【摘要】：目的:隨著生活節(jié)奏急速,人們精神心理負擔的加重、飲食結構的改變、以及社會環(huán)境因素等都能產生便秘情況。功能性便秘不單只見于老年人以及孕婦,此疾病已經慢慢趨向年輕化。因此本次課題通過隨機對照法在臨床上抽取小樣本進行研究,治療組采用溫艾配合針刺治療痰濕型功能性便秘,對照組單純針刺方法,通過比較兩種治療方法的臨床療效,結合體質學科知識探尋防治療痰濕型便秘的較優(yōu)治療方案,并從體質學方面探討其相關之處。方法:本次研究參照設定中篩選出受試者62例,符合功能性便秘的診斷標準及中醫(yī)體質分類表中的痰濕體質,簽署知情同意書,再隨機分成治療組和對照組兩組,各31例。揀選穴位方面,兩組都針刺(天樞、大腸俞、手三里、支溝)。而治療組在上述針刺基礎上配合溫針灸(豐隆、太白、脾俞)。兩組針灸每周進行2次治療,1個月為1次療程,共3個療程。待3個療程結束后,觀察其治療前后的便秘癥狀改變,體質變化,用EXCEL記錄并設立數(shù)據(jù)庫,并運用SPSS 24.0統(tǒng)計學軟件來進行分析。結果:在62例受試者中,治療組剔除因治療期間前往外地讀書的患者1例,對照組亦剔除因治療期間懷孕的患者1例,而不得不終止試驗。最后完成各30例。兩組病例對功能性便秘的效果都有顯著的治療效果,便秘嚴重程度均有所改善。當中治療組的總有效率約為900%;對照組的總有效率約為800%,經過兩組比較后,有統(tǒng)計學上的差異(P0.05)。3個療程結束后,兩組在改善便秘程度方面,較治療前便秘積分有下降,但治療組積分的下降程度較為明顯,兩者比較后的差異,具有統(tǒng)計學意義(P0.05),表明治療組的總療效較為優(yōu)越。兩組在痰濕體質改善方面,都比治療前痰濕體質積分有下降,而治療組的積分的下降程度較對照組明顯,兩者比較后的差異,具有統(tǒng)計學意義(P0.05),表明治療組對于受試者的痰濕體質情況改善效果較對照組優(yōu)越。結論:對于功能性便秘的治療,兩組都有一定的療效,但治療組的總有效率、便秘的改善、體質的改善皆比對照組明顯優(yōu)越。運用溫針灸結合一般針刺的治療組從基礎上改善體質,對于基于痰濕體質便秘的治療及痰濕體質的調理效果皆優(yōu)于對照組。溫針灸來調理痰濕體質的綜合療法對于便秘及其他以痰濕體質為主的疾病亦有較為深刻的指導意義,應在臨床上給予高度重視,并進行全面推廣。
[Abstract]:Objective: with the rapid pace of life, people's mental and psychological burden, dietary structure changes, and social environmental factors can lead to constipation. Functional constipation is not only seen in the elderly and pregnant women, the disease has gradually become younger. Therefore, this topic through the random control method in the clinical sampling small sample study, the treatment group with Wenai combined with acupuncture to treat functional constipation of phlegm-dampness type, the control group simple acupuncture method, by comparing the clinical efficacy of the two treatment methods, Combined with the knowledge of physique to explore the better treatment plan for phlegm and damp type constipation, and to discuss its correlation from the aspect of physique. Methods: in this study, 62 subjects were selected according to the criteria of functional constipation and the phlegm and dampness constitution in TCM constitution classification table. They were randomly divided into two groups: treatment group and control group with 31 cases each. Pick points, the two groups are acupuncture (Tianshu, Dachang Yu, hand Sanli, branch ditch). The treatment group on the basis of the above acupuncture combined with warm acupuncture (Fenglong, Taibai, Peshu). Acupuncture and moxibustion were treated twice a week, one month as a course of treatment for 3 courses of treatment. After three courses of treatment, the changes of constipation symptoms and physique were observed before and after treatment. EXCEL was used to record and set up a database, and SPSS 24.0 statistical software was used to analyze the changes of constipation symptoms and physique. Results: in the treatment group, one patient who went to other places to study during the treatment period was excluded, while the control group excluded one patient who was pregnant during the treatment period and had to stop the experiment. The final completion of each 30 cases. In both groups, the effect of functional constipation was significant and the severity of constipation was improved. The total effective rate of the treatment group is about 900 and the total effective rate of the control group is about 800. After comparison between the two groups, there is a statistical difference (P0.05). After three courses of treatment, the two groups have decreased in terms of improving the degree of constipation compared with the score before treatment. But the treatment group score decline is more obvious, the difference between the two after the comparison, with statistical significance (P0.05), indicating that the treatment group of the overall efficacy is superior. In the improvement of phlegm-dampness constitution, the scores of phlegm and dampness in the treatment group were lower than those in the control group. There is statistical significance (P0.05), indicating that the treatment group for the phlegm dampness of the subjects to improve the physical condition of the effect is superior to the control group. Conclusion: the treatment of functional constipation is effective in both groups, but the total effective rate, constipation improvement and physique improvement in the treatment group are better than those in the control group. The treatment group with warm acupuncture combined with general acupuncture can improve the physique on the basis of phlegm and dampness constitution constipation and the regulating effect of phlegm dampness constitution is better than that of the control group. The comprehensive therapy of warming acupuncture and moxibustion to regulate phlegm and dampness constitution also has profound guiding significance for constipation and other diseases with phlegm and dampness constitution, which should be attached great importance to in clinic and be popularized in an all-round way.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.1

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