平衡針結(jié)合傳統(tǒng)針刺治療肩周炎的臨床研究
發(fā)布時間：2019-04-27 00:07
【摘要】：目的:本研究旨在觀察平衡針結(jié)合傳統(tǒng)針刺治療肩周炎的療效,經(jīng)過采用隨機對照方法,與傳統(tǒng)針刺相對照,以探求治療肩周炎有效的治療方案。方法:回顧總結(jié)近年來肩周炎的定義、中醫(yī)病名、中醫(yī)病因病機、流行病學、現(xiàn)代醫(yī)學發(fā)病機理及臨床臨床常見治療方法等理論研究成果,以確立本觀察方案。本研究包含的研究對象是廣中醫(yī)一附屬針灸科的病人,共收治符合本研究方案納入標準的肩周炎患者60例,隨機分為對照組30例、治療組30例。其中,治療組患者為暴露患側(cè)肩部,選取坐位、側(cè)臥位。穴位常規(guī)消毒后,將針刺入穴位,做捻轉(zhuǎn)提插瀉法運針,以患側(cè)肩關節(jié)局部有較強酸脹感為度,之后主穴(肩前穴-肩貞穴,肩髁穴-肩毼穴)接G6805電針儀(上海制造),采用疏密波,刺激量以患者能耐受為度,余穴留針,每次30分鐘。出針后,患者取坐位,暴露患肩對側(cè)小腿,取肩痛穴,常規(guī)消毒后,采用華佗牌30號1.5寸針灸針快速刺入穴位,行快速地捻轉(zhuǎn)提插運針,同時囑患者盡可能做最大范圍肩部環(huán)旋動作,當足面、足趾或腓淺神經(jīng)出現(xiàn)觸電樣針感時,快速出針不留針。每周治療五次,每日一次(周一至周五),兩周為一療程,共治療一個療程。治療組亦選取上述肩部穴位,并采用相同的操作方法,然出針后取患肩對側(cè)條口穴,常規(guī)消毒后,采用華佗牌30號1.5寸針灸針快速刺入穴位,使針尖向承山穴方向透刺,每周治療五次,每日一次(周一至周五),兩周為一療程,共治療一個療程。治療前后,比較治療組和對照組患者的疼痛視覺模擬(VAS)評分表和肩關節(jié)活動度(Melle評分),以判定治療效果,比較二者間的差異。結(jié)果:1.經(jīng)查閱相關文獻后,對肩周炎的病因、發(fā)病機制、癥狀、體征及治療方法有了較深入和較全面的認識。2.治療組30例,其中女性17例,男性13例,平均年齡為56.50±12.54歲,年齡范圍為23-77歲;對照組30例,其中女性17例,男性13例,平均年齡為56.13±13.02,年齡范圍為22-75歲。兩組患者的病程均在6月內(nèi)。經(jīng)檢驗兩組病例在年齡、性別、病程方面均無顯著性差異,具有可比性。3.經(jīng)t檢驗治療組與對照組在治療前疼痛視覺模擬(VAS)評分和肩關節(jié)活動度(Melle評分)亦均無顯著性差異,具有可比性。4.治療后對兩組VAS評分進行比較,治療組治療前VAS評分為7.07±1.02,治療后VAS評分為3.87± 1.04;對照組治療前VAS評分為6.27±0.98,對照組治療后VAS評分為3.90±0.80,兩組治療后VAS評分與治療前VAS評分比較均有明顯差異(p0.05);比較治療后兩組間VAS評分,差異顯著�？芍�:治療組與對照組都能降低VAS評分,并且前者降低VAS評分方面明顯優(yōu)于后者。5.治療后對兩組Melle評分進行比較,治療組治療前Melle評分為10.40±1.25,治療后Melle評分為3.67± 1.37;對照組治療前Melle評分為10.20± 1.61,對照組治療后Melle評分為6.80±2.63,兩組治療后Melle評分與治療前比較均有明顯差異(P0.05)。比較治療后兩組間Melle評分,有明顯差異。可知:治療組與對照組都能降低Melle評分,并且前者降低Melle評分方面明顯優(yōu)于后者。6.比較治療組與對照組療效,治療組未愈3例,有效7例,顯效13例,治愈7例,總有效率90.00%;對照組未愈10例,有效8例,治愈3例,顯效9例,總有效率63.33%。經(jīng)Ridit分析,P=0.020.05,差異性顯著�？芍�,治療組療效明顯優(yōu)于對照組。結(jié)論:平衡針結(jié)合傳統(tǒng)針刺對肩周炎的治療療效好,能緩解肩關節(jié)疼痛,改善肩關節(jié)活動受限情況,從而保障肩周炎患者的生活質(zhì)量。
[Abstract]:Objective: The purpose of this study is to observe the curative effect of balance needle combined with traditional acupuncture on the treatment of scapulohumeral periarthritis. Methods: The definition of scapulohumeral periarthritis in recent years, the name of traditional Chinese medicine, the etiology and pathogenesis of TCM, the epidemiology, the mechanism of the pathogenesis of modern medicine and the common treatment methods of clinical practice were reviewed in order to establish the observation plan. The study included a total of 60 cases of scapulohumeral periarthritis, which were included in the study protocol, and were randomly divided into control group (n = 30) and treatment group (30 cases). In the treatment group, the patient was exposed to the shoulder of the affected side, and the sitting position and the lateral position were selected. After the conventional disinfection of the acupuncture points, the acupuncture points are inserted, and then the needle is inserted into the acupuncture point, so that the shoulder joint of the affected side is locally provided with a strong strong acid expansion feeling, and then the main point (the shoulder-shoulder-shoulder, the shoulder-shoulder and the shoulder-shoulder point) is connected with a G6805 electro-acupuncture instrument (Shanghai manufacturing), and the sparse-dense wave is adopted, The amount of stimulation can be tolerated by the patient, and the remaining points are retained for 30 minutes each time. After the needle is out, the patient takes the sitting position, exposes the opposite leg of the affected shoulder, and takes the shoulder and pain points; after the conventional disinfection, the acupuncture needle with the size of 1.5 inches of the Chinese medicine card is used to rapidly penetrate the acupuncture points, When an electric shock-like needle is present in the toe or the superficial peroneal nerve, the needle is quickly released without leaving the needle. Treatment five times a week, once a day (from Monday to Friday), two weeks for a course of treatment, and a course of treatment. The treatment group also selects the above-mentioned shoulder points, and adopts the same operation method, and then, after the needle is taken out of the needle, the opposite side strip of the shoulder is taken out, and after the conventional disinfection, the acupuncture needle with the size of the Chinese medicine 30 is used to rapidly penetrate the acupuncture points, so that the needle point is penetrated in the direction of the bearing hill, and the acupuncture points are treated five times per week, One course per day (Monday to Friday) and two weeks for a course of treatment. The pain visual simulation (VAS) and the shoulder motion (Melle score) were compared between the treatment group and the control group before and after treatment to determine the treatment effect and to compare the difference between them. Results:1. After consulting the relevant literature, the causes, the pathogenesis, the symptoms, the signs and the treatment methods of the scapulohumeral periarthritis have been deeply and comprehensively recognized. The average age of the treatment group was 56.50 and 12.54 years. The age range was 23-77 years. The average age of the control group was 56.13-13.02, and the age ranged from 22 to 75 years. The course of the two groups was within 6 months. There was no significant difference in age, sex and course of the two groups. The pre-treatment pain visual (VAS) score and the shoulder motion (Melle score) were not significantly different between the treatment group and the control group by the t-test and control group, and were comparable. The VAS scores were 7.07 and 1.02 in the treatment group and 3.87 to 1.04 after the treatment, and the VAS score was 6.27 to 0.98 in the control group and 3.90 to 0.80 for the control group after the treatment. The VAS scores in the two groups were significantly different from the pre-treatment VAS scores (p0.05), and the difference was significant between the two groups after the treatment. It can be seen that both the treatment group and the control group can reduce the VAS score, and the former decreases the VAS score better than the latter. In the treatment group, the Melle score was 10.40-1.25, the Melle score was 3.67-1.37 after the treatment, and the Melle score was 10.20-1.61 in the control group and 6.80-2.63 in the control group. There was a significant difference between the post-treatment Melle score and the pre-treatment (P0.05). There was a significant difference in the Melle scores between the two groups after the treatment. It can be seen that the Melle score can be reduced in both the treatment group and the control group, and the former is superior to the latter in the reduction of the Melle score. The curative effect of the treatment group and the control group was compared. In the treatment group,3 cases were not recovered,7 cases were effective,13 cases were effective,7 cases were cured, the total effective rate was 90.00%,10 cases in the control group,8 cases were effective,3 cases were cured,9 cases were effective, and the total effective rate was 63.33%. After the analysis of Ridit, P = 0.020.05, the difference was significant. It was found that the curative effect of the treatment group was better than that of the control group. Conclusion: The balance needle combined with the traditional acupuncture has good curative effect on the scapulohumeral periarthritis, can relieve the pain of the shoulder joint, improve the limited condition of the shoulder joint, and thus guarantee the quality of life of the patients with scapulohumeral periarthritis.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.9
本文編號：2466512
[Abstract]:Objective: The purpose of this study is to observe the curative effect of balance needle combined with traditional acupuncture on the treatment of scapulohumeral periarthritis. Methods: The definition of scapulohumeral periarthritis in recent years, the name of traditional Chinese medicine, the etiology and pathogenesis of TCM, the epidemiology, the mechanism of the pathogenesis of modern medicine and the common treatment methods of clinical practice were reviewed in order to establish the observation plan. The study included a total of 60 cases of scapulohumeral periarthritis, which were included in the study protocol, and were randomly divided into control group (n = 30) and treatment group (30 cases). In the treatment group, the patient was exposed to the shoulder of the affected side, and the sitting position and the lateral position were selected. After the conventional disinfection of the acupuncture points, the acupuncture points are inserted, and then the needle is inserted into the acupuncture point, so that the shoulder joint of the affected side is locally provided with a strong strong acid expansion feeling, and then the main point (the shoulder-shoulder-shoulder, the shoulder-shoulder and the shoulder-shoulder point) is connected with a G6805 electro-acupuncture instrument (Shanghai manufacturing), and the sparse-dense wave is adopted, The amount of stimulation can be tolerated by the patient, and the remaining points are retained for 30 minutes each time. After the needle is out, the patient takes the sitting position, exposes the opposite leg of the affected shoulder, and takes the shoulder and pain points; after the conventional disinfection, the acupuncture needle with the size of 1.5 inches of the Chinese medicine card is used to rapidly penetrate the acupuncture points, When an electric shock-like needle is present in the toe or the superficial peroneal nerve, the needle is quickly released without leaving the needle. Treatment five times a week, once a day (from Monday to Friday), two weeks for a course of treatment, and a course of treatment. The treatment group also selects the above-mentioned shoulder points, and adopts the same operation method, and then, after the needle is taken out of the needle, the opposite side strip of the shoulder is taken out, and after the conventional disinfection, the acupuncture needle with the size of the Chinese medicine 30 is used to rapidly penetrate the acupuncture points, so that the needle point is penetrated in the direction of the bearing hill, and the acupuncture points are treated five times per week, One course per day (Monday to Friday) and two weeks for a course of treatment. The pain visual simulation (VAS) and the shoulder motion (Melle score) were compared between the treatment group and the control group before and after treatment to determine the treatment effect and to compare the difference between them. Results:1. After consulting the relevant literature, the causes, the pathogenesis, the symptoms, the signs and the treatment methods of the scapulohumeral periarthritis have been deeply and comprehensively recognized. The average age of the treatment group was 56.50 and 12.54 years. The age range was 23-77 years. The average age of the control group was 56.13-13.02, and the age ranged from 22 to 75 years. The course of the two groups was within 6 months. There was no significant difference in age, sex and course of the two groups. The pre-treatment pain visual (VAS) score and the shoulder motion (Melle score) were not significantly different between the treatment group and the control group by the t-test and control group, and were comparable. The VAS scores were 7.07 and 1.02 in the treatment group and 3.87 to 1.04 after the treatment, and the VAS score was 6.27 to 0.98 in the control group and 3.90 to 0.80 for the control group after the treatment. The VAS scores in the two groups were significantly different from the pre-treatment VAS scores (p0.05), and the difference was significant between the two groups after the treatment. It can be seen that both the treatment group and the control group can reduce the VAS score, and the former decreases the VAS score better than the latter. In the treatment group, the Melle score was 10.40-1.25, the Melle score was 3.67-1.37 after the treatment, and the Melle score was 10.20-1.61 in the control group and 6.80-2.63 in the control group. There was a significant difference between the post-treatment Melle score and the pre-treatment (P0.05). There was a significant difference in the Melle scores between the two groups after the treatment. It can be seen that the Melle score can be reduced in both the treatment group and the control group, and the former is superior to the latter in the reduction of the Melle score. The curative effect of the treatment group and the control group was compared. In the treatment group,3 cases were not recovered,7 cases were effective,13 cases were effective,7 cases were cured, the total effective rate was 90.00%,10 cases in the control group,8 cases were effective,3 cases were cured,9 cases were effective, and the total effective rate was 63.33%. After the analysis of Ridit, P = 0.020.05, the difference was significant. It was found that the curative effect of the treatment group was better than that of the control group. Conclusion: The balance needle combined with the traditional acupuncture has good curative effect on the scapulohumeral periarthritis, can relieve the pain of the shoulder joint, improve the limited condition of the shoulder joint, and thus guarantee the quality of life of the patients with scapulohumeral periarthritis.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.9
【參考文獻】
相關期刊論文 前10條
1 楊健;廖仲波;周銳鈞;周光輝;;體外沖擊波治療肩周炎患者疼痛的效果觀察[J];中外醫(yī)學研究;2017年02期
2 盛超;王蜜;鞏尊科;;浮針刀結(jié)合手法松解治療肩周炎的臨床觀察[J];中醫(yī)藥導報;2016年24期
3 孫華堂;萬歡;張錄杰;何曉慧;;減壓放血針加電針治療急性期肩周炎臨床療效觀察[J];中國針灸;2016年09期
4 劉婷;肖锎;劉建武;;火針痛點治療肩周炎30例臨床觀察[J];中醫(yī)雜志;2016年17期
5 劉軍;;火針配合關節(jié)松動術(shù)治療肩周炎療效觀察[J];中醫(yī)臨床研究;2015年15期
6 王勇堅;;小針刀聯(lián)合大秦艽湯治療肩周炎臨床療效分析[J];中國中藥雜志;2013年23期
7 陽煦;安嘉懿;孔建;李志平;唐萬欽;;黃芪桂枝五物湯聯(lián)合按摩手法治療肩周炎80例[J];陜西中醫(yī);2013年09期
8 李成剛;周麗;沈霖;楊艷萍;徐曉娟;;關節(jié)腔內(nèi)注射玻璃酸鈉加小針刀治療肩周炎臨床療效觀察[J];中國中醫(yī)骨傷科雜志;2013年06期
9 楊周平;馬建平;張繼芳;;葛根湯加味配合電針療法治療肩周炎60例[J];實用中醫(yī)內(nèi)科雜志;2013年01期
10 陳振虎;;溫針灸治療肩周炎42例[J];實用中醫(yī)藥雜志;2012年04期
相關博士學位論文 前1條
1 林裕杰;毫火針針刺結(jié)筋病灶點治療肩周炎療效觀察[D];廣州中醫(yī)藥大學;2016年
，本文編號：2466512
本文鏈接：http://sikaile.net/zhongyixuelunwen/2466512.html
最近更新
教材專著
