消髓化核湯結(jié)合針刺治療破裂型腰椎間盤(pán)突出癥的臨床研究
本文關(guān)鍵詞:消髓化核湯結(jié)合針刺治療破裂型腰椎間盤(pán)突出癥的臨床研究 出處:《南京中醫(yī)藥大學(xué)》2017年碩士論文 論文類(lèi)型:學(xué)位論文
更多相關(guān)文章: 破裂型腰椎間盤(pán)突出癥 消髓化核湯 針刺治療 JOA評(píng)分 MRI影像學(xué)改變 重吸收
【摘要】:目的:通過(guò)臨床研究,觀察消髓化核湯結(jié)合針刺治療破裂型腰椎間盤(pán)突出癥的臨床療效及椎間盤(pán)重吸收程度,并與單獨(dú)服用消髓化核湯和單獨(dú)使用針刺治療對(duì)比。探討中藥結(jié)合針刺治療腰椎間盤(pán)突出癥是否可以提高臨床療效,并分析中醫(yī)體系中這兩大方面的傳統(tǒng)保守治療對(duì)于破裂型腰椎間盤(pán)突出癥的優(yōu)勢(shì)與不足。方法:將2015年5月至2016年11月期間,在蘇州市中醫(yī)醫(yī)院和新加坡仁大中醫(yī)診所被診斷為破裂型腰椎間盤(pán)突出癥的病人,通過(guò)納入及排除標(biāo)準(zhǔn),選出60例患者,根據(jù)其個(gè)人意愿,分為消髓化核湯為主的中藥組(20例)、針刺組(20例)和消髓化核湯結(jié)合針刺的中藥結(jié)合針刺組(20例),采取隨訪(fǎng)的形式,根據(jù)患者治療前和治療2個(gè)月后的自身情況,根據(jù)J0A評(píng)分和MRI影像學(xué)改變?nèi)鐚?shí)記錄數(shù)據(jù),進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果:(1)中藥組、針刺組和中藥結(jié)合針刺組治療均可顯著提高患者的J0A評(píng)分(P0.05),而中藥結(jié)合針刺組J0A評(píng)分的改善率高于其余兩組(P0.05)。根據(jù)J0A評(píng)分的療效評(píng)估,中藥組療效優(yōu)良7例,總的優(yōu)良率為35%(7/20);針刺組療效優(yōu)良2例,總的優(yōu)良率為10%(2/20);中藥結(jié)合針刺組療效優(yōu)良9例,總的優(yōu)良率為45%(9/20)。(2)中藥組、針刺組和中藥結(jié)合針刺組治療均可使突出物縮小(P0.05),而中藥結(jié)合針刺組突出物的吸收率高于其余兩組(P0.05)。根據(jù)吸收程度,中藥組完全吸收1例,明顯吸收1例,部分吸收15例,幾乎不變1例,突出體積增大2例,總的吸收率為85%(17/20);針刺組完全吸收0例,明顯吸收4例,部分吸收12例,幾乎不變1例,突出體積增大3例,總的吸收率為80%(16/20);中藥結(jié)合針刺組完全吸收2例,明顯吸收5例,部分吸收11例,幾乎不變0例,突出體積增大2例,總的吸收率為90%(18/20)。結(jié)論:(1)治療后3組患者的J0A評(píng)分較治療前均明顯提高;腰椎間盤(pán)突出程度較治療前均縮小。說(shuō)明通過(guò)保守治療,腰椎間盤(pán)突出癥的臨床癥狀及椎間盤(pán)突出程度均能夠取得良好的轉(zhuǎn)歸。(2)中藥結(jié)合針刺組J0A評(píng)分提高比例及突出物縮小程度最大;中藥組次之,稍微弱于中藥結(jié)合針刺組;而針刺組最低。說(shuō)明中藥和針刺治療腰椎間盤(pán)突出癥均能取得良好療效,但兩者結(jié)合能協(xié)同增加療效。
[Abstract]:Objective: to observe the clinical effect of Xiaomuanhuahe decoction combined with acupuncture in treating ruptured lumbar disc herniation and the degree of disc reabsorption. And compared with the treatment of Xiaoliaohuanhe decoction alone and acupuncture alone, to explore whether the combination of traditional Chinese medicine and acupuncture can improve the clinical efficacy of lumbar disc herniation. And analyze the advantages and disadvantages of traditional conservative treatment in these two aspects of traditional Chinese medicine system for ruptured lumbar disc herniation. Methods: from May 2015 to November 2016. Patients diagnosed as ruptured lumbar disc herniation in Suzhou traditional Chinese Medicine Hospital and Singapore Renda TCM Clinic selected 60 patients according to their personal wishes through inclusion and exclusion criteria. The patients were divided into two groups: the traditional Chinese medicine group (20 cases) and the acupuncture group (20 cases) and the group (20 cases) and the group (20 cases) were followed up. According to the patient's condition before treatment and 2 months after treatment, according to J0A score and MRI imaging changes, the data were recorded truthfully and statistically. Results: 1) Chinese medicine group. The treatment of acupuncture group and Chinese medicine combined with acupuncture group can significantly improve the J0A score of patients (P0.05). The improvement rate of J0A score in the TCM combined with acupuncture group was higher than that in the other two groups (P 0.05). According to the evaluation of J0A score, 7 cases of the TCM group were good, and the total excellent and good rate was 35% / 20%. In the acupuncture group, the curative effect was good in 2 cases, and the total excellent and good rate was 10% 20%. There were 9 cases of excellent curative effect in Chinese medicine combined with acupuncture group. The total excellent and good rate was 45% 20 / 20. 2) Chinese medicine group, acupuncture group and traditional Chinese medicine combined with acupuncture group could reduce the protrusions (P0.05). However, the absorptivity of protrusions in TCM combined with acupuncture group was higher than that in the other two groups. According to the degree of absorption, 1 case was completely absorbed, 1 case was obviously absorbed, 15 cases were partially absorbed, and 1 case was almost unchanged. The volume of protrusion increased in 2 cases, and the total absorptivity was 85 / 20%. In the acupuncture group, there were 0 cases of complete absorption, 4 cases of obvious absorption, 12 cases of partial absorption, almost 1 case of no change, and 3 cases of enlarged protrusion volume. The total absorption rate was 80% 16 / 20%. In the combination of Chinese medicine and acupuncture group, 2 cases were completely absorbed, 5 cases were obviously absorbed, 11 cases were partially absorbed, almost 0 cases were unchanged, and 2 cases were enlarged protruding volume. The total absorptivity was 90 / 20. Conclusion the J0A score of the three groups after treatment was significantly higher than that before treatment. The degree of lumbar disc herniation was smaller than that before treatment. The clinical symptoms of lumbar disc herniation and the degree of disc herniation can achieve good outcome. The Chinese medicine group was the second, slightly weaker than the traditional Chinese medicine combined with acupuncture group; The acupuncture group is the lowest. It shows that both Chinese medicine and acupuncture can achieve good curative effect on lumbar disc herniation, but the combination of both can increase the curative effect synergistically.
【學(xué)位授予單位】:南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類(lèi)號(hào)】:R274.9
【相似文獻(xiàn)】
相關(guān)期刊論文 前10條
1 李靜;劉玉祁;李春華;苑鴻雯;張鵬;林馳;辛思源;郭崢嶸;馬良宵;朱江;;關(guān)于機(jī)體相關(guān)因素對(duì)針刺得氣影響的探討[J];中國(guó)針灸;2013年04期
2 傅德元;;談針刺得氣[J];遼寧中醫(yī)雜志;1987年12期
3 王水清;促進(jìn)針刺得氣的一些方法與體會(huì)[J];中國(guó)醫(yī)刊;2000年10期
4 張海杰;針刺與得氣及其臨床應(yīng)用[J];中醫(yī)函授通訊;2000年06期
5 楊曉樺;針刺治療眼病體會(huì)[J];中國(guó)中醫(yī)眼科雜志;2001年02期
6 潘光輝,田莉婭;針刺治療中風(fēng)后呃逆37例[J];針灸臨床雜志;2001年08期
7 廉治軍,曲燕;王耀斌教授針刺經(jīng)驗(yàn)輯略[J];針灸臨床雜志;2004年05期
8 周立志,趙大貴,彭力;針刺致聲音嘶啞之管見(jiàn)[J];上海針灸雜志;2005年01期
9 潘永清;;針刺治療郁證的臨床研究進(jìn)展[J];光明中醫(yī);2007年01期
10 由克舉;;針刺配合中藥治療周?chē)悦嫔窠?jīng)麻痹38例[J];河南中醫(yī);2008年01期
相關(guān)會(huì)議論文 前10條
1 雷虹;;有感于針刺“得氣”——王毅剛老師經(jīng)驗(yàn)[A];重慶市針灸學(xué)會(huì)2010年學(xué)術(shù)年會(huì)論文集[C];2010年
2 朱榮英;李泳庭;;針刺得氣在痛癥中的應(yīng)用[A];2006中國(guó)針灸學(xué)會(huì)臨床分會(huì)第十四屆全國(guó)針灸學(xué)術(shù)研討會(huì)針?biāo)幗Y(jié)合論壇[C];2006年
3 邢方印;張莉;;腦卒中后吞咽障礙的針刺治療[A];2011中國(guó)針灸學(xué)會(huì)年會(huì)論文集(摘要)[C];2011年
4 陳秀榮;;針刺的護(hù)理[A];河南省科普、五官、中西醫(yī)結(jié)合護(hù)理學(xué)術(shù)會(huì)議資料匯編[C];2005年
5 梁粵;皮敏;;針刺牽引治療腰椎間盤(pán)突出癥的療效分析[A];廣東省針灸學(xué)會(huì)第十次學(xué)術(shù)交流會(huì)論文匯編[C];2007年
6 李育紅;;針刺戒煙研究進(jìn)展[A];中國(guó)中西醫(yī)結(jié)合學(xué)會(huì)第七屆精神疾病學(xué)術(shù)討論會(huì)論文匯編[C];2002年
7 金鈺紅;金鈺鈞;;矩陣針刺治療高血壓病臨床觀察[A];中國(guó)針灸學(xué)會(huì)全國(guó)中青年針灸推拿學(xué)術(shù)經(jīng)驗(yàn)交流會(huì)論文匯編[C];1999年
8 鄺偉川;;分期針刺治療中風(fēng)后肢體偏癱的研究[A];廣東省針灸學(xué)會(huì)第十一次學(xué)術(shù)研討會(huì)論文匯編[C];2010年
9 陳述榮;;針刺配合運(yùn)動(dòng)療法治療膝骨關(guān)節(jié)炎的臨床觀察[A];中華醫(yī)學(xué)會(huì)第九次全國(guó)物理醫(yī)學(xué)與康復(fù)學(xué)學(xué)術(shù)會(huì)議論文集[C];2007年
10 劉延?xùn)|;崔秋紅;于桂芬;;針刺對(duì)腦梗死患者運(yùn)動(dòng)功能康復(fù)的影響[A];中國(guó)康復(fù)醫(yī)學(xué)會(huì)腦血管病專(zhuān)業(yè)委員會(huì)第八次全國(guó)學(xué)術(shù)研討會(huì)論文集[C];2004年
相關(guān)重要報(bào)紙文章 前7條
1 程莘農(nóng)院士名醫(yī)工作室 楊金生 王瑩瑩 程凱 王宏才 朱兵;三要得氣至上[N];中國(guó)中醫(yī)藥報(bào);2010年
2 北京中醫(yī)藥大學(xué) 張良登;針刺頭穴治療中風(fēng)后遺癥療效好[N];中國(guó)中醫(yī)藥報(bào);2008年
3 ;針刺對(duì)乳腺組織影像和血流動(dòng)力有影響[N];中國(guó)中醫(yī)藥報(bào);2005年
4 劉俊嶺;專(zhuān)家認(rèn)為針灸是對(duì)生物醫(yī)學(xué)模式的挑戰(zhàn)[N];中國(guó)中醫(yī)藥報(bào);2006年
5 ;頭部圍針治中風(fēng)失語(yǔ)癥[N];中國(guó)中醫(yī)藥報(bào);2009年
6 ;針刺治療肩周炎[N];農(nóng)村醫(yī)藥報(bào)(漢);2007年
7 ;調(diào)衛(wèi)健腦針?lè)ㄖ问遊N];中國(guó)中醫(yī)藥報(bào);2009年
相關(guān)博士學(xué)位論文 前10條
1 唐樂(lè)微;基于多模態(tài)磁共振技術(shù)對(duì)針刺治療慢性疲勞綜合征認(rèn)知功能改善的中樞機(jī)制研究[D];成都中醫(yī)藥大學(xué);2015年
2 劉西通;針刺治療原發(fā)性痛經(jīng)腧穴配伍規(guī)律研究[D];山東中醫(yī)藥大學(xué);2015年
3 詹益能;分期針刺治療貝爾氏麻痹的臨床研究[D];廣州中醫(yī)藥大學(xué);2016年
4 李曉U,
本文編號(hào):1381417
本文鏈接:http://www.sikaile.net/shoufeilunwen/mpalunwen/1381417.html