(總療程結(jié)束后)比較,刺絡(luò)放血組與藥物組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。刺絡(luò)放血組在改善患者疼痛引起的睡眠質(zhì)量降低方面優(yōu)于藥物組,且改善速率優(yōu)于藥物組,隨著治療時(shí)間增加優(yōu)效性更加突出。4.McGill疼痛綜合積分比較:兩組治療中(一療程結(jié)束后)比較,刺絡(luò)放血組與藥物組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后(總療程結(jié)束后)比較,刺絡(luò)放血組與藥物組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。刺絡(luò)放血組在改善患者疼痛綜合癥狀方面優(yōu)于藥物組,且改善速率優(yōu)于藥物組,隨著治療時(shí)間增加優(yōu)效性更加突出。5.副反應(yīng)量表(TESS)比較:兩組治療結(jié)束后,刺絡(luò)放血組與藥物組比較。刺絡(luò)放血組治療后有1人出現(xiàn)輕微皮膚癥狀;藥物組治療后出現(xiàn)不同程度的不良反應(yīng),人數(shù)為10人,副反應(yīng)率為33.33%,最明顯副作用為頭暈頭昏癥狀。結(jié)論:1.瀉熱逐瘀刺絡(luò)放血療法對(duì)瘀血阻絡(luò)型帶狀皰疹后遺神經(jīng)痛治愈率、顯效率、有效率明顯優(yōu)于口服藥物治療。2.瀉熱逐瘀刺絡(luò)放血療法在改善患者疼痛程度優(yōu)于藥物組,且止痛速率優(yōu)于藥物組,隨著治療時(shí)間的增加優(yōu)效性更加突出。3.瀉熱逐瘀刺絡(luò)放血療法在改善患者睡眠情況方面優(yōu)于藥物組,且改善速率優(yōu)于藥物組,隨著治療時(shí)間增加優(yōu)效性更加突出。4.瀉熱逐瘀刺絡(luò)放血療法在改善患者疼痛綜合癥狀方面優(yōu)于藥物組,且改善速率優(yōu)于藥物組,隨著治療時(shí)間增加優(yōu)效性更加突出。5.瀉熱逐瘀刺絡(luò)放血療法治療組治療后副反應(yīng)不明顯,藥物組治療后出現(xiàn)頭暈頭昏、口干、嗜睡、消化系統(tǒng)主觀癥狀以及血、尿、便及肝、腎功能等客觀體征的異常。6.瀉熱逐瘀刺絡(luò)放血療法以病灶局部阿是穴、大椎、委中、為主穴以刺絡(luò)放血治療瘀血阻絡(luò)型帶狀皰疹后遺神經(jīng)痛起效快、療效好、治愈速度快、隨著治療時(shí)間的增加優(yōu)效性更加突出,是一種簡(jiǎn)便、安全、優(yōu)效、高治愈率的方法。
[Abstract]:Objective: To observe the effect of "Purging Heat stasis bloodletting therapy" (for lesion Ashi point, Dazhui, Weizhong of bloodletting) and oral administration of Pregabalin Capsules, Mecobalamin Tablets observed "clinical curative effect on treating blood stasis type of postherpetic neuralgia. Fully verify the purging heat stasis pricking blood therapy for the treatment of blood stasis Type of postherpetic neuralgia is a high cure rate, safe, effective method. Methods: 60 cases were randomly divided into treatment group, patients in the control group, 30 cases in each group. The treatment group: the use of "Purging Heat stasis bloodletting therapy, taking local lesions point, Dazhui acupoint Weizhong of bloodletting, (Monday, Wednesday, Friday The lesion of bloodletting, Tuesday, Thursday Commission in blood pricking Dazhui). A week for a course of treatment is five days, weekend rest for two days. A total of 2 courses of treatment; the control group with oral administration of drugs: "Pregabalin Capsules and Mecobalamin Tablets" at the same time taking. Pregabalin Capsules, oral dose: 150m bid; Mecobalamin Tablets the oral dose was 0. .5mg Tid. dose, taking medication for 14 days. (1) in two groups before treatment, treatment (the first after the end of treatment, second courses before the start of treatment (second days), the total course of treatment after the end of both), with VAS degree of pain assessment score, pain symptom score comprehensive evaluation McGill pain table with QS The sleep quality score. (2) the two groups in the total course of treatment before the end of the treatment respectively, side effects scale, were observed as side effects of the two groups. The overall curative effect, the onset rate, cure rate, efficiency, side effects are to evaluate purging heat, removing blood stasis bloodletting the treatment of blood stasis type of postherpetic neuralgia. Results: 1. efficacy comparison: the treatment group after treatment, the end of the two, bloodletting group total effective rate was 100%, the cure rate is 60%, effective rate was 30%; the medicine group total effective rate was 83.33%, the cure rate was 23%, statistically significant difference (P0.05) was 20%. The total efficiency of bloodletting group and the cure rate, the effective rate was higher than the control group.2. pain rating VAS Comparison: two groups of treatment (one after the end of treatment), there was significant difference between the bloodletting group and drug group (P0.05). The two groups after treatment (total after treatment), there was significant difference between the bloodletting group and drug group (P0.05). Pricking blood group on analgesic effect, analgesic rate is better than the drug group, with treatment time Increase efficiency more prominent sleep quality.3.QS scores were compared between the two treatment (after a period of treatment), there was significant difference between the bloodletting group and drug group (P0.05). The two groups after treatment (total after treatment), bloodletting group and drug group was statistically significant compared the difference (P0.05). Pricking blood group in improving patients Pain caused by sleep quality is better than the drug group decreased, and the improvement rate is better than the drug group, with treatment time increase efficiency more prominent.4.McGill pain score comparison: two groups of treatment (one after the end of treatment), there was significant difference between the bloodletting group and drug group (P0.05 group) two. After treatment (total therapy After the end of the process), there was significant difference between the bloodletting group and drug group (P0.05). Bloodletting group in improving patients' pain symptoms than the drug group, and the improvement rate is better than the drug group, with treatment time increase efficiency more prominent.5. side effects scale (TESS): end the two groups after treatment, pricking blood group Compared with the drug group. Bloodletting group after treatment 1 showed mild skin symptoms; different degrees of adverse reactions occurred in drug group after treatment, the number is 10, the rate of side reaction was 33.33%, the most obvious side effects were dizziness symptoms. Conclusion: 1. purging heat, blood stasis bloodletting therapy to cure rate blood stasis type of postherpetic neuralgia, The significant efficiency, efficiency is obviously superior to oral therapy.2. Purging Heat stasis pricking blood therapy in improving the pain degree of patients better than the drug group, and the analgesic rate is better than the drug group, with the increase of treatment time superiority is more prominent.3. Purging Heat stasis pricking blood therapy in improving the patients sleep better than drug group and improve the speed. The rate is better than the drug group, with treatment time increase efficiency more prominent.4. Purging Heat stasis pricking blood therapy in improving the patients pain symptoms than the drug group, and the improvement rate is better than the drug group, with treatment time increase efficiency more prominent.5. Purging Heat stasis bloodletting therapy without obvious adverse reactions in the treatment after the treatment group, Dizziness, drug group after treatment, dry mouth, digestive system symptoms and subjective sleepiness, blood, urine, liver and renal function, abnormal.6. Purging Heat and other objective signs of blood stasis bloodletting therapy to the lesion point, Dazhui, commission, the main points with pricking blood therapy on blood stasis blocking collateral type ribbon postherpetic neuralgia rapid onset, good curative effect, treatment The speed, with the increase of treatment time superiority is more prominent, is a simple, safe, effective, high cure rate.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.7

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