俞募配穴針刺治療腦卒中后陰虛火旺型失眠的臨床研究
發(fā)布時(shí)間：2018-10-10 12:11
【摘要】：目的：1.在常規(guī)治療基礎(chǔ)上,比較俞募配穴針刺與常規(guī)針刺治療腦卒中后陰虛火旺型失眠的臨床療效。2.觀察俞募配穴針刺對腦卒中后睡眠質(zhì)量及日常生活活動(dòng)能力的影響,初步探討其作用機(jī)理。方法：將70例符合腦卒中后陰虛火旺型失眠患者隨機(jī)分為試驗(yàn)組和對照組,每組35例。兩組均在治療基礎(chǔ)病、營養(yǎng)腦神經(jīng)、防治并發(fā)癥及營養(yǎng)支持等基礎(chǔ)治療上,對照組采用常規(guī)穴位：神門、內(nèi)關(guān)、百會(huì)、安眠、太溪、太沖、涌泉針刺治療；試驗(yàn)組采用俞募配穴：心俞配巨闕、腎俞配京門、肝俞配期門針刺治療。兩組均每日治療1次,連續(xù)治療6天為1個(gè)療程,1個(gè)療程結(jié)束后,休息1天,共治療2個(gè)療程。觀察兩組患者治療前后中醫(yī)證候總積分、匹茲堡睡眠質(zhì)量指數(shù)量表(PSQI)評分、睡眠狀況自評量表(SRSS)評分及Barthel指數(shù)(BI)評定量表評分,并比較兩組臨床療效。結(jié)果：1.一般資料治療前兩組患者在性別、年齡、病程、基礎(chǔ)疾病等一般資料比較方面差異無統(tǒng)計(jì)學(xué)意義(均P0.05),提示兩組患者基線資料比較基本一致,各影響因素分布均衡,具有可比性。2.中醫(yī)證候總積分治療后兩組患者中醫(yī)證候總積分均較治療前改善,前后差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05)：治療后組間比較,試驗(yàn)組改善更明顯,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。提示試驗(yàn)組在中醫(yī)證候總積分改善方面優(yōu)于對照組。3. PSQI評分治療后兩組患者PSQI評分均較治療前改善,前后差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05)；治療后組間比較,試驗(yàn)組改善更明顯,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。提示試驗(yàn)組在PSQI評分改善方面優(yōu)于對照組。4. SRSS評分治療后兩組患者SRSS評分均較治療前改善,前后差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05)；治療后組間比較,試驗(yàn)組改善更明顯,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。提示試驗(yàn)組在SRSS評分改善方面優(yōu)于對照組。5.BI評定量表評分治療后兩組患者BI評定量表評分均較治療前改善,前后差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05)；治療后組間比較,試驗(yàn)組改善更明顯,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。提示試驗(yàn)組在BI評定量表評分改善方面優(yōu)于對照組。6.療效評定治療后試驗(yàn)組臨床痊愈5例,顯效17例,有效10例,無效3例,總有效率為91.4%(32/35)；對照組臨床痊愈2例,顯效11例,有效16例,無效6例,總有效率為82.9%(29/35)；兩組臨床療效比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。提示試驗(yàn)組臨床療效優(yōu)于對照組。結(jié)論：1.俞募配穴針刺比常規(guī)針刺更能有效地改善腦卒中后陰虛火旺型失眠患者的臨床癥狀,其臨床療效優(yōu)于常規(guī)針刺。2.俞募配穴針刺能顯著提高腦卒中后睡眠質(zhì)量,對患者日常生活活動(dòng)能力的改善具有促進(jìn)作用,其作用機(jī)理可能是元神功能恢復(fù),臟腑陰陽平調(diào),臟神安藏守舍。
[Abstract]:Purpose 1. On the basis of routine treatment, the clinical curative effect of Shufu combined with acupoint acupuncture and conventional acupuncture in treating insomnia of Yin deficiency and fire flourishing type after stroke was compared. 2. Objective: to observe the effect of acupoint acupuncture on sleep quality and activity of daily living after stroke, and to explore its mechanism. Methods: 70 cases of insomnia were randomly divided into experimental group and control group with 35 cases in each group. Both groups were treated with basic diseases, neurotrophic nerves, prevention and treatment of complications and nutritional support. The control group was treated with routine acupoints: Shenmen, Neiguan, Baihui, Anmiens, Taixi, Taichong and Yongquan acupuncture. The experimental group was treated with acupoints Shu-Fu, Shenshu and Jingmen, and Ganshu, respectively. The two groups were treated once a day for 6 consecutive days as a course of treatment. After the end of one course of treatment, the two groups were given a rest for 1 day and a total of 2 courses of treatment. The total score of TCM syndromes, (PSQI) score of Pittsburgh Sleep quality Index, (SRSS) score of Sleep Self-Rating scale and (BI) rating scale of Barthel Index before and after treatment were observed in the two groups. The clinical efficacy of the two groups was compared. The result is 1: 1. There was no significant difference between the two groups in sex, age, course of disease, basic diseases and other general data before treatment (P0.05), indicating that the baseline data of the two groups were basically the same, and the distribution of the influencing factors was balanced. Comparable. 2. The total integral of TCM syndromes in the two groups was improved after treatment, and the difference was statistically significant before and after treatment (P0.05): after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the experimental group is superior to the control group in improving the total integral of TCM syndromes. PSQI scores after treatment of the two groups of patients PSQI scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of PSQI score in the trial group is better than that in the control group. 4. 4. SRSS scores after treatment of the two groups of patients SRSS scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of SRSS score in the trial group is better than that in the control group. The BI rating scale scores of the two groups after treatment are improved compared with those before and after treatment (P0.05), the difference between the two groups after treatment is significant (P0.05), the difference between the two groups after treatment is significant (P0.05). The improvement in the test group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of BI rating scale in the trial group is better than that in the control group. 6. 6%. In the experimental group, the total effective rate was 91.4% (32 / 35), and the total effective rate was 91.4% (32 / 35), while in the control group, there were 2 cases of clinical cure, 11 cases of remarkable effect, 16 cases of effective and 6 cases of ineffectiveness, the total effective rate was 82.9% (29 / 35). The difference between the two groups was statistically significant (P0.05). It suggested that the clinical effect of the test group was better than that of the control group. Conclusion 1. The clinical symptoms of insomnia patients with Yin deficiency and fire flourishing type after stroke were improved more effectively than that of routine acupuncture, and the clinical curative effect was better than that of routine acupuncture. 2. The acupuncture of Shu-Fu combined with acupoint can significantly improve the quality of sleep after stroke and promote the improvement of patients' activities of daily life. The mechanism may be the recovery of the function of the Yuan Shen, the regulation of the yin and yang of the viscera, and the regulation of the viscera and the yin and yang.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6
本文編號：2261719
[Abstract]:Purpose 1. On the basis of routine treatment, the clinical curative effect of Shufu combined with acupoint acupuncture and conventional acupuncture in treating insomnia of Yin deficiency and fire flourishing type after stroke was compared. 2. Objective: to observe the effect of acupoint acupuncture on sleep quality and activity of daily living after stroke, and to explore its mechanism. Methods: 70 cases of insomnia were randomly divided into experimental group and control group with 35 cases in each group. Both groups were treated with basic diseases, neurotrophic nerves, prevention and treatment of complications and nutritional support. The control group was treated with routine acupoints: Shenmen, Neiguan, Baihui, Anmiens, Taixi, Taichong and Yongquan acupuncture. The experimental group was treated with acupoints Shu-Fu, Shenshu and Jingmen, and Ganshu, respectively. The two groups were treated once a day for 6 consecutive days as a course of treatment. After the end of one course of treatment, the two groups were given a rest for 1 day and a total of 2 courses of treatment. The total score of TCM syndromes, (PSQI) score of Pittsburgh Sleep quality Index, (SRSS) score of Sleep Self-Rating scale and (BI) rating scale of Barthel Index before and after treatment were observed in the two groups. The clinical efficacy of the two groups was compared. The result is 1: 1. There was no significant difference between the two groups in sex, age, course of disease, basic diseases and other general data before treatment (P0.05), indicating that the baseline data of the two groups were basically the same, and the distribution of the influencing factors was balanced. Comparable. 2. The total integral of TCM syndromes in the two groups was improved after treatment, and the difference was statistically significant before and after treatment (P0.05): after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the experimental group is superior to the control group in improving the total integral of TCM syndromes. PSQI scores after treatment of the two groups of patients PSQI scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of PSQI score in the trial group is better than that in the control group. 4. 4. SRSS scores after treatment of the two groups of patients SRSS scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of SRSS score in the trial group is better than that in the control group. The BI rating scale scores of the two groups after treatment are improved compared with those before and after treatment (P0.05), the difference between the two groups after treatment is significant (P0.05), the difference between the two groups after treatment is significant (P0.05). The improvement in the test group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of BI rating scale in the trial group is better than that in the control group. 6. 6%. In the experimental group, the total effective rate was 91.4% (32 / 35), and the total effective rate was 91.4% (32 / 35), while in the control group, there were 2 cases of clinical cure, 11 cases of remarkable effect, 16 cases of effective and 6 cases of ineffectiveness, the total effective rate was 82.9% (29 / 35). The difference between the two groups was statistically significant (P0.05). It suggested that the clinical effect of the test group was better than that of the control group. Conclusion 1. The clinical symptoms of insomnia patients with Yin deficiency and fire flourishing type after stroke were improved more effectively than that of routine acupuncture, and the clinical curative effect was better than that of routine acupuncture. 2. The acupuncture of Shu-Fu combined with acupoint can significantly improve the quality of sleep after stroke and promote the improvement of patients' activities of daily life. The mechanism may be the recovery of the function of the Yuan Shen, the regulation of the yin and yang of the viscera, and the regulation of the viscera and the yin and yang.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6
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