本文選題：混合痔 + 外剝內(nèi)扎術(shù)　； 參考：《廣西中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察并評價活血通絡(luò)針刺法治療混合痔外剝內(nèi)扎術(shù)后疼痛的臨床療效,探討活血通絡(luò)針刺法在緩解混合痔外剝內(nèi)扎術(shù)后疼痛癥狀的機制和臨床應(yīng)用價值,為臨床治療混合痔外剝內(nèi)扎術(shù)后疼痛提供安全有效的治療方法。方法:將符合標(biāo)準(zhǔn)的60例患者隨機分為治療組、對照組各30例。治療組采用活血通絡(luò)針刺法治療,對照組采用口服鹽酸曲馬多片治療。觀察并記錄患者2h、4h、10h、24h、48h、72h疼痛VAS、VRS評分,鎮(zhèn)痛起效時間,術(shù)后發(fā)生不良反應(yīng)情況,鎮(zhèn)痛藥物使用情況比較,統(tǒng)計數(shù)據(jù)采用SPSS22.O統(tǒng)計軟件進行分析。結(jié)果:1、主要療效評價指標(biāo):(1)術(shù)后VAS評分比較,兩組患者術(shù)后2h、4h、10h、24h、72h比較無顯著差異(P0.05),無統(tǒng)計學(xué)意義,治療組與對照組療效相當(dāng),因此可以認(rèn)為治療組和對照組對混合痔術(shù)后疼痛均有止痛作用;術(shù)后第48h小時的疼痛VAS積分比較差異具有顯著性(P0.05),具有統(tǒng)計學(xué)意義,治療組止痛療效優(yōu)于對照組;(2)兩組患者術(shù)后2h、4h、10h、24h、48h、72h VRS評分比較無顯著差異(P0.05),無統(tǒng)計學(xué)意義,治療組與對照組療效相當(dāng);(3)經(jīng)重復(fù)測量方差分析,(1)兩組之間相同時間VAS評分比較,差異有統(tǒng)計學(xué)意義(F=7.25,P=0.0093);兩組組內(nèi)不同治療時間之間VAS評分比較,差異有統(tǒng)計學(xué)意義(F=31.09,P=0.0000);治療時間與VAS評分之間無交互效應(yīng)(F=0.08,P=0.493);(2)兩組之間相同時間VRS評分比較,差異無統(tǒng)計學(xué)意義(F分組=3.53,P分組=0.656);兩組組內(nèi)不同治療時間之間VRS評分比較,差異有統(tǒng)計學(xué)意義(F時間=3.12,P時間=0.0092);治療時間與VRS評分之間無交互效應(yīng)(F交互=0.52,P交互=0.762)。2、次要療效評價指標(biāo):(1)術(shù)后兩組鎮(zhèn)痛起效時間比較差異具有顯著性(P0.05),有統(tǒng)計學(xué)意義,治療組優(yōu)于對照組,說明活血通絡(luò)針刺法鎮(zhèn)痛效果快于對照組;(2)兩組術(shù)后發(fā)生不良反應(yīng)人數(shù)比較差異十分顯著(P0.01),具有統(tǒng)計學(xué)意義,治療組不良反應(yīng)人數(shù)較對照組少,可以認(rèn)為治療組具有更高的安全性;(3)鎮(zhèn)痛藥物使用情況比較差異有統(tǒng)計學(xué)意義(P0.01),治療組鎮(zhèn)痛藥物人均用量遠(yuǎn)低于對照組。結(jié)論:活血通絡(luò)針刺法在治療混合痔外剝內(nèi)扎術(shù)后疼痛具有確切的療效,能減輕疼痛強度,緩解疼痛癥狀,鎮(zhèn)痛迅速,減少術(shù)后不良情況的發(fā)生,安全有效,為臨床提供了一項新的治療手段。
[Abstract]:Objective: to observe and evaluate the clinical effect of activating blood circulation and Tongluo acupuncture on the pain after external exfoliation and internal ligation of mixed hemorrhoids, and to explore the mechanism and clinical application value of activating blood circulation Tongluo acupuncture in relieving the pain symptoms after external stripping and internal ligation of mixed hemorrhoids. To provide a safe and effective method for the treatment of pain after external exfoliation and internal ligation of mixed hemorrhoids. Methods: 60 patients were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated by activating blood circulation and collaterals acupuncture, and the control group was treated with tramadol hydrochloride tablets. The VRS scores, the onset time of analgesia, the adverse reactions after operation and the use of analgesic drugs were observed and recorded. The statistical data were analyzed by SPSS 22.O. Results: (1) there was no significant difference in VAS score between the two groups (P0.05), and there was no significant difference between the two groups (P0.05), and the curative effect of the treatment group was similar to that of the control group. It can be concluded that the treatment group and the control group have analgesic effect on postoperative pain of mixed hemorrhoids, and the VAS scores of pain at 48h after operation have significant difference (P0.05), which has statistical significance. The curative effect of the treatment group was better than that of the control group, (2) there was no significant difference in VRS score between the two groups (P0.05), there was no significant difference in VRS score between the two groups (P0.05), there was no significant difference between the treatment group and the control group; (3) after repeated measurement of variance analysis, (1) VAS scores were compared at the same time between the two groups. There were significant differences in VAS scores between the two groups (F0. 25 P0. 0093), there were significant differences in the VAS scores between the two groups at different treatment times (F0. 09% P0. 0000), and there was no interaction between the treatment time and the VAS score (F0. 08% PX 0. 493); (2) between the two groups at the same time. There was no significant difference between the two groups (F group, 3.53 P group, 0.656), and the VRS scores were compared between the two groups at different treatment time. The difference was statistically significant (F time was 3.12p time 0.0092), there was no interactive effect between treatment time and VRS score (F interaction time: 0.52P interaction: 0.762). Secondary efficacy evaluation index: (1) there was significant difference in analgesia onset time between the two groups (P0.05), there was significant difference between the two groups (P0.05), and there was significant difference between the two groups (P0.05), and there was no significant difference between the treatment time and the VRS score (P < 0.05). The treatment group was superior to the control group, indicating that the analgesic effect of the acupuncture method of activating blood circulation and dredging collaterals was faster than that of the control group; (2) the number of adverse reactions in the treatment group was significantly different (P0.01), and the number of adverse reactions in the treatment group was less than that in the control group. It can be considered that the treatment group has higher safety; (3) the use of analgesic drugs was significantly different (P0.01), the average dosage of analgesic drugs in the treatment group was much lower than that in the control group. Conclusion: the acupuncture method of activating blood circulation and dredging collaterals is effective in the treatment of pain after external exfoliation and internal ligation of mixed hemorrhoids, which can reduce the intensity of pain, relieve the symptoms of pain, relieve pain quickly, reduce the occurrence of adverse conditions after operation, and be safe and effective. It provides a new treatment for clinic.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R266

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