【摘要】：目的：以《頸性眩暈癥狀與功能評(píng)估量表》為主要評(píng)估手段,通過對(duì)比通督調(diào)任法針刺與常規(guī)取穴法針刺治療頸性眩暈的臨床療效,研究通督調(diào)任法針刺治療頸性眩暈的臨床療效,擬為頸性眩暈提供更多有效的治療方案。方法：將60例符合該課題納入要求的頸性眩暈患者,采取隨機(jī)分組法分為治療組30例及對(duì)照組30例。實(shí)際完成課題實(shí)驗(yàn)共59例,對(duì)照組29例,治療組30例。治療組以通督調(diào)任法為指導(dǎo),通督取穴位風(fēng)府、腦戶、大椎、后溪(雙),調(diào)任取穴位氣海、中脘、列缺(雙),結(jié)合辨證取穴。對(duì)照組按常規(guī)取穴法取頸椎夾脊(C4-7)、天柱(雙)、風(fēng)池(雙)、百會(huì)、懸鐘(雙),辨證取穴同治療組。兩組皆留針0.5h,每隔lOmin以平補(bǔ)平瀉捻轉(zhuǎn)法運(yùn)針。每天治療1次,連續(xù)5天為一個(gè)療程,第一療程結(jié)束后休息2天開始第二個(gè)療程。共進(jìn)行兩個(gè)療程。采用《眩暈癥狀與功能評(píng)估量表》分別對(duì)治療前及第2療程結(jié)束時(shí)進(jìn)行評(píng)分,其結(jié)果運(yùn)SPSS 22.0軟件進(jìn)行分析比較。以驗(yàn)證通督調(diào)任法針刺治療本病的臨床療效。結(jié)果：對(duì)治療前兩組患者性別、年齡、病程、中醫(yī)證型及《眩暈癥狀與功能評(píng)估量表》評(píng)分進(jìn)行組間比較,經(jīng)統(tǒng)計(jì)學(xué)分析(P0.05),差異不具統(tǒng)計(jì)學(xué)意義,說明兩組病例具有可比較性。1.治療組治療前后比較：治療組實(shí)際完成病例數(shù)30例,治療前《眩暈癥狀與功能評(píng)估量表》評(píng)分20.5分的有11例,20.5-30分的7例,30分的有2例；治療后分別為2例、2例、26例。使用Ridit檢驗(yàn)對(duì)治療前后的評(píng)分進(jìn)行分析,治療后評(píng)分較治療前提高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),說明治療組治療后癥狀及生活心理情況較治療前有明顯改善。2.對(duì)照組治療前后比較：對(duì)照組實(shí)際完成病例數(shù)29例,治療前《眩暈癥狀與功能評(píng)估量表》評(píng)分20.5分的有9例,20.5-30分的13例,30分的有7例；治療后分別為1例、9例、19例。使用Ridit檢驗(yàn)對(duì)治療前后的評(píng)分進(jìn)行分析,治療后評(píng)分較治療前提高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),說明對(duì)照組治療后癥狀及生活心理情況較治療前有明顯改善。3.組間比較：治療組治療后《眩暈癥狀與功能評(píng)估量表》評(píng)分較治療前提高分,其中提高7分的有5例,提高7-14分的有9例,提高14分的有16例；對(duì)照組治療后《眩暈癥狀與功能評(píng)估量表》評(píng)分較治療前提高,其中提高7分的有8例,提高7-14分的有20例,提高14分的有1例；使用Ridit檢驗(yàn),治療組治療前后評(píng)分差值較對(duì)照組大,差值具有統(tǒng)計(jì)學(xué)意義(P＜0.05),說明治療組評(píng)分改善明顯優(yōu)于對(duì)照組。4.療效比較：治療2個(gè)療程后,治療組治愈6例,顯效11例,有效10例,無效3例；對(duì)照組治愈4例,顯效7例,有效12例,無效6例。經(jīng)Ridit檢驗(yàn)分析,兩組總有效率無明顯差異(P＞0.05)。結(jié)論：通督調(diào)任法針刺能改善頸性患者的眩暈情況及眩暈對(duì)其生活心理的影響,與常規(guī)取穴法相比,通督調(diào)任法針刺的臨床療效更為顯著。
[Abstract]:Objective: to evaluate the symptoms and function of cervical vertigo by comparing the clinical effect of acupuncture with Tongdu-Ren method and conventional acupoint acupuncture in the treatment of cervical vertigo. To study the clinical effect of acupuncture on cervical vertigo by transposition of Tongdu and to provide more effective treatment for cervical vertigo. Methods: 60 patients with cervical vertigo were randomly divided into treatment group (n = 30) and control group (n = 30). There were 59 cases in the experiment, 29 cases in the control group and 30 cases in the treatment group. The treatment group was guided by Tongdu transfer method, Tongdu took acupoints Fengfu, Naohu, Dazhui, Houxi (double), transferred to take points of air sea, Zhongwan, column deficiency (double), combined with syndrome differentiation. In the control group, the cervical spine (C4-7), Tianzhu (double), Fengchi (double), Baihui, Xuanzhong (double) were collected according to the routine method. In both groups, the needle was kept for 0.5 h, and the needle was transported with the method of flat nourishing and flattening and twirling every lOmin. Once a day, 5 consecutive days as a course of treatment, the first course of rest 2 days after the start of the second course. Two courses of treatment were performed. The vertigo symptom and function evaluation scale was used to evaluate the scores before treatment and at the end of the second course of treatment. The results were analyzed and compared with SPSS 22.0 software. In order to verify the Tongdu transfer method acupuncture treatment of the clinical efficacy of this disease. Results: sex, age, course of disease, TCM syndrome type and score of < vertigo symptom and function evaluation scale > were compared between the two groups before treatment. The difference was not statistically significant (P0.05). Indicating that the two groups of cases are comparable. 1. Comparison before and after treatment in the treatment group: 30 cases were actually completed in the treatment group. Before treatment, there were 11 cases with 20.5 score of vertigo symptom and function evaluation scale, 7 cases with 20.5-30 points and 2 cases with 30 points. After treatment, there were 2 cases, 2 cases and 26 cases respectively. Ridit test was used to analyze the scores before and after treatment, the scores after treatment were higher than before treatment, the difference was statistically significant (P0.05), indicating that the treatment group after treatment symptoms and life and psychological conditions were significantly improved compared with before treatment. 2. Comparison before and after treatment in the control group: 29 cases were actually completed in the control group. Before treatment, there were 9 cases with 20.5 score of vertigo symptom and function evaluation scale, 13 cases with 20.5-30 points and 7 cases with 30 points. After treatment, there were 1 case, 9 cases and 19 cases respectively. Ridit test was used to analyze the scores before and after treatment, the scores after treatment were higher than before treatment, the difference was statistically significant (P0.05), indicating that the symptoms and psychological status of the control group were significantly improved after treatment. 3. Comparison between groups: the score of "vertigo symptom and function evaluation scale" after treatment in the treatment group was higher than that before treatment. Among them, 5 cases increased 7 points, 9 cases improved 7-14 points, and 16 cases improved 14 points. The score of vertigo symptom and function evaluation scale after treatment in control group was higher than that before treatment. Among them, 8 cases increased 7 points, 20 cases improved 7-14 points, and 1 case increased 14 points. Using Ridit test, the difference of score before and after treatment in the treatment group was larger than that in the control group (P < 0. 05), which indicated that the improvement of the score in the treatment group was obviously better than that in the control group. Comparison of therapeutic effects: 6 cases were cured, 11 cases were effective, 10 cases were effective, 3 cases were ineffective in the treatment group, 4 cases were cured, 7 cases were remarkable effect, 12 cases were effective, and 6 cases were ineffective in the control group. There was no significant difference in the total effective rate between the two groups by Ridit test (P > 0. 05). Conclusion: acupuncture can improve the condition of vertigo and the influence of vertigo on the life psychology of cervical patients. Compared with the routine method of acupoint collection, the clinical effect of acupuncture by transposition of Tongdu and Ren is more obvious.
【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】：2016
【分類號(hào)】：R246.9

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