【摘要】：目的:本研究對(duì)傳統(tǒng)中藥奄包的操作方法進(jìn)行改良,將按摩手法運(yùn)用于傳統(tǒng)中藥奄包中,即按摩式中藥奄包法,探討其改善頸型頸椎病患者頸部疼痛、功能障礙、焦慮癥狀、抑郁癥狀及生活質(zhì)量方面的效果。從而促進(jìn)中藥奄包的臨床效應(yīng)學(xué)研究及中醫(yī)護(hù)理的發(fā)展,為臨床的推廣奠定實(shí)踐基礎(chǔ)。方法:本研究選取2016年7~12月在四川省某三甲綜合醫(yī)院中醫(yī)骨科就診并符合納入標(biāo)準(zhǔn)的患者62例為研究對(duì)象,采用隨機(jī)數(shù)字表法分為試驗(yàn)組和對(duì)照組各31例。兩組患者均按醫(yī)囑給予頸復(fù)康顆粒(每袋4g)口服,1次1袋,1日3次,分早、中、晚3次服用,7天為一個(gè)療程,共2個(gè)療程。在此基礎(chǔ)上,對(duì)照組實(shí)施傳統(tǒng)中藥奄包法,試驗(yàn)組實(shí)施按摩式中藥奄包法,兩組均每日1次,每次25分鐘,7天為1個(gè)療程,共2個(gè)療程。采用簡(jiǎn)明Mc Gill疼痛評(píng)分表(SF-MPQ)和頸椎功能障礙指數(shù)問卷表(NDI)在干預(yù)前后對(duì)患者頸部疼痛、功能障礙進(jìn)行評(píng)價(jià);采用焦慮自評(píng)量表(SAS)、抑郁自評(píng)量表(SDS)、SF-36健康調(diào)查表(SF-36)在干預(yù)前后對(duì)患者焦慮、抑郁情緒和生活質(zhì)量進(jìn)行評(píng)價(jià)。結(jié)果:共60例患者完成全部資料收集,其中對(duì)照組30例(脫落1例),試驗(yàn)組30例(剔除1例)。結(jié)果顯示:1.疼痛評(píng)價(jià)結(jié)果:干預(yù)后,試驗(yàn)組在Mc Gill中PRI(疼痛分級(jí)指數(shù))、VAS(視覺模擬定級(jí))、PPI(現(xiàn)有疼痛強(qiáng)度)得分均低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。提示按摩式中藥奄包法對(duì)頸型頸椎病疼痛的改善效果優(yōu)于傳統(tǒng)中藥奄包法。2.功能障礙評(píng)價(jià)結(jié)果:干預(yù)后,試驗(yàn)組頸椎功能指數(shù)(NDI)得分低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),提示按摩式中藥奄包法對(duì)頸型頸椎病功能障礙的改善效果優(yōu)于傳統(tǒng)中藥奄包法。3.焦慮、抑郁癥狀評(píng)價(jià)結(jié)果:干預(yù)后,試驗(yàn)組在焦慮自評(píng)量表(SAS)得分和抑郁自評(píng)量表(SDS)得分均低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),提示按摩式中藥奄包法對(duì)頸型頸椎病患者焦慮、抑郁癥狀的改善效果優(yōu)于傳統(tǒng)中藥奄包法。4.生活質(zhì)量評(píng)價(jià)結(jié)果:干預(yù)后,試驗(yàn)組生活質(zhì)量評(píng)價(jià)量表總分及(SF-36)8個(gè)維度得分均高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),提示按摩式中藥奄包法能有效提高頸型頸椎病患者的生活質(zhì)量,且效果優(yōu)于傳統(tǒng)中藥奄包法。結(jié)論:按摩式中藥奄包法可減輕頸型頸椎病患者頸部疼痛癥狀和功能障礙,緩解患者焦慮、抑郁癥狀,促進(jìn)頸型頸椎病患者生活質(zhì)量的提高,其效果均優(yōu)于傳統(tǒng)中藥奄包法。中藥奄包作為中藥外治法中常用的中醫(yī)護(hù)理操作技術(shù),將按摩手法運(yùn)用于中藥奄包操作,可提高頸型頸椎病的治療效果,值得在臨床實(shí)踐中進(jìn)一步應(yīng)用和推廣。
[Abstract]:Objective: to improve the operation method of traditional Chinese medicine election bag, and apply massage manipulation to traditional Chinese medicine election package, that is, massage traditional Chinese medicine election package method, to explore the improvement of cervical pain, dysfunction and anxiety in patients with cervical spondylosis. Effects of depression and quality of life. So as to promote the clinical effect of traditional Chinese medicine election bag and the development of traditional Chinese medicine nursing, lay a practical foundation for clinical promotion. Methods: from July to December 2016, 62 patients in the orthopedic department of traditional Chinese medicine (TCM) in a Sanjia General Hospital in Sichuan Province were selected as the study objects. The patients were randomly divided into two groups: the experimental group (n = 31) and the control group (n = 31). The patients in both groups were given Jingfukang granules (4 g / bag) orally, 1 bag, 3 times a day, 3 times early, 3 times late, 7 days as a course of treatment, 2 courses of treatment. On this basis, the traditional Chinese medicine election package was applied in the control group and the traditional Chinese medicine election package method was applied in the experimental group. The two groups received 25 minutes a day, 7 days as a course of treatment, and two courses of treatment. Simple Mc Gill pain scale (SF-MPQ) and cervical dysfunction index questionnaire (NDI) were used to evaluate cervical pain and dysfunction before and after intervention. The anxiety, depression and quality of life (QOL) of the patients were evaluated by (SDS), SF-36 Health questionnaire (SF-36) before and after intervention with the self rating anxiety scale (SAS),). Results: a total of 60 patients completed the data collection, including 30 cases in the control group (1 case off) and 30 cases in the experimental group (1 case removed). The results showed that: 1. Pain evaluation results: after intervention, the PRI (pain grading index), VAS (visual analogue), PPI (existing pain intensity) scores in the trial group were lower than those in the control group (P0.05). It is suggested that the effect of massage Chinese medicine on cervical spondylosis pain is better than that of traditional Chinese medicine. 2. Evaluation results of dysfunction: after intervention, the (NDI) score of cervical spine function index in the experimental group was lower than that in the control group, the difference was statistically significant (P0.05). It is suggested that the effect of massage method on cervical spondylosis is better than that of traditional Chinese medicine. Evaluation results of anxiety and depression symptoms: after intervention, the scores of (SAS) and (SDS) in the test group were lower than those in the control group, the difference was statistically significant (P0.05). It is suggested that the effect of massage traditional Chinese medicine on anxiety and depression of patients with cervical spondylosis is better than that of traditional Chinese medicine. 4. Quality of life evaluation results: after intervention, the total score and (SF-36) of the eight dimensions of the quality of life evaluation scale in the trial group were higher than those in the control group, the difference was statistically significant (P0.05). It is suggested that the traditional Chinese medicine can effectively improve the quality of life of patients with cervical spondylosis, and the effect is better than that of traditional Chinese medicine. Conclusion: traditional Chinese medicine can relieve cervical pain and dysfunction, relieve anxiety and depression, and promote the improvement of quality of life of patients with cervical spondylosis, and its effect is better than that of traditional Chinese medicine. The traditional Chinese medicine election bag is the traditional Chinese medicine nursing operation technique which is commonly used in the external treatment of traditional Chinese medicine. Applying massage technique to the traditional Chinese medicine election bag operation can improve the treatment effect of cervical spondylopathy. It is worthy of further application and popularization in clinical practice.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R248

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