發(fā)布時(shí)間：2018-09-14 13:32

【摘要】：研究背景:盆腔炎性疾病后遺癥慢性盆腔痛,是多種盆腔炎性疾病反復(fù)發(fā)作遷延而成,病程長難以治愈且容易誘發(fā),給患者身心生活工作帶來嚴(yán)重困擾�？股刂委熉耘枨煌葱Ч焕硐�,但對盆腔炎急性期發(fā)作效果尚好。其多為對癥治療,治療措施一般是物理治療、抗菌藥物和其他藥物治療,必要時(shí)手術(shù)。研究目的:通過觀察針刺取穴治療慢性盆腔痛的臨床效果,對比出穴位的治療特性,期望指導(dǎo)臨床醫(yī)生對慢性盆腔痛患者的健康指導(dǎo)及針刺治療,以減輕疼痛對患者產(chǎn)生的影響。研究方法:本研究中對象均來源于黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院婦科門診及住院部,診斷為盆腔炎性疾病后遺癥慢性盆腔痛(氣滯血瘀型)患者45例(5例要求退出,5例脫落,3例證型錯(cuò)誤,2例病例記錄不全),最后觀察30例患者。收集相關(guān)材料,對患者一般情況、治療前后中醫(yī)證候、局部體征積分及檢查情況等進(jìn)行記錄,運(yùn)用統(tǒng)計(jì)分析軟件分析治療前后的評分情況,間接評價(jià)臨床效果及其實(shí)用性。結(jié)果:1、治療后患者在中醫(yī)證候、局部體征等方面均有所改善,通過比較,治療后積分低于治療前,治療后明顯優(yōu)于治療前,具有顯著差異(P0.05)。2、治療后患者痊愈率為16.67%,顯效率為43.33%,有效率為26.67%,無效率為13.33%,總有效率為86.67%。結(jié)論:盆腔炎性疾病后遺癥慢性盆腔痛具有復(fù)發(fā)率高、治愈率低、病程較長、纏綿難愈等特點(diǎn),是育齡期婦女常見病,嚴(yán)重影響患者的身心健康。西醫(yī)常用抗生素治療,抗菌藥物局部難吸收,療效不佳,長期使用易造成腸道菌群失調(diào)及耐藥性,故目前尚無特效治療措施。而中醫(yī)藥特色治療慢性盆腔痛目前應(yīng)用比較廣泛,患者樂于接受,減少了抗生素的副作用,同時(shí)也調(diào)理身體,治療起來比較方便效果明顯。本研究采用臨床組內(nèi)治療前后對照試驗(yàn),采用中醫(yī)證候評分表及體征評分表進(jìn)行評估,以及血液流變學(xué)變化的檢測和監(jiān)測等結(jié)果,觀察慢性盆腔痛的針刺療法,為其在臨床中的實(shí)用性提供廣泛依據(jù)。針刺治療前后的中醫(yī)癥狀及體征及綜合積分,經(jīng)秩和檢驗(yàn)說明治療前后癥狀、體征有顯著差異,具有統(tǒng)計(jì)學(xué)意義。
[Abstract]:Background: the sequelae of pelvic inflammatory diseases, chronic pelvic pain, is caused by repeated attacks of many pelvic inflammatory diseases, the long course of disease is difficult to cure and easy to induce, which brings serious problems to the patients' physical and mental life and work. Antibiotic treatment of chronic pelvic pain effect is not ideal, but the acute stage of pelvic inflammatory attack effect is still good. Most of them are symptomatic therapy. The treatment measures are physical therapy, antimicrobial drugs and other drugs, and surgery if necessary. Objective: to observe the clinical effect of acupuncture in the treatment of chronic pelvic pain, compare the therapeutic characteristics of acupoints, and expect to guide the clinicians to give health guidance and acupuncture treatment to patients with chronic pelvic pain. In order to alleviate the effect of pain on patients. Methods: the subjects of this study were all from gynecological outpatient department and inpatient department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. There were 45 cases of chronic pelvic pain (Qi stagnation and blood stasis type) diagnosed as sequelae of pelvic inflammatory disease (5 cases asked to quit 5 cases of exfoliation and 3 cases of example error 2 cases of incomplete record), and 30 cases were observed at last. To collect relevant materials, to record the general situation of patients, TCM syndromes, local physical signs and examination before and after treatment, and to use statistical analysis software to analyze the scores before and after treatment, and to evaluate the clinical effect and practicability indirectly. Results: after treatment, the patients improved in TCM syndromes, local signs and so on. By comparison, the score after treatment was lower than that before treatment, and after treatment it was obviously better than before treatment. There was significant difference (P0.05) .2The cure rate of the patients after treatment was 16.677.The effective rate was 43.33. the effective rate was 26.67. the ineffective rate was 13.33.The total effective rate was 86.67. Conclusion: chronic pelvic pain has the characteristics of high recurrence rate, low cure rate, long course of disease and difficult to heal. It is a common disease in women of childbearing age and seriously affects the physical and mental health of patients. Antibiotics are commonly used in western medicine, which are difficult to absorb locally and have poor curative effect. It is easy to cause intestinal flora imbalance and drug resistance in long term use, so there are no special treatment measures at present. The traditional Chinese medicine characteristic treatment of chronic pelvic pain is widely used, patients are willing to accept, reduce the side effects of antibiotics, but also conditioning the body, treatment is more convenient effect. In this study, the clinical control test before and after treatment, the evaluation of TCM syndrome score table and sign score table, and the results of hemorheological changes were used to observe the acupuncture therapy of chronic pelvic pain. To provide a broad basis for its clinical practicability. Before and after acupuncture treatment, the symptoms and signs of traditional Chinese medicine and their integrative scores were significantly different before and after treatment by rank sum test, and there were significant differences in the symptoms and signs before and after treatment, which had statistical significance.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.3

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