針刺結(jié)合溫潤(rùn)附葛湯治療陽虛型干燥綜合征的臨床療效觀察
發(fā)布時(shí)間：2019-07-05 05:39
【摘要】：目的:通過觀察針刺結(jié)合溫潤(rùn)附葛湯對(duì)陽虛型干燥綜合征(SS)的有效性,為臨床治療SS提供一種新的臨床思路和辨證依據(jù)。方法:1.研究對(duì)象:全部來自于2016年3月至2017年3月老年病三門診就診的患者。2.分組:將符合納入標(biāo)準(zhǔn)的90例干燥綜合征患者隨機(jī)分為針?biāo)幗M、針刺組和西藥組,每組各30例。3.治療方法:針?biāo)幗M予以針刺與溫潤(rùn)附葛湯聯(lián)合治療,即針刺睛明、金津、玉液、牽正、腎俞、脾俞、命門及三陰交穴,同時(shí)配合口服溫潤(rùn)附葛湯;針刺組采用單純針刺治療;西藥組予以口服硫酸羥氯喹每次0.2g,日2次治療;三種療法皆治療8周。4.觀察指標(biāo):在治療前后觀察三組患者的臨床癥狀,記錄中醫(yī)證候評(píng)分、外分泌腺檢查(即Schirmer試驗(yàn)和唾液流率試驗(yàn))、ESR、IgG、抗SSA及抗SSB實(shí)驗(yàn)室指標(biāo)。5.統(tǒng)計(jì)方法:采用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)分析三組治療前后各指標(biāo)變化,對(duì)比臨床療效。結(jié)果:1.臨床療效比較:針?biāo)幗M痊愈3例,顯效12例,有效13例,無效2例,總有效率93.3%;針刺組痊愈0例,顯效3例,有效17例,無效10例,總有效率66.7%;西藥組痊愈0例,顯效5例,有效16例,無效9例,總有效率70.0%。具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.中醫(yī)證候評(píng)分比較:三組中醫(yī)證候評(píng)分較療前均減少;治療后針?biāo)幗M與針刺組、西藥組比較具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.腺體分泌量比較:三組治療后腺體分泌量較前均增加;治療后針?biāo)幗M與西藥組、針刺組比較具有統(tǒng)計(jì)學(xué)意義(P0.05)。4.ESR、IgG比較:三組治療后ESR、IgG較前均有所降低;治療后針?biāo)幗M與西藥組、針刺組比較具有統(tǒng)計(jì)學(xué)意義(P0.05)。5.抗SSA、抗SSB比較:三組治療前后抗SSA、抗SSB比較P0.05,無統(tǒng)計(jì)學(xué)意義;但各抗體陽性率均有所下降,且針?biāo)幗M陽性率降低優(yōu)于西藥組和針刺組。結(jié)論:1.針刺結(jié)合溫潤(rùn)附葛湯對(duì)治療陽虛型干燥綜合征有效。2.針刺結(jié)合溫潤(rùn)附葛湯能有效減少中醫(yī)證候評(píng)分、增加腺體分泌量,降低ESR、IgG水平,其療效優(yōu)于西藥組和針刺組。
[Abstract]:Objective: to observe the effectiveness of acupuncture combined with Wenrun Fuge decoction in the treatment of (SS) with Yang deficiency Sjogren's syndrome (Sjogren's syndrome), and to provide a new clinical train of thought and syndrome differentiation basis for clinical treatment of SS. Method: 1. Subjects: all of them came from the third outpatient clinic of geriatrics from March 2016 to March 2017. 2. Group: 90 patients with Sjogren's syndrome who met the inclusion criteria were randomly divided into acupuncture group (n = 30), acupuncture group (n = 30) and western medicine group (n = 30). Treatment methods: acupuncture group was treated with acupuncture combined with Wenrun Fuge decoction, that is, acupuncture Jingming, Jinjin, Yu liquid, Zaizheng, Shenshu, spleen Shu, Mingmen and Sanyinjiao points, combined with oral Wenrun Fuge decoction; acupuncture group was treated with simple acupuncture; western medicine group was treated with oral hydroxychloroquine sulfate 0.2g twice a day; all three treatments were treated for 8 weeks. Outcome measures: the clinical symptoms of the three groups were observed before and after treatment, the scores of TCM syndromes, exocrine gland test (Schirmer test and saliva flow rate test), anti-SSA and anti-SSB laboratory indexes of ESR,IgG, were recorded. Statistical methods: SPSS17.0 software was used to analyze the changes of each index before and after treatment in the three groups, and the clinical efficacy was compared. Result: 1. Comparison of clinical efficacy: in acupuncture group, 3 cases were cured, 12 cases were markedly effective, 13 cases were effective, 2 cases were ineffective, the total effective rate was 93.3%, 0 cases were cured, 3 cases were markedly effective, 17 cases were effective, 10 cases were ineffective, the total effective rate was 66.7%, and 0 cases were cured, 5 cases were markedly effective, 16 cases were effective, 9 cases were ineffective, the total effective rate was 70.0%. It is statistically significant (P 0.05). 2. Comparison of TCM syndrome scores: the scores of TCM syndromes in the three groups were lower than those before treatment; after treatment, the scores of TCM syndromes in acupuncture group, acupuncture group and western medicine group were significantly lower than those before treatment (P 0.05). Comparison of gland secretion: after treatment, the secretion of gland in the three groups increased compared with that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). 4. IgG comparison: the ESR,IgG of the three groups after treatment was lower than that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). Comparison of anti-SSA, and anti-SSB: there was no significant difference in anti-SSA, and anti-SSB between the three groups before and after treatment, but the positive rate of each antibody was decreased, and the positive rate of acupuncture group was better than that of western medicine group and acupuncture group. Conclusion: 1. Acupuncture combined with Wenrun Fuge decoction is effective in the treatment of Yang deficiency Sjogren's syndrome. 2. Acupuncture combined with Wenrun Fuge decoction can effectively reduce the score of TCM syndromes, increase the secretion of gland and decrease the level of ESR,IgG. The curative effect of acupuncture is better than that of western medicine group and acupuncture group.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.1
[Abstract]:Objective: to observe the effectiveness of acupuncture combined with Wenrun Fuge decoction in the treatment of (SS) with Yang deficiency Sjogren's syndrome (Sjogren's syndrome), and to provide a new clinical train of thought and syndrome differentiation basis for clinical treatment of SS. Method: 1. Subjects: all of them came from the third outpatient clinic of geriatrics from March 2016 to March 2017. 2. Group: 90 patients with Sjogren's syndrome who met the inclusion criteria were randomly divided into acupuncture group (n = 30), acupuncture group (n = 30) and western medicine group (n = 30). Treatment methods: acupuncture group was treated with acupuncture combined with Wenrun Fuge decoction, that is, acupuncture Jingming, Jinjin, Yu liquid, Zaizheng, Shenshu, spleen Shu, Mingmen and Sanyinjiao points, combined with oral Wenrun Fuge decoction; acupuncture group was treated with simple acupuncture; western medicine group was treated with oral hydroxychloroquine sulfate 0.2g twice a day; all three treatments were treated for 8 weeks. Outcome measures: the clinical symptoms of the three groups were observed before and after treatment, the scores of TCM syndromes, exocrine gland test (Schirmer test and saliva flow rate test), anti-SSA and anti-SSB laboratory indexes of ESR,IgG, were recorded. Statistical methods: SPSS17.0 software was used to analyze the changes of each index before and after treatment in the three groups, and the clinical efficacy was compared. Result: 1. Comparison of clinical efficacy: in acupuncture group, 3 cases were cured, 12 cases were markedly effective, 13 cases were effective, 2 cases were ineffective, the total effective rate was 93.3%, 0 cases were cured, 3 cases were markedly effective, 17 cases were effective, 10 cases were ineffective, the total effective rate was 66.7%, and 0 cases were cured, 5 cases were markedly effective, 16 cases were effective, 9 cases were ineffective, the total effective rate was 70.0%. It is statistically significant (P 0.05). 2. Comparison of TCM syndrome scores: the scores of TCM syndromes in the three groups were lower than those before treatment; after treatment, the scores of TCM syndromes in acupuncture group, acupuncture group and western medicine group were significantly lower than those before treatment (P 0.05). Comparison of gland secretion: after treatment, the secretion of gland in the three groups increased compared with that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). 4. IgG comparison: the ESR,IgG of the three groups after treatment was lower than that before treatment; after treatment, there was significant difference between the acupuncture group and the western medicine group and the acupuncture group (P 0.05). Comparison of anti-SSA, and anti-SSB: there was no significant difference in anti-SSA, and anti-SSB between the three groups before and after treatment, but the positive rate of each antibody was decreased, and the positive rate of acupuncture group was better than that of western medicine group and acupuncture group. Conclusion: 1. Acupuncture combined with Wenrun Fuge decoction is effective in the treatment of Yang deficiency Sjogren's syndrome. 2. Acupuncture combined with Wenrun Fuge decoction can effectively reduce the score of TCM syndromes, increase the secretion of gland and decrease the level of ESR,IgG. The curative effect of acupuncture is better than that of western medicine group and acupuncture group.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.1
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