本文選題：腕管綜合征 + 內(nèi)關(guān)�。� 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本課題以輕中度腕管綜合征患者為研究病例,選取以內(nèi)關(guān)穴為主穴的相同穴位,運(yùn)用不同針刺手法,治療組患者采用內(nèi)關(guān)穴關(guān)刺法,對(duì)照組患者采用普通針刺法,探討不同針刺手法對(duì)本病的臨床療效,為針灸療法治療腕管綜合征選穴方案提供臨床依據(jù)。方法：課題組在研究期間一共納入60例符合臨床診斷納入標(biāo)準(zhǔn)的腕管綜合征患者60例。運(yùn)用DME隨機(jī)分組方法,分為治療組30例,對(duì)照組30例。兩組患者選用相同穴位,采用不同針刺手法,均連續(xù)治療5天為一個(gè)療程。共治療4個(gè)療程。在治療結(jié)束后統(tǒng)計(jì)兩組患者的VAS評(píng)分、Levine腕管綜合征問卷評(píng)分,通過比較兩組患者的臨床療效,評(píng)價(jià)針灸療法治療腕管綜合征的最佳治療方案。結(jié)果：納入60例腕管綜合征患者隨機(jī)分為兩組,治療前比較兩組患者的基線資料具有可比性(P＞0.05),兩組患者一般情況分布均衡,研究觀察具有科學(xué)性和可信性。(1)VAS評(píng)分：在治療前的基數(shù)資料分析中,兩組患者VAS評(píng)分具有可比性(P＞0.05)。經(jīng)過4個(gè)療程治療后,關(guān)刺組和普通針刺組VAS評(píng)分均下降,疼痛均有緩解。而關(guān)刺組VAS評(píng)分較普通針刺組下降更為顯著(P＜0.05)。關(guān)刺療法對(duì)腕管綜合征患者具有顯著的鎮(zhèn)痛效果。(2) Levine評(píng)分：在治療前的基數(shù)資料分析中,兩組患者Levine評(píng)分具有可比性(P＞0.05)。經(jīng)過4個(gè)療程治療后,關(guān)刺組和普通針刺組Levine評(píng)分均下降,臨床癥狀均有緩解,腕關(guān)節(jié)功能不同程度恢復(fù)。而關(guān)刺組VAS評(píng)分較普通針刺組下降更為顯著(P＜0.05)。關(guān)刺療法顯著緩解對(duì)腕管綜合征患者的臨床癥狀,更有助于患者局部功能的恢復(fù)。(3)臨床療效分析：根據(jù)臨床療效統(tǒng)計(jì),關(guān)刺組患者臨床治愈為4例,顯效19例,有效5例,無效2例,治愈率為13.33%,總有效率為93.33%。普通針刺組患者臨床治愈為1例,顯效12例,有效8例,無效9例,治愈率為3.33%,總有效率為70.00%。經(jīng)統(tǒng)計(jì)分析,關(guān)刺組患者臨床療效優(yōu)于普通針刺組(P＜0.05)。結(jié)論：腕管綜合征屬于傳統(tǒng)醫(yī)學(xué)“經(jīng)筋病”范疇,而“關(guān)刺”治“筋病”。本課題選取位于正中神經(jīng)循行區(qū)域的內(nèi)關(guān)穴,行關(guān)刺手法,以松止痛,以疏緩急,以通為補(bǔ),有效的緩解腕管綜合征的臨床癥狀,有助于局部功能的恢復(fù),對(duì)輕中度腕管綜合征具有良好的臨床療效,作為本病的保守治療方案值得臨床推廣。
[Abstract]:Objective: to study the patients with mild to moderate carpal tunnel syndrome, select the same acupoints with Neiguan acupoint as the main point, and apply different acupuncture methods to treat the patients in the treatment group and the general acupuncture method in the control group. To explore the clinical effect of different acupuncture manipulation on carpal tunnel syndrome. Methods: a total of 60 patients with carpal tunnel syndrome who met the criteria of clinical diagnosis were included in the study. DME was randomly divided into treatment group (n = 30) and control group (n = 30). The patients in the two groups were treated for 5 days with the same acupoints and different acupuncture manipulations. There were 4 courses of treatment. After the treatment, the VAS scores and Levine carpal tunnel syndrome questionnaire scores of the two groups were counted, and the best treatment of carpal tunnel syndrome was evaluated by comparing the clinical efficacy of acupuncture and moxibustion therapy. Results: sixty patients with carpal tunnel syndrome were randomly divided into two groups. The baseline data of the two groups were compared before treatment (P > 0.05). (1) VAS score: in the analysis of baseline data before treatment, the VAS scores of the two groups were comparable (P > 0.05). After 4 courses of treatment, the VAS scores of Guan acupuncture group and general acupuncture group were decreased and the pain was relieved. However, the VAS score of Guan acupuncture group was significantly lower than that of common acupuncture group (P < 0.05). (2) Levine score: in the analysis of cardinal data before treatment, Levine scores were comparable between the two groups (P > 0.05). After 4 courses of treatment, Levine scores of Guan acupuncture group and general acupuncture group were decreased, clinical symptoms were alleviated, wrist joint function was recovered to different degrees. However, the VAS score of Guan acupuncture group was significantly lower than that of common acupuncture group (P < 0.05). Guan acupuncture significantly alleviated the clinical symptoms of patients with carpal tunnel syndrome, and also contributed to the recovery of local function of the patients. (3) Clinical efficacy analysis: according to the clinical curative effect statistics, the patients of Guan acupuncture group were clinically cured in 4 cases, significantly effective in 19 cases, and effective in 5 cases. The cure rate was 13.33 and the total effective rate was 93.33. In the common acupuncture group, 1 case was cured, 12 cases were effective, 8 cases were effective, 9 cases were ineffective, the cure rate was 3.33 and the total effective rate was 70.00g. The clinical effect of Guan acupuncture group was better than that of common acupuncture group (P < 0.05). Conclusion: carpal tunnel syndrome belongs to the category of meridian disease in traditional medicine. This topic selects Neiguan acupoint located along the median nerve region, carries on the closing prickle manipulation, to relax the pain, to be sparse and urgent, to take the communication as the tonic, effectively alleviates the clinical symptom of carpal tunnel syndrome, and is helpful to the recovery of the local function. Mild to moderate carpal tunnel syndrome has a good clinical efficacy, as a conservative treatment of this disease is worthy of clinical promotion.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.9

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