【摘要】：背景：腎虛型腰痛是腰痛臨床上常見病之一,隨著社會(huì)的不斷發(fā)展,生活壓力的不斷增加,腎虛型腰痛的發(fā)病率也在不斷地增長(zhǎng)。中醫(yī)治療腎虛型腰痛多采用口服中藥、針灸推拿等方法,療效尚佳。艾灸也常用在腎虛型腰痛的中醫(yī)治療當(dāng)中,其中麥粒灸既有艾的溫補(bǔ)作用,具有溫補(bǔ)、通絡(luò)、散寒止痛之功,治療虛證的效果可。現(xiàn)代文獻(xiàn)表明麥粒灸有消炎鎮(zhèn)痛的作用。麥粒灸有刺激量大,定位準(zhǔn)確、操作簡(jiǎn)單等優(yōu)點(diǎn),便于臨床使用。目的：本課題采用麥粒灸治療腎虛型腰痛,對(duì)照組采用溫和灸治療,通過觀察麥粒灸治療腎虛型腰痛的臨床療效,為麥粒灸治療腎虛型腰痛提供臨床依據(jù)。方法：將符合納入標(biāo)準(zhǔn)的腎虛型腰痛患者共66例,采用隨機(jī)對(duì)照方法分至治療組和對(duì)照組,治療組33例,對(duì)照組33例,對(duì)照組予溫和灸治療,治療組予麥粒灸治療,研究周期為1個(gè)月,從視覺模擬VAS評(píng)分、JOA腰痛癥狀評(píng)分兩方面進(jìn)行治療前、治療后組內(nèi)和組間比較,評(píng)價(jià)兩組患者臨床療效差異。結(jié)果：1.治療前麥粒灸組和溫和灸組患者年齡、性別、病程、中醫(yī)證型、基線組間比較,無(wú)顯著性差異(P0.05)組間存在可比性。2.VAS視覺模擬評(píng)分比較：治療前與1個(gè)療程后、2個(gè)療程后兩組組內(nèi)前后比較,患者的VAS視覺模擬評(píng)分均減低,有顯著性差異(P0.05)。治療1個(gè)療程后麥粒灸組和溫和灸組組間比較,有顯著性差異(P0.05)。治療2個(gè)療程后麥粒灸組和溫和灸組組間比較,有顯著性差異(P0.05)。3.JOA腰痛癥狀評(píng)分：治療前與1個(gè)療程后、2個(gè)療程后兩組組內(nèi)前后比較,JOA腰痛癥狀評(píng)分均上升,有顯著性差異(P0.05)。治療1個(gè)療程后麥粒灸組和溫和灸組組間比較,無(wú)顯著性差異(P0.05)。治療2個(gè)療程后麥粒灸組和溫和灸組組間比較,有顯著性差異(P0.05)。4.總體療效比較：麥粒灸組治愈4例,顯效18例,有效9例,無(wú)效2例,總有效率93.93%。溫和灸組治愈2例,顯效13例,有效14例,無(wú)效4例,總有效率87.89%。兩組患者治療總有效率比較,麥粒灸組優(yōu)于溫和灸組(P0.05)。結(jié)論：麥粒灸和溫和灸對(duì)腎虛型腰痛均有療效,都能改善患者的腰痛癥狀、體征和肢體受限功能。2.麥粒灸治療腎虛型腰痛的效果對(duì)患者腰痛癥狀、體征等改善優(yōu)于溫和灸組。
[Abstract]:Background: low back pain of kidney deficiency type is one of the common diseases of low back pain. With the development of society and the increasing of life pressure, the incidence of low back pain of kidney deficiency type is also increasing. Chinese medicine treatment of kidney deficiency low back pain by oral Chinese medicine, acupuncture massage and other methods, the curative effect is good. Moxibustion is also commonly used in the treatment of kidney deficiency type of low back pain, in which wheat grain moxibustion not only has the effect of warming up, clearing the collaterals, dispersing cold and relieving pain, but also the effect of treating deficiency syndrome. Modern literature shows that grain moxibustion has anti-inflammatory and analgesic effect. Grain moxibustion has the advantages of large stimulation, accurate positioning, simple operation, and is convenient for clinical use. Objective: to treat kidney deficiency low back pain with grain moxibustion and mild moxibustion with mild moxibustion in control group, and to provide clinical basis for grain moxibustion treatment of kidney deficiency low back pain by observing the clinical effect of grain moxibustion on low back pain of kidney deficiency type. Methods: 66 patients with low back pain of kidney deficiency type were divided into treatment group (n = 33) and control group (n = 33), the control group (n = 33) were treated with mild moxibustion, the treatment group (n = 33) were treated with moxibustion, and the control group (n = 33) were treated with grain moxibustion. The study period was 1 month. The clinical efficacy of the two groups was compared before and after treatment with visual analog VAS score and JOA low back pain symptom score. Results: 1. Before treatment, there was no significant difference in age, sex, course of disease, TCM syndrome type and baseline group between the two groups (P0.05). Comparison of 2.VAS visual analogue score: before and after treatment, there was no significant difference between the two groups. After two courses of treatment, the VAS visual analogue scores of the two groups were significantly lower than those of the two groups (P0.05). After one course of treatment, there was a significant difference between grain moxibustion group and mild moxibustion group (P0.05). There was significant difference between grain moxibustion group and mild moxibustion group after 2 courses of treatment (P0.05). The score of 3.JOA low back pain symptom: before and after one course of treatment, after 2 courses of treatment, there was a significant difference between the two groups before and after treatment. JOA low back pain symptom scores were increased, there was significant difference (P0.05). There was no significant difference between grain moxibustion group and mild moxibustion group after one course of treatment (P0.05). There was significant difference between grain moxibustion group and mild moxibustion group after two courses of treatment (P0.05). Comparison of total curative effects: 4 cases were cured, 18 cases were markedly effective, 9 cases were effective, 2 cases were ineffective in the moxibustion group, the total effective rate was 93.93%. In mild moxibustion group, 2 cases were cured, 13 cases were markedly effective, 14 cases were effective and 4 cases were ineffective. The total effective rate was 87.89%. The total effective rate of the two groups was better than that of the mild moxibustion group (P0.05). Conclusion: both granulated moxibustion and mild moxibustion have curative effect on kidney deficiency low back pain, both of which can improve the symptoms, signs and limited function of limbs of patients with kidney deficiency. 2. The effect of granulated moxibustion on low back pain of kidney deficiency type was better than that of mild moxibustion group.
【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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