本文選題：肩周炎 + 透刺　； 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本課題旨在探討透刺結(jié)合放血療法治療肩關(guān)節(jié)周圍炎的臨床療效。通過(guò)對(duì)透刺配合放血療法治療肩周炎的臨床研究,客觀、科學(xué)地探究透刺配合放血療法的臨床有效性,進(jìn)一步推廣針灸療法,為今后選擇治療肩關(guān)節(jié)周圍炎更有效的途徑提供依據(jù)。方法:采用隨機(jī)數(shù)字表、單盲的研究方法,將來(lái)自于湖北省中醫(yī)院光谷院區(qū)符合本試驗(yàn)要求的70例患者,隨機(jī)分為透刺放血組和常規(guī)針刺組,每組35例。透刺放血組最終完成34例,脫落1例,采用透刺結(jié)合放血療法治療肩周炎,透刺取穴為肩毭透肩前、肩毼透臂佈、肩貞透佈俞、外關(guān)透內(nèi)關(guān)(以上均為患側(cè)),條口透承山(健側(cè)),針灸治療每天1次,每周連續(xù)5次,5次為1療程,兩個(gè)療程間間隔2天;針刺后對(duì)阿是穴進(jìn)行放血療法,每周2次,分別為第1次和第4次針灸治療后進(jìn)行放血療法,共治療4個(gè)療程。常規(guī)針刺組最終完成33例,脫落2例,采用常規(guī)針刺療法(參考王啟才版《針灸治療學(xué)》中肩周炎的治療方法)治療肩周炎,針刺取穴為肩毭、肩前、肩貞、陽(yáng)陵泉、中平穴、阿是穴,每天1次,每周連續(xù)5次,5次為1療程,兩個(gè)療程間休息2天,共治療4個(gè)療程。分別評(píng)估兩組治療前、治療2個(gè)療程后、治療4個(gè)療程后McGill疼痛問(wèn)卷評(píng)分、Constant-murley評(píng)分、ADL評(píng)分及進(jìn)行療效評(píng)定,并對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.在緩解肩周炎疼痛方面:兩組McGill疼痛評(píng)分比較,組內(nèi)比較,治療2個(gè)療程和4個(gè)療程后分別與治療前比較,均P0.05,差異均有統(tǒng)計(jì)學(xué)意義,說(shuō)明兩組在改善肩周炎疼痛癥狀方面均有效。組間比較,治療2個(gè)療程后,兩組比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義,因此,不能說(shuō)明透刺放血組改善肩周炎疼痛癥狀療效優(yōu)于常規(guī)針刺組;治療4個(gè)療程后,兩組比較,P0.05,差異具有統(tǒng)計(jì)學(xué)意義,說(shuō)明透刺放血組改善肩周炎疼痛癥狀優(yōu)于常規(guī)針刺組。2.在改善肩周炎肩關(guān)節(jié)功能活動(dòng)方面:兩組Constant-murley評(píng)分比較,組內(nèi)比較,治療2個(gè)療程后、4個(gè)療程后分別與治療前比較,均P0.05,差異均有統(tǒng)計(jì)學(xué)意義,說(shuō)明兩組在改善肩周炎功能活動(dòng)方面均有效;組間比較,兩組在治療2個(gè)療程及4個(gè)療程后分別進(jìn)行比較,均P0.05,差異均有統(tǒng)計(jì)學(xué)意義,說(shuō)明透刺放血組在改善肩周炎功能活動(dòng)方面優(yōu)于常規(guī)針刺組。3.在改善日常生活能力方面:兩組ADL評(píng)分比較,組內(nèi)比較,在治療2個(gè)療程、4個(gè)療程后分別與治療前比較,均P0.05,差異均有統(tǒng)計(jì)學(xué)意義,說(shuō)明兩組在改善肩周炎功能活動(dòng)方面均有效;組間比較,兩組在治療2個(gè)療程及4個(gè)療程后分別進(jìn)行比較,均P0.05,差異均有統(tǒng)計(jì)學(xué)意義,說(shuō)明透刺放血組在改善日常生活能力方面優(yōu)于常規(guī)針刺組。4.療效評(píng)定:透刺組34例,痊愈13例,顯效16例,有效4例,無(wú)效1例,總有效率均為97.06%;常規(guī)針刺組33例,痊愈6例,顯效11例,有效13例,無(wú)效3例,總有效率均為90.9%,兩組療效比較,經(jīng)秩和檢驗(yàn),差異具有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明透刺結(jié)合放血療法治療肩周炎療效優(yōu)于常規(guī)針刺。結(jié)論:1.兩種治療方法在改善肩周炎疼痛、功能活動(dòng)及日常生活能力方面均有效;透刺結(jié)合放血療法在改善肩周炎疼痛、功能活動(dòng)及日常生活能力方面有明顯優(yōu)勢(shì)。2.短期內(nèi)治療肩周炎在改善疼痛方面,透刺結(jié)合放血療法無(wú)明顯優(yōu)勢(shì),但改善功能活動(dòng)、日常生活能力有明顯優(yōu)勢(shì)。3.本課題研究表明,透刺結(jié)合放血療法治療肩周炎療效確切,具有極大的臨床應(yīng)用價(jià)值,值得進(jìn)一步臨床推廣。
[Abstract]:Objective: the purpose of this study is to explore the clinical efficacy of puncture combined with blood letting therapy for the treatment of periarthritis of shoulder. Through the clinical study of the treatment of scapulohumeral periarthritis with the combination of puncture and blood letting therapy, the clinical effectiveness of puncture and blood letting therapy is objectively and scientifically explored, and the needle moxibustion therapy is further popularized to be more effective for the treatment of periarthritis of the shoulder in the future. Methods: a random number table, a single blind study method, 70 patients in Optics Valley Hospital District of Hubei Provincial Traditional Chinese Medical Hospital, which meet the requirements of the test in the future, were randomly divided into 35 cases in each group. 34 cases were completed by puncture and blood release group, 1 cases were dropped out, and the scapulohumeral periarthritis was treated by puncture combined with blood letting therapy. There were 1 times a day, 5 times a week, 5 times for 1 courses, 2 days between two courses, and 2 times a week after acupuncture, 2 times a week, first and fourth times respectively. A total of 4 courses of treatment were performed. The routine acupuncture group was treated with 4 courses of treatment. 33 cases were completed in the routine acupuncture group, 2 cases were dropped out, and the treatment of scapulohumeral periarthritis was treated by conventional acupuncture (reference Wang Qicai edition < acupuncture therapy > middle scapulohumeral periarthritis). Acupuncture points were taken as shoulder, shoulder, shoulder chastity, Yang Ling spring, middle Ping acupoint, and acupoint, 1 times a day, 5 consecutive 1 courses, two courses of 1, two After 2 days of treatment, 4 courses were treated. Before treatment of two groups, after treatment of two groups, after treatment for 2 courses, after 4 courses of treatment, the pain questionnaire, Constant-murley score, ADL score and curative effect were evaluated, and the data were statistically analyzed. Results: 1. in alleviating the pain of shoulder periarthritis: the two groups of McGill pain scores were compared and the intra group ratio was compared. Compared with the treatment of 2 courses and 4 courses, compared with before treatment, the difference was P0.05, the difference was statistically significant, indicating that the two groups were effective in improving the pain symptoms of scapulohumeral periarthritis. Group comparison, after the treatment of 2 courses, the two groups were compared, P0.05, the difference was not statistically significant, because this could not explain the improvement of the pain symptoms in the scapulohumeral periarthritis. After 4 courses of treatment, the two groups were compared, P0.05, and the difference was statistically significant. It showed that the pain symptom of scapulohumeral periarthritis was better than that of the conventional acupuncture group.2. in improving shoulder joint function activities in the scapulohumeral periarthritis: the two group Constant-murley score compared with the group, after the treatment of 2 courses, after the 4 course of treatment, respectively, Before treatment, the difference was P0.05, the difference was statistically significant, indicating that the two groups were effective in improving the function of scapulohumeral periarthritis, and the two groups were compared in 2 courses and 4 courses respectively, and the difference was statistically significant, indicating that the group of penetrating blood and letting blood were better than the conventional acupuncture group in improving the function of scapulohumeral periarthritis. .3. in the improvement of daily life capacity: two groups of ADL score comparison, in group comparison, in the treatment of 2 courses, after 4 courses compared with before treatment, respectively, were P0.05, the difference was statistically significant, indicating that the two groups were effective in improving the function of periarthritis of shoulder; the two groups were compared in 2 courses and after 4 courses, respectively. All P0.05, the difference was statistically significant, indicating that through the thorns and letting blood group is better than the conventional acupuncture group.4. efficacy evaluation in improving the daily life ability: 34 cases in the puncture group, 13 cases, effective 16 cases, effective 4 cases, invalid 1 cases, the total effective rate is 97.06%; the routine acupuncture group 33 cases, 6 cases, 13 cases, invalid 3 cases, the total effective rate are all 90.9%, the comparison of the two groups, through the rank sum test, the difference has statistical significance (P0.05), indicating that the treatment of periarthritis of shoulder is better than the conventional acupuncture. Conclusion: 1. two kinds of treatment methods are effective in improving the pain of scapulohumeral periarthritis, functional activity and daily living ability; through the puncture combined with blood letting therapy in improving the pain of scapulohumeral periarthritis There is obvious advantage in activity and daily life ability,.2. in the short term treatment of periarthritis of shoulder in the improvement of pain, through the combination of puncture and blood letting therapy has no obvious advantages, but the improvement of functional activities and daily living ability has obvious advantages.3. research shows that through the combination of puncture and blood letting therapy with the rule of law treatment of scapulohumeral periarthritis is effective and has great clinical application. The value is worth further clinical promotion.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.9

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