本文選題：頸椎病 + 夾脊穴��； 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的本研究結(jié)合導(dǎo)師的臨床經(jīng)驗(yàn)采用夾脊穴深刺的方法治療頸椎病。探討夾脊穴深刺治療頸椎病的療效,觀察其在疼痛的緩解及功能障礙改善方面的差異,為治療頸椎病的針刺深度提供更有效的方法。方法采用隨機(jī)單盲的試驗(yàn)方法,依據(jù)國(guó)家中醫(yī)藥管理局頒布的《國(guó)家中醫(yī)藥管理局·中醫(yī)病證診斷療效標(biāo)準(zhǔn)》被診斷為頸椎病的患者納入本試驗(yàn),且患者自愿加入本試驗(yàn)并簽署知情同意書。一共納入患者96例,按照隨機(jī)數(shù)字表法將其隨機(jī)分為兩組,即深刺組和常規(guī)針刺組每組各48例,其中深刺組針刺深度為2~3寸,常規(guī)針刺組針刺深度為0.5~1寸。選取頸部?jī)蓚?cè)與天柱、頸百勞水平位置的夾脊穴共4針為主穴,同時(shí)常規(guī)針刺組結(jié)合其他癥狀配伍相應(yīng)穴位。針刺后進(jìn)行電針治療20分鐘,每周治療3次,共治療4周,分別于入組前、第一次治療結(jié)束當(dāng)日、第一周治療結(jié)束當(dāng)日及第四周治療結(jié)束當(dāng)日,以視覺模擬量表(VAS)對(duì)患者病情變化給予評(píng)價(jià)。填寫頸痛量表NPQ,以觀察研究治療前后患者的功能改善情況和生活質(zhì)量變化;配合頸椎MRI測(cè)量頸部表皮到椎間孔后緣的距離,找出治療頸椎病在安全范圍內(nèi)能達(dá)到最佳治療效果的最佳針刺深度。使用Excel表格建立數(shù)據(jù)庫(kù),全部計(jì)量資料采用均數(shù)±標(biāo)準(zhǔn)差來(lái)表示((?)±s),使用SPSS17.0對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,得出結(jié)論。結(jié)果1視覺模擬量表(VAS)評(píng)分:無(wú)論是深刺組還是常規(guī)針刺組,入組前、第一次治療后、第三次治療后及第十二次治療后,兩組患者的VAS評(píng)分變化呈逐次下降趨勢(shì),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。2頸痛量表(NPQ)評(píng)分:無(wú)論是深刺組還是常規(guī)針刺組,入組前、第一次治療后、第三次治療后及第十二次治療后,兩組患者的NPQ評(píng)分變化呈逐次下降趨勢(shì),差異均有統(tǒng)計(jì)學(xué)意義差異(P0.05)。3比較深刺組和常規(guī)針刺組在第一次治療后、第三次治療及第十二次治療后的均數(shù),深刺組的療效優(yōu)于傳統(tǒng)針刺組,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。4測(cè)量頸部皮膚表面到椎間孔后緣的距離為:男:5.07~7.13cm;女:4.76~6.68cm。結(jié)論1針刺夾脊穴治療頸椎病能夠改善患者的疼痛狀況、促進(jìn)功能恢復(fù)、提高生活質(zhì)量。2深刺較常規(guī)方法針刺夾脊穴在治療頸椎病上效果更為顯著。3夾脊穴深刺治療頸椎病是行之安全、療效可靠的治療方法。
[Abstract]:Objective to study the treatment of cervical spondylopathy with Jiaji point deep pricking combined with the clinical experience of tutor. To explore the therapeutic effect of Jiaji acupoint on cervical spondylosis, to observe the difference of pain relief and dysfunction improvement, and to provide a more effective method for the treatment of cervical spondylosis with acupuncture depth. Methods A randomized, single-blind trial was conducted on the patients diagnosed as cervical spondylosis according to the criteria for the diagnosis of TCM Diseases and Syndromes issued by the State Administration of traditional Chinese Medicine. And patients voluntarily participate in the trial and sign informed consent. A total of 96 patients were randomly divided into two groups according to the method of random number table. There were 48 cases in each group in deep acupuncture group and conventional acupuncture group. The depth of acupuncture in deep acupuncture group was 2 ~ 3 inches, and that in routine acupuncture group was 0.5 ~ 1 inch. Four main acupuncture points were selected from both sides of the neck and Tianzhu and Jiaji points in the horizontal position of neck, while the routine acupuncture group combined with other symptoms were combined with corresponding acupoints. After acupuncture, the patients were treated with electroacupuncture for 20 minutes, 3 times a week for 4 weeks, respectively, before entering the group, on the end of the first treatment, on the end of the first week and on the end of the fourth week, respectively. Visual analogue scale (VAS) was used to evaluate the change of patient's condition. To observe the improvement of function and quality of life of patients before and after treatment, and to measure the distance between cervical epidermis and posterior margin of intervertebral foramina with cervical MRI. To find out the best depth of acupuncture for the treatment of cervical spondylosis in safe range. The Excel table is used to set up the database, and the mean 鹵standard deviation is used to represent the data. SPSS17.0 is used to analyze the data statistically, and the conclusion is drawn. Results (1) Visual analogue scale (VAS) score: the VAS score of the two groups decreased gradually before entering the group, after the first treatment, after the third treatment and after the twelfth treatment, whether in the deep acupuncture group or the routine acupuncture group. The difference was statistically significant (P 0.05). 2 neck pain scale and NPQs: whether in the deep acupuncture group or the routine acupuncture group, the NPQ scores of the two groups decreased gradually before, after the first treatment, after the third treatment and after the twelfth treatment. The differences were statistically significant. P0.053.Compared with the conventional acupuncture group and the deep acupuncture group, after the first treatment, the third treatment and the twelfth treatment, the curative effect of the deep acupuncture group was better than that of the traditional acupuncture group. The distance between cervical skin surface and posterior margin of intervertebral foramen was measured by P0.014.The distance between male and female was: male: 5.07 ~ 7.13 cm, female: 4.76 ~ 6.68 cm. Conclusion 1 the treatment of cervical spondylosis with acupuncture at Jiaji point can improve the pain status and promote the recovery of function. To improve the quality of life .2 Deep acupuncture is more effective than the conventional method in the treatment of cervical spondylosis. 3 it is safe and reliable to treat cervical spondylopathy with deep acupuncture at Jiaji point. 3 the treatment of cervical spondylosis by deep acupuncture at Jiaji point is a safe and reliable method for treatment of cervical spondylosis.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.9

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