【摘要】：目的本課題旨在運用天竺灸結合針刺法治療神經(jīng)性耳鳴,并設常規(guī)針刺對照,探討其優(yōu)越性。方法根據(jù)隨機數(shù)字表將符合病例納入標準的72例患者隨機分為治療組(天竺灸結合針刺組)36例和對照組(常規(guī)針刺組)36例。兩組均按照《針灸治療學》辨證標準將其分為風邪外襲證、肝膽火盛證、痰火郁結證、腎精虧損證、脾胃虛弱證五型。治療組取主穴:聽會、顳后線、風市、腎關、外關、中渚,外耳道施天竺灸;對照組取主穴:聽宮、聽會、翳風、中渚、俠溪。兩組均按照《針灸治療學》配穴:風邪外襲者,加風池、外關、合谷;肝膽火盛者,加行間、丘墟、足臨泣;痰火郁結者,加豐隆、內庭;腎精虧損者,加太溪、關元;脾胃虛弱者,加氣海、足三里。兩組病例療程相同,每日1次,每周5次,周末休息,共治療6周。分別觀察治療中(3周)、治療結束后(6周)兩組患者的THI得分及純音聽閾測試結果變化,以THI得分作為療效觀察指標,對治療結果進行統(tǒng)計分析及療效評定。結果(1)兩組患者共72例,治療1療程(3周)時,治療組臨床痊愈1例,顯效12例,有效18例,無效5例,總有效率為86.11%;對照組治愈0例,顯效8例,好轉20例,無效8例,總有效率為77.78%。治療結束后(6周),治療組臨床痊愈3例,顯效21例,有效10例,無效2例,總有效率為94.44%;對照組治愈1例,顯效16例,好轉14例,無效5例,總有效率為86.1%。對兩組療效進行比較,治療3周后,差異不具有統(tǒng)計學意義(P0.05);治療6周后療效比較,差異具有統(tǒng)計學意義(P0.05)。(2)兩組治療中、治療結束時,THI癥狀量表評分,以及THI量表評分功能性、情緒性、災難性評分,純音聽閾測試結果與治療前比較,差異均有高度統(tǒng)計學意義(P0.01)。對兩組進行組間比較,兩組治療3周后差異不具有統(tǒng)計學意義(P0.05);治療6周后療效比較,差異具有統(tǒng)計學意義(P0.05)。結論(1)天竺灸結合針刺、常規(guī)針刺治療神經(jīng)性耳鳴均有療效,且天竺灸結合針刺組的總有效率優(yōu)于常規(guī)針刺組。(2)天竺灸結合針刺治療神經(jīng)性耳鳴,在改善THI量表情緒性、功能性評分方面優(yōu)于對照組,改善THI量表災難性評分方面兩組療效相當。
[Abstract]:Objective to use Tianzhu moxibustion combined with acupuncture in the treatment of neurotic tinnitus. Methods according to the random number table, 72 patients were randomly divided into treatment group (Tianzhu moxibustion combined with acupuncture group) and control group (routine acupuncture group). According to the standard of acupuncture and moxibustion therapy, the two groups were divided into five types: the syndrome of external attack of wind and evil, the syndrome of fire of liver and gallbladder, the syndrome of stagnation of phlegm and fire, the syndrome of deficiency of kidney and essence, and the syndrome of deficiency of spleen and stomach. In the treatment group, the main points: hearing, temporal line, Fengshi, Shenguan, Waiguan, Zhongzhu, external ear canal Shi Tianzhu moxibustion; in the control group, main points: hearing palace, hearing, Yifeng, Zhongzhu, Xiaxi. According to acupuncture and moxibustion therapy, the two groups were assigned points: those with wind evil attack, plus wind pond, Waiguan, Hegu; those with liver-gallbladder fire, add line, Qiu market, foot sobbing; those with phlegm and fire stagnation, Jia Feng long, chamber; those with deficiency of kidney essence, Jia Tai Xi, Guan Yuan; Weak spleen and stomach, aerated sea, Zusanli. The two groups had the same course of treatment, once a day, 5 times a week, rest at the weekend, and treated for 6 weeks. The changes of THI score and pure tone audiometry were observed during the treatment (3 weeks) and 6 weeks after the treatment. The THI score was taken as the therapeutic observation index and the treatment results were statistically analyzed and evaluated. Results (1) there were 72 patients in both groups. After one course of treatment (3 weeks), 1 case was cured, 12 cases were effective, 18 cases were effective, 5 cases were ineffective, and the total effective rate was 86.11% in the treatment group, while in the control group, 0 cases were cured, 8 cases were improved, 20 cases were improved, 8 cases were ineffective. The total effective rate was 77.78. In the treatment group, 3 cases were cured, 21 cases were effective, 10 cases were effective, 2 cases were ineffective, the total effective rate was 94.444.In the control group, 1 case was cured, 16 cases were markedly effective, 14 cases were improved, 5 cases were ineffective, and the total effective rate was 86.1%. After 3 weeks of treatment, the difference was not statistically significant (P0.05); after 6 weeks of treatment, the difference was statistically significant (P0.05). (2), and the scores of Thi symptom scale and THI scale were functional at the end of treatment. The scores of emotion, catastrophic score and pure tone audiometry were significantly different from those before treatment (P0.01). There was no significant difference between the two groups after 3 weeks of treatment (P0.05); after 6 weeks of treatment, the difference was statistically significant (P0.05). Conclusion (1) Tianzhu moxibustion combined with acupuncture and routine acupuncture are effective in the treatment of neurotic tinnitus, and the total effective rate of Tianzhu moxibustion combined with acupuncture group is better than that of routine acupuncture group. (2) Tianzhu moxibustion combined with acupuncture therapy can improve the emotional properties of THI scale. The functional score was better than that of the control group, and the efficacy of the two groups in improving the catastrophic score of THI scale was equal.
【學位授予單位】：云南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.81

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