循經(jīng)遠(yuǎn)取動(dòng)法治療腰扭傷的臨床療效觀察
發(fā)布時(shí)間：2018-07-25 12:09
【摘要】：目的：觀察循經(jīng)遠(yuǎn)取動(dòng)法治療腰扭傷的臨床療效,為腰扭傷的針刺治療尋求更有效、更方便的方法。方法：選取60例符合本研究要求的腰扭傷患者隨機(jī)分為治療組和對(duì)照組各30例,兩組均給予基礎(chǔ)治療。治療組采用循經(jīng)遠(yuǎn)取動(dòng)法,膀胱經(jīng)型腰扭傷選取患側(cè)攢竹穴、后溪穴,督脈型腰扭傷選取水溝穴,同時(shí)結(jié)合腰部主動(dòng)或被動(dòng)運(yùn)動(dòng),針刺后留針30分鐘,每10分鐘行針1次,7天為1個(gè)療程,治療1個(gè)療程。對(duì)照組采用常規(guī)針刺法,取局部穴位及膀胱經(jīng)穴為主,針刺腎俞、大腸俞、阿是穴、委中穴,留針30分鐘,每10分鐘行針1次,7天為1個(gè)療程,治療1個(gè)療程。觀察兩組患者首次治療后的視覺模擬評(píng)分(VAS)、腰椎活動(dòng)度評(píng)分(ROM),和治療1個(gè)療程后的VAS評(píng)分ROM評(píng)分和腰部功能障礙指數(shù)評(píng)分(JOA)的變化。所得數(shù)據(jù)采用SPSS17.0統(tǒng)計(jì)軟件處理,計(jì)量資料采用t檢驗(yàn),用均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,計(jì)數(shù)資料采用卡方檢驗(yàn),等級(jí)資料采用秩和檢驗(yàn),P0.05表示具有顯著性差異,P0.01表示具有極顯著性差異,P0.05表示差異無統(tǒng)計(jì)學(xué)意義。將兩組進(jìn)行治療前、首次治療后和治療1個(gè)療程后的組內(nèi)對(duì)比和組間比較,觀察其臨床療效差異。結(jié)果：60例患者均完成本次臨床觀察研究,無脫落、中止病例,無針刺不良反應(yīng)發(fā)生。1、臨床療效評(píng)價(jià)：治療組30例患者中,治愈18例,顯效8例,有效3例,無效1例,治愈率60%,總有效率96.7%。對(duì)照組30例患者中,治愈12例,顯效7例,有效4例,無效7例,治愈率40%,總有效率76.7%,治療組的治愈率高于對(duì)照組。治療組總有效率與對(duì)照組比較,經(jīng)秩和檢驗(yàn),Z=-2.054,P=0.04,P0.05,差異具有統(tǒng)計(jì)學(xué)意義,提示總有效率治療組優(yōu)于對(duì)照組。2、VAS評(píng)分比較：兩組患者首次治療后VAS評(píng)分較同組治療前評(píng)分有所下降,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),說明兩組患者治療1次后疼痛感均有不同程度的減輕。首次治療后治療組的VAS評(píng)分與對(duì)照組比較,P0.01,具有極顯著性差異,說明首次治療后治療組在緩解疼痛方面優(yōu)于對(duì)照組。兩組治療1個(gè)療程后VAS評(píng)分與同組治療前比較,差異具有統(tǒng)計(jì)學(xué)意義,P0.01,提示兩種方法治療腰扭傷可以緩解患者的腰部疼痛。治療1個(gè)療程后,治療組的VAS評(píng)分與對(duì)照組比較差異具有統(tǒng)計(jì)學(xué)意義,P0.05,說明治療組對(duì)疼痛的改善程度優(yōu)于對(duì)照組。3、JOA綜合評(píng)分比較：兩組患者治療1個(gè)療程后JOA綜合評(píng)分較治療前均有所降低,(P0.01),說明治療后的兩組患者在自覺癥狀、日常生活活動(dòng)功能等方面都有所改善,兩種治療方法均有效。治療組治療1個(gè)療程后JOA評(píng)分的改善程度優(yōu)于對(duì)照組,治療1個(gè)療程后兩組患者的JOA評(píng)分比較差異具有統(tǒng)計(jì)學(xué)意義P0.01,說明治療組對(duì)腰部功能障礙的改善優(yōu)于對(duì)照組。4、ROM評(píng)分比較：兩組患者首次治療后ROM評(píng)分較同組治療前評(píng)分均有所下降,比較差異具有統(tǒng)計(jì)學(xué)意義(P0.01),提示經(jīng)過1次治療,治療組和對(duì)照組均可以使腰部活動(dòng)范圍增大。首次治療后治療組的ROM評(píng)分與對(duì)照組比較,P0.05,差異具有統(tǒng)計(jì)學(xué)意義,提示治療組對(duì)腰椎范圍的改善程度更大。治療1個(gè)療程后兩組患者的ROM評(píng)分較同組治療前,比較差異具有統(tǒng)計(jì)學(xué)意義(P0.01),治療1個(gè)療程后治療組的ROM評(píng)分與對(duì)照組相比,P0.05,具有顯著性差異,說明兩種方法對(duì)腰扭傷的腰椎活動(dòng)度改善均有效,治療組優(yōu)于對(duì)照組。結(jié)論：1、循經(jīng)遠(yuǎn)取動(dòng)法與常規(guī)針刺法治療腰扭傷均有明顯療效,循經(jīng)遠(yuǎn)取動(dòng)法組療效更為顯著,優(yōu)于常規(guī)針刺法組。2、首次治療后兩組患者的VAS評(píng)分、ROM評(píng)分較治療前均有所改善,循經(jīng)遠(yuǎn)取動(dòng)法組疼痛的緩解程度、腰椎活動(dòng)范圍的改善均優(yōu)于常規(guī)針刺法組。3、治療1個(gè)療程后兩組患者的VAS評(píng)分、JOA評(píng)分和ROM評(píng)分較治療前均下降明顯,兩種方法均有效,循經(jīng)遠(yuǎn)取動(dòng)法組在緩解患者腰部疼痛、改善腰椎活動(dòng)范圍、提高生活質(zhì)量等方面均優(yōu)于常規(guī)針刺法組。
[Abstract]:Objective: To observe the clinical effect of the treatment of lumbar sprain in the treatment of lumbar sprain, and to seek more effective and convenient methods for the acupuncture treatment of lumbar sprain. Method: 60 cases of lumbar sprain were randomly divided into treatment group and control group of 30 cases, two groups were given basic treatment. The type of lumbar sprain was selected from the side of the suffering side bamboo point, the posterior stream point, the vein type waist sprain to select the water groove point, combined with the active or passive movement of the waist. After acupuncture, the needle was retained for 30 minutes, 1 times every 10 minutes, 7 days for 1 courses and 1 courses of treatment. The control group adopted the local acupuncture point and the bladder meridian points, and the acupuncture of the Shenshu, the large intestine Shu and the acupoint. To observe the changes of the visual analogue score (VAS) for the first treatment of the two groups of patients (VAS), the lumbar activity score (ROM), the VAS score and the function barrier index score (JOA) after the 1 course of treatment. The results of the data were measured by SPSS17.0 software, and the changes in the VAS score and the function barrier index score (JOA) after the 1 courses of treatment were observed. The data were treated with t test and mean number + standard deviation (x + s). Counting data were checked by chi square test, rank data were tested with rank sum test, P0.05 showed significant difference. P0.01 showed significant difference, P0.05 showed no statistical difference. Two groups were treated before treatment, after first treatment and after 1 courses of treatment. Results: 60 cases completed this clinical observation and study, 60 cases complete this clinical observation, no shedding, discontinuation of cases, no adverse effects of acupuncture,.1, clinical efficacy evaluation: 30 cases in the treatment group, 18 cases, 8 cases, effective 3 cases, 1 cases, cure rate 60%, total effective rate of 96.7%. control group 30 cases. In the patients, 12 cases were cured, 7 cases were markedly effective, 4 cases were effective, 7 cases were invalid, the cure rate was 40%, the total effective rate was 76.7%, the cure rate of the treatment group was higher than the control group. The total effective rate of the treatment group was compared with the control group. The difference had statistical significance through the rank sum test, Z=-2.054, P=0.04, P0.05, suggesting that the total effective treatment group was superior to the control group.2, VAS score comparison: two groups: two groups comparison: two groups comparison: two groups comparison: two groups comparison comparison: two groups comparison: two groups comparison: two groups comparison: two groups comparison: two groups comparison: two groups After the first treatment of the patients, the VAS score was lower than the same group before treatment, the difference was statistically significant (P0.01), indicating that two groups of patients were relieved of pain in different degrees after 1 times of treatment. After the first treatment, the VAS score of the treatment group was compared with the control group, with a significant difference, indicating that the treatment group after the first treatment was relieving pain after the first treatment. The pain was better than the control group. After 1 courses of treatment, the VAS score was compared with the same group before treatment, the difference was statistically significant, P0.01, suggesting that the two methods of treatment of lumbar sprain can relieve the pain of the waist. After the treatment of the 1 courses, the VAS score of the treatment group was statistically significant compared with the control group, P0.05, indicating the pain in the treatment group. The improvement of pain was better than that of the control group.3, and the JOA comprehensive score was compared: the JOA comprehensive score of the two groups was lower after 1 courses of treatment than before the treatment, (P0.01), indicating that the two groups of patients after the treatment were improved in the conscious symptoms, the daily living function and so on, and the two treatment methods were all effective. The treatment group was treated with JOA after 1 courses of treatment. The improvement of the score was better than that of the control group. The difference of JOA score in the two groups after 1 courses of treatment was statistically significant P0.01, indicating that the improvement of the waist dysfunction in the treatment group was better than that of the control group.4, and the ROM score was compared: the ROM score of the two groups was lower than that of the same group after the first treatment, and the difference was statistically significant. Learning significance (P0.01), suggesting that after 1 times of treatment, both the treatment group and the control group could increase the range of the waist activity. After the first treatment, the ROM score of the treatment group was compared with the control group, P0.05, the difference was statistically significant, suggesting that the treatment group improved the extent of the lumbar vertebra greater. After the treatment of the 1 courses, the two groups of patients were compared with the same group treatment. Before 1 courses of treatment, the difference was statistically significant (P0.01). Compared with the control group, the ROM score of the treatment group was significantly different from the control group. It showed that the two methods were effective in improving the lumbar activity of lumbar sprain, and the treatment group was superior to the control group. Conclusion: 1, there was a significant treatment in the treatment of Lumbar Sprain with the method of far fetching and conventional acupuncture. The effect was more significant than the conventional acupuncture group, which was better than the conventional acupuncture group.2. The VAS score of the two groups of patients after the first treatment was improved. The improvement of the ROM score was better than that before the treatment. The improvement of the range of activity of the lumbar vertebra was better than that of the conventional acupuncture group.3, and the VAS score of the two groups after the 1 course of treatment, and JOA evaluation. The score and ROM score were obviously lower than those before the treatment. The two methods were all effective. The group was better than the conventional acupuncture group in alleviating the pain of the waist, improving the range of lumbar activity and improving the quality of life.
【學(xué)位授予單位】：黑龍江中醫(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
[Abstract]:Objective: To observe the clinical effect of the treatment of lumbar sprain in the treatment of lumbar sprain, and to seek more effective and convenient methods for the acupuncture treatment of lumbar sprain. Method: 60 cases of lumbar sprain were randomly divided into treatment group and control group of 30 cases, two groups were given basic treatment. The type of lumbar sprain was selected from the side of the suffering side bamboo point, the posterior stream point, the vein type waist sprain to select the water groove point, combined with the active or passive movement of the waist. After acupuncture, the needle was retained for 30 minutes, 1 times every 10 minutes, 7 days for 1 courses and 1 courses of treatment. The control group adopted the local acupuncture point and the bladder meridian points, and the acupuncture of the Shenshu, the large intestine Shu and the acupoint. To observe the changes of the visual analogue score (VAS) for the first treatment of the two groups of patients (VAS), the lumbar activity score (ROM), the VAS score and the function barrier index score (JOA) after the 1 course of treatment. The results of the data were measured by SPSS17.0 software, and the changes in the VAS score and the function barrier index score (JOA) after the 1 courses of treatment were observed. The data were treated with t test and mean number + standard deviation (x + s). Counting data were checked by chi square test, rank data were tested with rank sum test, P0.05 showed significant difference. P0.01 showed significant difference, P0.05 showed no statistical difference. Two groups were treated before treatment, after first treatment and after 1 courses of treatment. Results: 60 cases completed this clinical observation and study, 60 cases complete this clinical observation, no shedding, discontinuation of cases, no adverse effects of acupuncture,.1, clinical efficacy evaluation: 30 cases in the treatment group, 18 cases, 8 cases, effective 3 cases, 1 cases, cure rate 60%, total effective rate of 96.7%. control group 30 cases. In the patients, 12 cases were cured, 7 cases were markedly effective, 4 cases were effective, 7 cases were invalid, the cure rate was 40%, the total effective rate was 76.7%, the cure rate of the treatment group was higher than the control group. The total effective rate of the treatment group was compared with the control group. The difference had statistical significance through the rank sum test, Z=-2.054, P=0.04, P0.05, suggesting that the total effective treatment group was superior to the control group.2, VAS score comparison: two groups: two groups comparison: two groups comparison: two groups comparison: two groups comparison comparison: two groups comparison: two groups comparison: two groups comparison: two groups comparison: two groups comparison: two groups After the first treatment of the patients, the VAS score was lower than the same group before treatment, the difference was statistically significant (P0.01), indicating that two groups of patients were relieved of pain in different degrees after 1 times of treatment. After the first treatment, the VAS score of the treatment group was compared with the control group, with a significant difference, indicating that the treatment group after the first treatment was relieving pain after the first treatment. The pain was better than the control group. After 1 courses of treatment, the VAS score was compared with the same group before treatment, the difference was statistically significant, P0.01, suggesting that the two methods of treatment of lumbar sprain can relieve the pain of the waist. After the treatment of the 1 courses, the VAS score of the treatment group was statistically significant compared with the control group, P0.05, indicating the pain in the treatment group. The improvement of pain was better than that of the control group.3, and the JOA comprehensive score was compared: the JOA comprehensive score of the two groups was lower after 1 courses of treatment than before the treatment, (P0.01), indicating that the two groups of patients after the treatment were improved in the conscious symptoms, the daily living function and so on, and the two treatment methods were all effective. The treatment group was treated with JOA after 1 courses of treatment. The improvement of the score was better than that of the control group. The difference of JOA score in the two groups after 1 courses of treatment was statistically significant P0.01, indicating that the improvement of the waist dysfunction in the treatment group was better than that of the control group.4, and the ROM score was compared: the ROM score of the two groups was lower than that of the same group after the first treatment, and the difference was statistically significant. Learning significance (P0.01), suggesting that after 1 times of treatment, both the treatment group and the control group could increase the range of the waist activity. After the first treatment, the ROM score of the treatment group was compared with the control group, P0.05, the difference was statistically significant, suggesting that the treatment group improved the extent of the lumbar vertebra greater. After the treatment of the 1 courses, the two groups of patients were compared with the same group treatment. Before 1 courses of treatment, the difference was statistically significant (P0.01). Compared with the control group, the ROM score of the treatment group was significantly different from the control group. It showed that the two methods were effective in improving the lumbar activity of lumbar sprain, and the treatment group was superior to the control group. Conclusion: 1, there was a significant treatment in the treatment of Lumbar Sprain with the method of far fetching and conventional acupuncture. The effect was more significant than the conventional acupuncture group, which was better than the conventional acupuncture group.2. The VAS score of the two groups of patients after the first treatment was improved. The improvement of the ROM score was better than that before the treatment. The improvement of the range of activity of the lumbar vertebra was better than that of the conventional acupuncture group.3, and the VAS score of the two groups after the 1 course of treatment, and JOA evaluation. The score and ROM score were obviously lower than those before the treatment. The two methods were all effective. The group was better than the conventional acupuncture group in alleviating the pain of the waist, improving the range of lumbar activity and improving the quality of life.
【學(xué)位授予單位】：黑龍江中醫(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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