本文選題：梨狀肌綜合征　切入點(diǎn)：針刀觸激術(shù)　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究背景:梨狀肌綜合征(Piriformis syndrome,PS)是指梨狀肌因急慢性損傷導(dǎo)致的梨狀肌緊張痙攣、水腫肥厚等刺激或卡壓坐骨神經(jīng)或其他骶叢神經(jīng)而產(chǎn)生一系列癥狀的綜合征。目前臨床上中西醫(yī)治療方式較多,主要分為非手術(shù)療法和手術(shù)療法,非手術(shù)療法存在著療效較慢、復(fù)發(fā)率較高的缺點(diǎn),手術(shù)雖可以直接解除卡壓,但存在著麻醉意外風(fēng)險和手術(shù)費(fèi)用高等缺點(diǎn)。針刀療法治療梨狀肌綜合征方法相對簡便、臨床療效顯著,本課題采用針刀觸激術(shù)治療梨狀肌綜合征,意在為針刀治療該病提供臨床依據(jù)、優(yōu)化臨床方案。研究目的:觀察針刀觸激術(shù)對梨狀肌綜合征患者的臨床療效情況、視覺模擬評分(VAS)、Oswestry功能障礙指數(shù)(ODI)的影響,探討針刀觸激術(shù)的安全性和有效性,分析針刀觸激術(shù)治療梨狀肌綜合征的原理。以豐富臨床治療梨狀肌綜合征的手段,提高患者的生活質(zhì)量。研究方法:招募2016年1月至2016年12月間在南京市中西醫(yī)結(jié)合醫(yī)院疼痛科門診、江蘇省中西醫(yī)結(jié)合醫(yī)院針刀科門診、南京中醫(yī)藥大學(xué)國醫(yī)堂針灸門診確診為梨狀肌綜合征的78名患者。預(yù)編序號1-78,用隨機(jī)數(shù)字表的方法并按隨機(jī)數(shù)字升序?qū)?-78號進(jìn)行分組,分2個平行組進(jìn)行,分別為針刀治療組、針刺對照組,每組各39例。針刀組患者3次為一療程,每次間隔5天;針灸組每兩日1次,5次為1療程,記錄兩組治療結(jié)束后的療效。療效觀察及評價標(biāo)準(zhǔn)選用視覺模擬評分法(VAS)、Oswestry功能障礙指數(shù)(ODI),用SPASS 20.0軟件進(jìn)行統(tǒng)計分析。研究結(jié)果:1.針刀治療梨狀肌綜合征,能明顯改善梨狀肌綜合征患者的臨床癥狀及體征,差異具有統(tǒng)計學(xué)意義(P0.05),療效明顯優(yōu)于針刺組。2.通過VAS視覺模擬評分法,治療后針刀組的評分改善優(yōu)于針刺組,差異具有統(tǒng)計學(xué)意義(P㩳0.05)。3.通過Owestry功能障礙指數(shù)問卷表,治療后針刀組的功能障礙改善優(yōu)于針刺組,差異具有統(tǒng)計學(xué)意義(P0.05)。研究結(jié)論:1.針刀觸激術(shù)治療梨狀肌綜合征的療效優(yōu)于傳統(tǒng)針刺方法。2.在臨床治療過程中,兩組患者治療過程中未出現(xiàn)神經(jīng)損傷、血腫等不良反應(yīng),說明針刺與針刀觸激術(shù)在臨床應(yīng)用中安全可靠。3.對于以梨狀肌綜合征為代表的軟組織損傷并以神經(jīng)卡壓為表現(xiàn)的疾病,在臨床上適宜選用針刀觸激術(shù)。
[Abstract]:Background: piriformis syndrome (Piriformis syndrome) refers to a series of symptoms of piriformis syndrome caused by acute and chronic injury of piriformis caused by spasm of piriformis muscle, edema and hypertrophy, or compression of sciatic nerve or other sacral plexus nerves.At present, there are many clinical treatments of traditional Chinese and western medicine, which are mainly divided into non-operative therapy and surgical therapy. Non-operative therapy has the disadvantages of slow curative effect and high recurrence rate. Although the operation can relieve compression directly,However, there are some disadvantages such as the risk of anaesthesia accident and the high cost of operation.The treatment of piriformis syndrome by needle knife therapy is relatively simple, and the clinical effect is remarkable. The purpose of this paper is to provide clinical basis for needle knife therapy of piriformis syndrome, and to optimize the clinical scheme.Objective: to observe the clinical curative effect and the visual analogue score of visual analogue score (VAS) and Oswestry dysfunction index (Oswestry) in patients with piriformis syndrome, and to explore the safety and effectiveness of needle touching.To analyze the principle of needle-knife touch-excitation in the treatment of piriformis syndrome.To enrich the clinical treatment of piriformis syndrome, improve the quality of life of patients.Methods: from January 2016 to December 2016, we recruited an outpatient from the pain Department of Nanjing Integrated Chinese and Western Medicine Hospital and the needle-knife department of Jiangsu Provincial Integrated Chinese and Western Medicine Hospital.A total of 78 patients with piriformis syndrome were diagnosed as piriformis syndrome in the clinic of National Medical College of Nanjing University of traditional Chinese Medicine.The number 1-78 was precompiled and divided into two parallel groups by random number table and ascending order of random numbers. Each group was divided into two groups: acupuncture treatment group (n = 39) and acupuncture control group (n = 39), each group was divided into two groups: acupuncture treatment group (n = 39) and acupuncture control group (n = 39).The patients in the acupuncture and knife group were treated for a course of treatment with an interval of 5 days, and the acupuncture and moxibustion group received 5 times every two days for a course of treatment. The curative effect of the two groups was recorded after the end of the treatment.The visual analogue scoring method was used to evaluate the curative effect and the SPASS 20.0 software was used for statistical analysis.The result of the study was: 1.Needle knife treatment of piriformis syndrome can significantly improve the clinical symptoms and signs of patients with piriformis syndrome, the difference is statistically significant (P 0.05), the curative effect is obviously better than acupuncture group. 2.The score of acupuncture group after treatment was better than that of acupuncture group by VAS visual analogue scoring method, and the difference was statistically significant.According to the questionnaire of Owestry dysfunction index, the improvement of functional disorder in the acupuncture group was better than that in the acupuncture group after treatment, and the difference was statistically significant (P 0.05).Conclusion: 1.The curative effect of needle knife touch stimulation in the treatment of piriformis syndrome is better than that of traditional acupuncture method.In the course of clinical treatment, there were no adverse reactions such as nerve injury and hematoma in the two groups, indicating that acupuncture and needle-knife touch stimulation were safe and reliable in clinical application.For the soft tissue injury represented by piriformis syndrome and the disease represented by nerve entrapment, needle-knife touch stimulation is suitable for clinical use.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.9

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本文編號：1715895