【摘要】：目的：系統(tǒng)歸納現(xiàn)代醫(yī)學(xué)與傳統(tǒng)醫(yī)學(xué)對(duì)女性尿道綜合征的認(rèn)識(shí)、流行病學(xué)特征、發(fā)病機(jī)制、診斷及治療的研究概況。開(kāi)展臨床研究,觀察針刺治療女性尿道綜合征的次數(shù)與療效的關(guān)系。方法：本研究選取了于2013年9月-2016年1月期間在北京中醫(yī)藥大學(xué)東直門(mén)醫(yī)院針灸科門(mén)診就診的患者,參照《臨床診療指南》(人民衛(wèi)生出版社,2006-06)中《泌尿外科分冊(cè)》關(guān)于女性尿道綜合征的診斷標(biāo)準(zhǔn),結(jié)合本試驗(yàn)的納入、排除、脫落標(biāo)準(zhǔn),共收治女性尿道綜合征患者36例�；颊吣挲g在35-70歲之間,平均年齡為58.4歲。病程最長(zhǎng)15年,最短2個(gè)月,平均病程3.5年。36名患者均采用傳統(tǒng)體針療法進(jìn)行針刺治療,穴位選取八毼、腎俞、膀胱俞、中極大赫、氣海、關(guān)元、肓俞、神庭、大陵、三陰交、合谷、太沖。其中八毼、腎俞、膀胱俞行快針,得氣后起針。中極、大赫、氣海、關(guān)元、肓俞、神庭、大陵、三陰交、合谷、太沖,得氣后留針30min,配合局部紅光照射。隔天治療一次,每周治療三次。使用國(guó)際下尿路癥狀(LUTS)評(píng)分表,以問(wèn)卷調(diào)查形式,分別記錄患者治療前及治療3次、6次、9次、12次、15次后LUTS評(píng)分。采用SPSS21.0統(tǒng)計(jì)軟件對(duì)所得數(shù)據(jù)進(jìn)行分析處理,計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,統(tǒng)計(jì)量服從正態(tài)分布,采用配對(duì)t檢驗(yàn),不服從正態(tài)分布,采用非參數(shù)檢驗(yàn)。P0.05為差異有統(tǒng)計(jì)學(xué)意義,得出結(jié)論。結(jié)果：LUTS評(píng)分隨治療次數(shù)增加整體呈下降趨勢(shì),并且前12次治療,曲線下降趨勢(shì)明顯,第12次至第15次治療曲線下降趨勢(shì)趨于平緩。分別將治療3次與治療前,治療6次與3次,治療9次與6次,治療12次與9次的LUTS評(píng)分進(jìn)行比較,P0.05,差異有統(tǒng)計(jì)學(xué)意義,治療15次與治療12次比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義。治療3次后的尿頻癥狀評(píng)分與治療前比較,治療15次與治療12次比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義,比較治療6次與治療3次,治療9次與治療6次,治療12次與治療9次的尿頻癥狀評(píng)分,P0.05,差異有統(tǒng)計(jì)學(xué)意義。治療3次后的尿急癥狀評(píng)分與治療前比較,治療6次與治療3次比較,治療9次與治療6次比較,治療12次與治療9次比較,P0.05,差異有統(tǒng)計(jì)學(xué)意義,治療15次與治療12次比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義。治療3次后的尿無(wú)力癥狀評(píng)分與治療前比較,治療12次與9次比較,15次與12次比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義。治療6次、9次、12次、15次與治療前比較,P0.05,差異有統(tǒng)計(jì)學(xué)意義。分別比較治療6次與治療3次,治療9次與治療6次,P0.05,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論：針刺治療女性尿道綜合征有顯著臨床效果,自第1次至第12次治療療效隨治療次數(shù)增多有明顯增加。第12次治療后,隨治療次數(shù)增多,療效無(wú)明顯增加。故每療程以12次為宜。其中針刺對(duì)尿頻、尿急癥狀改善明顯,對(duì)尿無(wú)力癥狀改善不明顯。比較女性尿道綜合征的主要癥狀,針刺治療尿急癥狀起效最快,尿頻次之,尿無(wú)力癥狀起效最慢。
[Abstract]:Objective: to summarize the knowledge, epidemiological characteristics, pathogenesis, diagnosis and treatment of female urethral syndrome in modern and traditional medicine. The clinical study was carried out to observe the relationship between the times of acupuncture and the curative effect on female urethral syndrome. Methods: this study selected patients from September 2013 to January 2016 in the Department of Acupuncture and moxibustion of Dongzhimen Hospital, Beijing University of traditional Chinese Medicine. According to the Diagnostic criteria of female urethral Syndrome in the guidelines for Clinical diagnosis and treatment (people's Health Publishing House 2006-06), 36 cases of female urethral syndrome were treated according to the criteria of inclusion, exclusion and exfoliation of this test. The age of the patients ranged from 35 to 70 years old, with an average age of 58.4 years. The longest course of disease was 15 years, the shortest period was 2 months, and the mean course of disease was 3.5 years. All the 36 patients were treated with traditional body acupuncture therapy. The acupoints were selected as Bazhou, Shenshu, Biaoshu, Zhongdahe, Qihai, Guan Yuan, Baiyu, Shenting, Daling, Sanyinjiao, Hegu, too Chong. Eight of them, Shen Yu, bladder Yu fast needle, get Qi from the needle. Middle pole, Dahe, Qihai, Guan Yuan, Huangshu, Shenting, Daling, Sanyinjiao, Hegu, Taochong, after 30 minutes, with local red light irradiation. Treatment once every other day, three times a week. The international (LUTS) scale of lower urinary tract symptoms was used to record the LUTS scores before treatment and after 3 times, 9 times and 12 times and 15 times respectively by questionnaire. SPSS21.0 statistical software was used to analyze and process the data. The measured data were expressed as mean 鹵standard deviation (x 鹵s). The statistical data were normal distribution, paired t test, not normal distribution. The use of non-parametric test. P0.05 as the difference has statistical significance, draw a conclusion. Results with the increase of the number of treatments, the score of the first 12 times of treatment showed a downward trend, and the curve of the first 12 times decreased obviously, and the decreasing trend of the 12th to 15th times of treatment tended to be gentle. The LUTS scores of 3 times and before treatment, 6 times and 3 times, 9 times and 6 times, 12 times of treatment and 9 times of treatment were compared respectively (P 0.05), the difference was statistically significant. There was no significant difference between 15 times of treatment and 12 times of treatment (P 0.05). The urinary frequency symptom score after 3 times of treatment was significantly higher than that before treatment (P 0.05). There was no significant difference between 15 times of treatment and 12 times of treatment (P 0.05). There was no significant difference between treatment and treatment of 6 times and 3 times, 9 times of treatment and 6 times of treatment. The urinary frequency symptom scores of 12 times and 9 times of treatment were significantly different (P 0.05). The scores of urinary symptoms after 3 times of treatment were compared with those before treatment, 6 times of treatment and 3 times of treatment, 9 times of treatment and 6 times of treatment, and 12 times of treatment compared with 9 times of treatment (P 0.05). There was no significant difference between 15 times of treatment and 12 times of treatment (P 0.05). The urinary asthenia symptom score after 3 times of treatment was compared with that before treatment, and there was no significant difference between 12 times and 9 times compared with 15 times and 12 times compared with 12 times (P 0.05). There was a significant difference between 6 times, 9 times, 12 times, 15 times and before treatment (P 0.05). The difference was statistically significant between 6 times of treatment and 3 times of treatment, 9 times of treatment and 6 times of treatment (P 0.05). Conclusion: acupuncture has a significant clinical effect in the treatment of female urethral syndrome, and the curative effect increases with the increase of treatment times from the first time to the 12th time. After the 12 th treatment, the curative effect did not increase with the increase of treatment frequency. Therefore, 12 times per course of treatment is appropriate. Acupuncture can improve urination frequency and urinal symptoms obviously, but it can not improve urine asthenia symptoms. Compared with the main symptoms of female urethral syndrome, acupuncture treatment of urinal symptoms was the fastest, followed by frequent urination, and the slowest onset of urinary asthenia.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R246.9

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