本文選題：局部電針　切入點(diǎn)：咽腔與頦舌肌鍛煉　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察局部電針結(jié)合咽腔與頦舌肌鍛煉法改善阻塞性睡眠呼吸暫停低通氣(Obstructive Sleep Apnea Hypopnea Syndrome,OS-AHS)患者夜間通氣情況的臨床療效,為本病的治療提供一個(gè)新的思路和方法。方法:30例符合標(biāo)準(zhǔn)的OSAHS患者采用隨機(jī)數(shù)字表法,分成治療組15例,對(duì)照組15例。治療組采用局部電針結(jié)合咽腔與頦舌肌鍛煉治療,選穴為:廉泉、外金津玉液,外金津玉液連電,波形為斷續(xù)波,頻率為80Hz,脈沖寬度為0.5ms,斷續(xù)比為1:1,并在每日針刺結(jié)束后進(jìn)行咽腔與頦舌肌鍛煉。對(duì)照組采用傳統(tǒng)針刺治療,選穴為:百會(huì)、水溝、足三里、合谷、三陰交、豐隆、列缺、尺澤、太淵,不連接電針。兩組均每天治療1次,時(shí)間為30min,1周為1個(gè)療程,連續(xù)治療4個(gè)療程。分別在治療前后選用多導(dǎo)睡眠監(jiān)測(cè)(Polysomnography,PSG)中的呼吸暫停低通氣指數(shù)(Apnea Hypopnea Index,AHI)、最低血氧飽和度(The Lowest Oxygen Saturation,LSaO_2)及愛潑沃斯嗜睡量表(Epworth sleepiness scale,ESS)評(píng)分進(jìn)行療效評(píng)價(jià)。治療結(jié)束后采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.局部電針結(jié)合咽腔與頦舌肌鍛煉組與傳統(tǒng)針刺組患者經(jīng)治療后,AHI指數(shù)較治療前明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),且局部電針結(jié)合咽腔與頦舌肌鍛煉組優(yōu)于傳統(tǒng)針刺組(P0.05)。2.局部電針結(jié)合咽腔與頦舌肌鍛煉組與傳統(tǒng)針刺組患者經(jīng)治療后,LSaO_2較治療前明顯升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),且局部電針結(jié)合咽腔與頦舌肌鍛煉組優(yōu)于傳統(tǒng)針刺組(P0.05)。3.局部電針結(jié)合咽腔與頦舌肌鍛煉組與傳統(tǒng)針刺組患者經(jīng)治療后,ESS評(píng)分較治療前明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),且局部電針結(jié)合咽腔與頦舌肌鍛煉組優(yōu)于傳統(tǒng)針刺組(P0.05)。結(jié)論:1.局部電針結(jié)合咽腔與頦舌肌鍛煉法可有效改善患者睡眠時(shí)的呼吸紊亂程度及低氧狀態(tài)。2.局部電針結(jié)合咽腔與頦舌肌鍛煉法可有效改善患者在日間的嗜睡狀態(tài)。3.局部電針結(jié)合咽腔與頦舌肌鍛煉法和傳統(tǒng)針刺療法對(duì)于OSAHS患者均有一定的臨床療效,且治療組優(yōu)于對(duì)照組。
[Abstract]:Objective: to observe the clinical effect of local electroacupuncture combined with pharyngeal cavity and genioglossus exercise on nocturnal ventilation in patients with obstructive Sleep Apnea Hypopnea Syndrome.OS-AHS. Methods 30 patients with OSAHS who met the standard were randomly divided into treatment group (n = 15) and control group (n = 15). The treatment group was treated with local electroacupuncture combined with pharyngeal cavity and genioglossus exercise. The selected acupoints were Lianquan, Waijin Jade, Oujin Jade, Waijinjinyu, the waveform was intermittent, the frequency was 80 Hz, the pulse width was 0.5 Ms, the intermittent ratio was 1: 1, and the pharyngeal cavity and genioglossus were exercised at the end of daily acupuncture. The control group was treated with traditional acupuncture. The selected acupoints were: Baihui, Shuigou, Zusanli, Hegu, Sanyinjiao, Fenglong, lack of column, ruler, Taiyuan, not connected with electroacupuncture. Both groups were treated once a day for 30 mins a week as a course of treatment. The apnea Hypopnea index (Apnea Hypopnea index), the Lowest Oxygen saturation (the Lowest Oxygen SaturationLSaOst2) and the Epworth sleepiness scale (ESS) were used to evaluate the efficacy before and after treatment for 4 consecutive courses of treatment. The apnea Hypopnea index and the Lowest Oxygen saturation of the apnea hypopnea index (Apnea Hypopnea index) and the Epworth sleepiness scaleESS (ESS) were used before and after treatment to evaluate the efficacy of the apnea hypopnea index (Apnea Hypopnea index) and the Lowest Oxygen saturation (LSAO _ 2). Results: 1. Local electroacupuncture combined with pharynx and genioglossus exercise group and traditional acupuncture group had lower AHI index after treatment. The difference was statistically significant, and the local electroacupuncture combined with pharyngeal cavity and genioglossus exercise group was better than that of the traditional acupuncture group (P 0.05). The LSaO2 level in the local electroacupuncture combined with genioglossus exercise group and the traditional acupuncture group was significantly higher than that before treatment. The difference was statistically significant (P 0.01), and the local electroacupuncture combined with pharyngeal cavity and genioglossus exercise group was better than that of the traditional acupuncture group (P 0.05). The ESS score of the patients in the local electroacupuncture combined with genioglossus exercise group and the traditional acupuncture group was significantly lower than that before treatment. The difference was statistically significant, and the combination of local electroacupuncture with pharyngeal cavity and genioglossus exercise group was better than that of traditional acupuncture group. Conclusion 1. Local electroacupuncture combined with pharyngeal cavity and genioglossus exercise can effectively improve the degree of respiratory disorder during sleep. Local electroacupuncture combined with pharyngeal cavity and genioglossus exercise can effectively improve the daytime somnolence of patients. Local electroacupuncture combined with pharynx and genioglossus exercise and traditional acupuncture therapy have certain clinical effects on OSAHS patients. The treatment group was superior to the control 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)】：R246.81

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