發(fā)布時(shí)間：2018-08-11 11:46

【摘要】：目的:本臨床實(shí)驗(yàn)采用隨機(jī)對(duì)照研究,將例中風(fēng)后遺癥患者按照隨機(jī)分組原則分為2組,其中治療組采用通元針?lè)?對(duì)照組單純采用傳統(tǒng)針灸治療,進(jìn)行對(duì)比觀察。療程為7天,兩個(gè)療程后,采用Barthel指數(shù)評(píng)分、FIM評(píng)分、腦卒中后偏癱恢復(fù)六階段測(cè)評(píng)、臨床總體療效評(píng)價(jià)標(biāo)準(zhǔn)觀察實(shí)驗(yàn)兩組對(duì)中風(fēng)后遺癥的臨床療效,進(jìn)一步驗(yàn)證通元針?lè)ㄖ委熤酗L(fēng)后遺癥的臨床療效,初步探討通元針?lè)ǖ睦碚撎厣�。方�?將符合納入標(biāo)準(zhǔn)的60例中風(fēng)后遺癥患者按照隨機(jī)分組原則分為2組,兩組在基礎(chǔ)藥物治療的基礎(chǔ)上,治療組(A組)采用通元針?lè)ㄖ委?對(duì)照組(B組)采用普通針刺療法治療。兩組留針時(shí)間相同。治療組與對(duì)照組每日治療1次,七天為1個(gè)療程,共治療2個(gè)療程。治療前后均應(yīng)用Barthel指數(shù)評(píng)分、FIM評(píng)分、腦卒中后偏癱恢復(fù)六階段測(cè)評(píng)對(duì)患者進(jìn)行病情程度評(píng)估,2個(gè)療程結(jié)束后對(duì)患者進(jìn)行臨床總體療效評(píng)價(jià)。統(tǒng)計(jì)方法:兩組計(jì)數(shù)資料采用獨(dú)立樣本t檢驗(yàn),分類資料(如性別)采用卡方檢驗(yàn),等級(jí)資料用雙樣本秩和檢驗(yàn),自身前后比較用配對(duì)t檢驗(yàn)或配對(duì)秩和檢驗(yàn)。結(jié)果：1.治療前,兩組在年齡、性別、日常生活活動(dòng)能力量表(Barthel指數(shù)評(píng)分)、功能獨(dú)立測(cè)定(FIM評(píng)分)、腦卒中后偏癱恢復(fù)六階段評(píng)定(Brunnstrom評(píng)定)無(wú)統(tǒng)計(jì)學(xué)差別(P0.05),兩組具有可比性。2.治療后Barthel指數(shù)評(píng)分:t=8.012,p=0.0000.01,說(shuō)明兩組評(píng)分存在差異(P0.01),結(jié)果有統(tǒng)計(jì)學(xué)意義。治療組前后Barthel指數(shù)評(píng)分自身對(duì)照比較,t=-12.711,p=0.0000.01,說(shuō)明在Barthel指數(shù)評(píng)分方面,治療組治療前后差異明顯,結(jié)果有統(tǒng)計(jì)學(xué)意義。對(duì)照組前后Barthel指數(shù)評(píng)分自身對(duì)照比較,t=-5.410,p=0.0000.01,說(shuō)明在Barthel指數(shù)評(píng)分方面,對(duì)照組治療前后差異明顯,結(jié)果有統(tǒng)計(jì)學(xué)意義。3.治療后FIM評(píng)分:t=7.55,p=0.0000.01,說(shuō)明兩組治療后FIM評(píng)分具有統(tǒng)計(jì)學(xué)差異(P0.01),結(jié)果有統(tǒng)計(jì)學(xué)意義。治療組前后FIM評(píng)分自身對(duì)照比較,t=-16.912,p=0.0000.01,說(shuō)明在FIM評(píng)分方面,治療組治療前后差異明顯,結(jié)果有統(tǒng)計(jì)學(xué)意義。對(duì)照組前后FIM評(píng)分自身對(duì)照比較,t=-8.993,p=0.0000.01,說(shuō)明在FIM評(píng)分方面,對(duì)照組治療前后差異明顯,結(jié)果有統(tǒng)計(jì)學(xué)意義。4.治療后腦卒中后偏癱恢復(fù)六階段測(cè)評(píng):通過(guò)對(duì)兩組治療后各階段例數(shù)進(jìn)行秩和檢驗(yàn),Z=-1.632,p=0.1030.05,兩組治療前兩組Brunnstrom評(píng)定分布差異不明顯,說(shuō)明治療后兩組在中風(fēng)后偏癱恢復(fù)各階段病例數(shù)對(duì)比不具有統(tǒng)計(jì)學(xué)意義。5.治療后總體療效對(duì)比:通過(guò)秩和檢驗(yàn)分析得出:Z=-2.508,p=0.0120.05,說(shuō)明兩組在總體療效上存在顯著差異,結(jié)果具有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.治療前,兩組在性別、年齡方面不具有統(tǒng)計(jì)學(xué)差異,在病情程度方面,包括日常生活活動(dòng)能力量表(Barthel指數(shù)評(píng)分)、功能獨(dú)立測(cè)定(FIM評(píng)分)、腦卒中后偏癱恢復(fù)六階段評(píng)定(Brunnstrom評(píng)定)均不具有統(tǒng)計(jì)學(xué)差異,保證了兩組的實(shí)驗(yàn)數(shù)據(jù)的可對(duì)比性。2.治療后,通過(guò)對(duì)Barthel指數(shù)評(píng)分、FIM評(píng)分兩組組內(nèi)治療前后對(duì)比統(tǒng)計(jì)學(xué)分析得出結(jié)果均具有差異性(P0.01),說(shuō)明兩種治療方法均可以明顯改善患者的病情。而組間比較則治療組在Barthel指數(shù)評(píng)分、FIM評(píng)分方面均與對(duì)照組有顯著差異,說(shuō)明治療采用的療法對(duì)患者的評(píng)分情況改善程度優(yōu)于對(duì)照組。3.通過(guò)對(duì)兩組治療后總體療效的對(duì)比,治療組總有效率優(yōu)于對(duì)照組,并且在顯效方面優(yōu)于對(duì)照組,本次課題兩組均沒(méi)有發(fā)現(xiàn)臨床治愈病例。4.在Brunnstrom評(píng)定方面,兩組在治療前后各階段病例數(shù)對(duì)比均不具有顯著差異性,說(shuō)明在腦卒中后偏癱恢復(fù)六階段評(píng)定方面,兩組療效不具有統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective:To study the clinical effect of Tongyuan Acupuncture on stroke sequelae by randomized controlled study.The treatment group was treated with Tongyuan Acupuncture and the control group was treated with traditional acupuncture. Methods: 60 patients with stroke sequelae were divided into two groups according to the principle of random grouping, and the two groups were divided into two groups. On the basis of basic drug therapy, the treatment group (group A) was treated with Tongyuan acupuncture, while the control group (group B) was treated with ordinary acupuncture. The needle retention time of the two groups was the same. Stage assessment was used to assess the severity of the disease and two courses were completed to evaluate the overall clinical efficacy of the patients. Before treatment, there was no significant difference between the two groups in age, sex, activity of daily living scale (Barthel index score), functional independence test (FIM score), stroke recovery six-stage assessment (Brunnstrom assessment), the two groups were comparable. 2. After treatment, Barthel index score: t = 8.012, P = 0.0000.01, indicating that the two groups were evaluated. Barthel index score before and after treatment group self-control comparison, t = - 12.711, P = 0.0000.01, indicating that the Barthel index score before and after treatment in the treatment group, the difference was significant, the results were statistically significant. In Barthel index score, the control group before and after treatment significant difference, the results were statistically significant. 3. After treatment FIM score: t = 7.55, P = 0.0000.01, indicating that the two groups after treatment FIM score was statistically significant (P 0.01), the results were statistically significant. Compared with the control group, the FIM score of the control group before and after treatment was t = - 8.993, P = 0.0000.01, indicating that the FIM score of the control group before and after treatment was significantly different, the results were statistically significant. Rank sum test, Z = - 1.632, P = 0.1030.05, the two groups before treatment Brunnstrom evaluation distribution difference is not significant, indicating that the two groups after treatment in the recovery of hemiplegia after stroke in different stages of the number of cases compared has no statistical significance.5. After treatment, the overall efficacy of comparison: through rank sum test analysis: Z = - 2.508, P = 0.0120.05, indicating that the two groups in the overall situation. Before treatment, there was no significant difference in gender and age between the two groups, including the degree of disease, including activity of daily living scale (Barthel index score), functional independence test (FIM score), stroke recovery six-stage assessment (Brunnstrom assessment) of hemiplegia. 2. There was no statistical difference between the two groups, which ensured the comparability of the experimental data. 2. After treatment, through the Barthel index score, FIM score of the two groups before and after treatment, the results were statistically different (P 0.01), indicating that the two treatment methods can significantly improve the patient's condition. Hel index score, FIM score were significantly different from the control group, indicating that the treatment used to improve the patient's score is better than the control group. 3. By comparing the overall efficacy of the two groups after treatment, the total effective rate of the treatment group is better than the control group, and is better than the control group in the significant effect, the two groups have not found impending. In Brunnstrom evaluation, there was no significant difference in the number of cases between the two groups before and after treatment, indicating that there was no statistical significance in the six-stage evaluation of hemiplegia recovery after stroke.
【學(xué)位授予單位】：廣州中醫(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)】：R246.6

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