【摘要】：研究目的本課題運(yùn)用隨機(jī)對照原則在臨床中抽取小樣本進(jìn)行觀察研究,最終評估陰虛質(zhì)痤瘡在調(diào)神針法結(jié)合針灸在臨床中的療效,對比治療組(調(diào)神針灸組)和對照組(普通針灸組)之間是否存在顯著差異性,尋找治療陰虛質(zhì)痤瘡的更好的治療方法。研究方法本課題將60例符合納入標(biāo)準(zhǔn)的陰虛體質(zhì)痤瘡患者隨機(jī)分成治療組(30例)和對照組(30例),治療分仰臥位和俯臥位兩個(gè)體位進(jìn)行。執(zhí)行方案(參考新世紀(jì)第二版全國高等中醫(yī)藥院校規(guī)劃教材《針灸治療學(xué)》)：1)治療組：顴毼、大椎、合谷、曲池、內(nèi)庭、百會(huì)、定神針(印堂、雙側(cè)陽白各上0.5寸)、內(nèi)關(guān)、神門、勞宮(溫針灸)、涌泉(溫針灸)、肺俞(溫灸)、膏肓(溫灸)、太溪、三陰交；2)對照組：顴毼、大椎、合谷、曲池、內(nèi)庭、勞宮(溫針灸)、涌泉(溫針灸)、肺俞(溫灸)、膏肓(溫灸)、太溪、三陰交；每周2次,4周為1個(gè)療程,總共2個(gè)療程。記錄患者治療前及治療后的痤瘡積分以及陰虛質(zhì)轉(zhuǎn)化分,采用SPSS 22.0對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,比較兩組之間的總體療效。研究結(jié)果1.60例受試者中,治療組剔除因治療期間懷孕而不得不終止試驗(yàn)的患者1例,最后完成29例；對照組完成30例。兩組病例在性別、年齡、病程、治療前痤瘡嚴(yán)重程度、治療前陰虛質(zhì)轉(zhuǎn)化分均無顯著差異(P0.05),兩組具有可比性。研究結(jié)果是治療組和對照組治療后痤瘡積分均有下降,具有統(tǒng)計(jì)意義(P＜0.05),說明兩種方法都能有效改善患者的痤瘡。治療組治療后治愈7例,顯效15例,有效6例,無效1例；對照組治療后治愈3例,顯效13例,有效9例,無效5例,經(jīng)秩和檢驗(yàn),Z=-2.136,P=0.033,P0.05,兩組療效具有顯著差異性,說明治療組治療效果優(yōu)于對照組。2.治療后兩組陰虛質(zhì)轉(zhuǎn)化分均有下降,說明體質(zhì)具有可調(diào)性,兩種方法對體質(zhì)調(diào)理都有一定效果。治療組陰虛質(zhì)轉(zhuǎn)化分治療前后差值"f10分的有17例,11-20分的有10例,21-30分有1例,30分有1例。對照組陰虛質(zhì)轉(zhuǎn)化分治療前后差值"f10分的有20例,11-20分的有9例,21-30分的有0例,30分的有1例,經(jīng)秩和檢驗(yàn),Z=-2.063,P=0.039,P0.05,兩組間具有顯著差異性,說明治療組體質(zhì)調(diào)理效果更好。但是體質(zhì)調(diào)理是一個(gè)漸進(jìn)緩慢的過程,筆者認(rèn)為本研究的研究時(shí)間較短,認(rèn)為該結(jié)果仍有待日后進(jìn)一步考究。研究結(jié)論從調(diào)神法在針灸調(diào)理陰虛質(zhì)痤瘡患者的臨床觀察中得出：相對于普通針灸組,運(yùn)用調(diào)神法在治療陰虛質(zhì)痤瘡方面更顯優(yōu)勢；2、針灸對陰虛體質(zhì)的改善有確切療效,且具有統(tǒng)計(jì)學(xué)差異,但筆者認(rèn)為調(diào)理體質(zhì)需要漫長的過程,而非1～2個(gè)月就能看見明顯效果的,本課題值得進(jìn)一步深入研究；3.本研究能有效改善陰虛質(zhì)痤瘡,而運(yùn)用調(diào)神法進(jìn)行針灸調(diào)理的效果更佳,值得在臨床上推廣。
[Abstract]:Objective to evaluate the curative effect of Yin-deficiency acne combined with acupuncture and moxibustion in clinic by using random control principle to select small samples in clinical observation and study, and finally to evaluate the therapeutic effect of Yin-deficiency acne in clinical practice. In order to find a better treatment method for Yin deficiency acne, we compared the difference between the treatment group and the control group (ordinary acupuncture group), and compared the difference between the treatment group and the control group whether there was a significant difference between the treatment group and the control group. Methods 60 patients with acne due to Yin deficiency were randomly divided into two groups: treatment group (30 cases) and control group (30 cases), which were divided into two positions: supine position and prone position. The patients were divided into two groups: treatment group (n = 30) and control group (n = 30). Implementation plan (reference to the second edition of the National College of traditional Chinese Medicine Planning textbook "Acupuncture Therapy"): 1) treatment group: zygomatic, Dazhui, Hegu, Quchi, atrium, Baihui, Shenshen Needle (Yin Tang), Each side Yangbai 0.5 inches above), Neiguan, Shenmen, Lao Gong (warm acupuncture), Yongquan (warm acupuncture), Feishu (warm moxibustion), Gaohuai (warm moxibustion), Taixi, Sanyinjiao; 2) Control group: zygomatic, Dazhui, Hegu, Quchi, atrium, Laogong (warm acupuncture), Yongquan (warm acupuncture), Feishu (warm moxibustion), Gaohuai (warm moxibustion), Taixi, Sanyinjiao; Two times a week, four weeks as a course of treatment, a total of 2 courses. The scores of acne before and after treatment and the scores of Yin-deficiency transformation were recorded. The data were analyzed statistically with SPSS 22. 0 to compare the overall curative effect between the two groups. Results 1. Among 60 subjects, the treatment group excluded one patient who had to terminate the trial because of pregnancy during treatment, and completed 29 cases in the treatment group and 30 cases in the control group. There was no significant difference between the two groups in sex, age, course of disease, severity of acne before treatment and the score of Yin deficiency quality transformation before treatment (P0.05), and the two groups were comparable. The results showed that the acne scores of the treatment group and the control group decreased significantly after treatment (P < 0.05), indicating that both methods could effectively improve the acne of the patients. In the treatment group, 7 cases were cured, 15 cases were markedly effective, 6 cases were effective and 1 case was ineffective. After treatment, 3 cases were cured, 13 cases were markedly effective, 9 cases were effective and 5 cases were ineffective in the control group. The results showed that the therapeutic effect of the treatment group was better than that of the control group. The results showed that the therapeutic effect of the treatment group was better than that of the control group. The results showed that the therapeutic effect of the treatment group was better than that of the control group. After treatment, the scores of quality transformation of Yin deficiency in both groups decreased, indicating that physique is adjustable, and both methods have certain effect on physique conditioning. In the treatment group, there were 17 cases with the difference of "f-10" before and after treatment, 10 cases with 11-20 points, 1 case with 21-30 points and 1 case with 30 points. In the control group, there were 20 cases with f10, 9 cases with 11-20 points, 0 cases with 21-30 points and 1 case with 30 points before and after treatment in the control group. By rank-sum test, Z, 2.063, P0. 039, P 0. 05, P < 0. 063, P < 0. 05, P < 0. 063. There was significant difference between the two groups, indicating that the treatment group had better physique conditioning effect. However, physique conditioning is a gradual and slow process. The author thinks that the study time is short, and the results need to be further studied in the future. Conclusion from the clinical observation of acupuncture and moxibustion on Yin-deficiency acne patients, we can draw a conclusion: compared with the ordinary acupuncture group, the treatment of Yin-deficiency acne by tonifying mind-regulating method is superior to that of normal acupuncture group; 2, acupuncture and moxibustion on the improvement of Yin deficiency physique has a definite curative effect, and there are statistical differences, but the author believes that the physical conditioning needs a long process, rather than one or two months to see the obvious effect, this topic is worth further in-depth study; 3. This study can effectively improve the Yin deficiency acne, and the effect of acupuncture and moxibustion conditioning by tonifying mind method is better, which is worth popularizing in clinical practice.
【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)】：R246.7

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