【摘要】：目的:推拿作為一種有效、簡(jiǎn)便的傳統(tǒng)療法,在臨床上被廣泛應(yīng)用于治療各種疾病,但關(guān)于推拿手法的研究則大多停留于對(duì)疾病療效的影響研究,而較少提及手法的基礎(chǔ)研究,如手法的操作時(shí)間、頻率、作用力等方面,從而缺乏較為系統(tǒng)的研究。一指禪推法作為推拿手法中較有代表性的手法之一,同樣也很少提到運(yùn)用手法時(shí)采取不同的刺激量(強(qiáng)度)對(duì)疾病的影響,如作用力這一因素,作用力的大小并沒(méi)有做出明確的界定,以至于無(wú)法確定作用力對(duì)一指禪推法的療效的影響大小。所以本次研究將從作用力著手,嘗試探究作用力對(duì)一指禪推法的療效影響,通過(guò)比較輕、重手法(自擬值域標(biāo)準(zhǔn))的一指禪推法分別對(duì)治療虛證便秘的療效差別,探討一指禪推法的補(bǔ)瀉作用,得到一組可靠、實(shí)用的有效作用力數(shù)據(jù),從而為一指禪推法,乃至其他推拿手法的標(biāo)準(zhǔn)化、量效化提供參考,為臨床治療所使用。方法:選用60例確診為虛證便秘的受試者,主要來(lái)自于本校一附院推拿門(mén)診、針灸門(mén)診。將收入的受試者按隨機(jī)分配分為兩組,每組30例,在同一組穴位上分別采用輕壓力、重壓力一指禪推法進(jìn)行治療,每個(gè)穴位操作2分鐘,兩天治療1次,一個(gè)星期治療3次,共計(jì)治療兩個(gè)星期。所得數(shù)據(jù)運(yùn)用Cleveland便秘評(píng)分系統(tǒng)(CCS)和便秘患者生存質(zhì)量量表(PAC-QOL)進(jìn)行評(píng)分。觀察治療前和治療后患者癥狀的改變情況,再將兩者療效進(jìn)行對(duì)比研究。選用腧穴如下:合谷(雙側(cè)),支溝(雙側(cè)),中脘,天樞(雙側(cè)),上巨虛(雙側(cè))。結(jié)果:經(jīng)過(guò)兩個(gè)星期治療后,將受試者治療前與治療后所得數(shù)據(jù)使用spss20.0統(tǒng)計(jì)學(xué)軟件進(jìn)行秩和檢驗(yàn)進(jìn)行統(tǒng)計(jì)分析。1、Cleveland便秘評(píng)分系統(tǒng)組內(nèi)比較:輕壓力組的治療前與治療后總分對(duì)比P0.01,提示本次研究具有統(tǒng)計(jì)學(xué)意義,說(shuō)明經(jīng)過(guò)治療后受試者癥狀得到明顯改善;重壓力組的治療前與治療后總分對(duì)比P0.05,無(wú)統(tǒng)計(jì)學(xué)差異;組間比較:兩組治療前后差值對(duì)比P0.01,說(shuō)明本次研究?jī)山M治療效果有明顯差異。2、便秘患者生存質(zhì)量量表組內(nèi)比較:輕壓力組的治療前與治療后總分對(duì)比P0.01,提示本次研究具有統(tǒng)計(jì)學(xué)意義,說(shuō)明受試者的生活質(zhì)量經(jīng)治療后得到明顯的提升;重壓力組的治療前與治療后總分對(duì)比P0.05,無(wú)統(tǒng)計(jì)學(xué)差異;組間比較:兩組治療前后差值對(duì)比P0.01,說(shuō)明本次研究?jī)山M治療效果有明顯差異。結(jié)論:通過(guò)臨床試驗(yàn)對(duì)比,輕壓力值一指禪推法治療虛證便秘具有良好的療效,能改善患者的各項(xiàng)癥狀及提升患者的生活質(zhì)量;而重壓力值一指禪推法治療虛證便秘?zé)o明顯的療效,且有加重病情的可能。
[Abstract]:Objective: as an effective and simple traditional therapy, massage is widely used in clinical treatment of various diseases, but the study of massage manipulation is mostly focused on the effect of disease, and less mention of the basic study of manipulation. Such as manipulation time, frequency, force and so on, so lack of systematic research. As one of the more representative methods of massage, one of the most representative methods of massage is the influence of different stimuli (intensity) on diseases, such as force. The size of the action force is not clearly defined, so it is impossible to determine the effect of the action force on the curative effect of a Zen push method. Therefore, this study will try to explore the effect of the action force on the curative effect of a phalanwhere pushing method from the point of view of force, and the difference of curative effect of the one Zen push method in treating asthenia syndrome constipation by comparing the light and heavy manipulation (self-designed range standard). In order to provide reference for the standardization and quantification of massage manipulation, a group of reliable and practical effective force data were obtained by discussing the reinforcing and reducing effect of the method of one finger meditation and pushing, thus providing a reference for clinical treatment. Methods: 60 subjects diagnosed as deficiency constipation were selected, mainly from the clinic of massage and acupuncture. The subjects were randomly divided into two groups, 30 cases in each group, treated with light pressure, heavy pressure and finger meditation on the same acupoints. Each acupoint was operated for 2 minutes, treated once twice a day, 3 times a week. A total of two weeks of treatment. The data were evaluated by Cleveland constipation scoring system (CCS) and constipation quality of life scale (PAC-QOL). The changes of symptoms before and after treatment were observed and compared with each other. The selected acupoints are as follows: Hegu (bilateral), Zhigou (bilateral), Zhongwan, Tianshu (bilateral), Shangjuxu (bilateral). Results: after two weeks of treatment, the data before and after treatment were analyzed by rank sum test using spss20.0 software. Comparison of Cleveland constipation score system: the total score of mild stress group before and after treatment compared with P0.01, suggesting that this study has statistical significance, indicating that after treatment, the symptoms of the subjects were significantly improved; There was no significant difference in the total score between the two groups before and after treatment (P 0.05). Comparison between the two groups: the difference between the two groups before and after treatment P0.01, indicating that the treatment effect of the two groups is significantly different. 2, constipation patients quality of life scale group comparison: light pressure group before and after treatment of the total score compared to P0.01, The results suggested that the quality of life of the subjects was significantly improved after treatment. There was no significant difference in the total score between the two groups before and after treatment (P0.05). Comparison between the two groups: the difference between the two groups before and after treatment P0.01, indicating that there is a significant difference between the two groups. Conclusion: compared with the clinical trial, the method of light pressure value and finger meditation is effective in treating asthenia syndrome constipation, which can improve the symptoms of the patients and improve the quality of life of the patients. However, the treatment of asthenia constipation with one finger-Zen method has no obvious effect, and it is possible to aggravate the condition.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R244.1
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本文編號(hào)：2317169