电针条口穴治疗肩关节周围炎临床疗效对比观察

【作者】 张佛明；

【导师】 郭长青；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2006， 硕士

【摘要】 本论文的研究目的是:研究腧穴单穴基础主治。选择条口穴,针对其治疗肩臂痛的基础主治进行验证性试验,以期对此作出客观科学的评价,并为临床提供治疗依据。首先,对肩周炎的治疗近况进行文献整理并做了综述,发现目前非药物疗法被广泛应用于肩周炎的治疗,与药物治疗和手术疗法比较,非药物疗法在肩周炎治疗上有优势。同时注意到在进行肩周炎的临床研究时,应采集尽量多的临床信息,包括患者自觉症状、体征、有效检查等各方面能反映病情变化的信息,制定统一的治疗方案和评价体系,并且尽量排除试验过程中的干扰因素,以确保研究结果的可比性。其次,对条口穴用于肩周炎治疗的临床报道进行综述,并探讨该疗法的起源,得到的结论是:条口穴用于治疗肩周炎是临床上行之有效的方法,得到医生的普遍采用,解除了众多患者的疾苦;但是其起源并无确切的文献记载,也没有就此疗法开展过科学的临床随机对照试验来验证其有效性,有必要就此问题进行研究。因此,为了验证条口穴治疗肩臂痛的基础主治作用,设计了本课题。研究方法:观察肩周炎病人120例,根据随机对照试验的原则,将符合纳入标准的病人随机分为三组,每组40例,分别接受针刺条口穴、循经按摩、循经针刺的治疗措施。选择肩部疼痛和功能活动作为观察指标,将得到的观察结果量化并进行统计学处理,得出结论。研究结果:三种疗法均可以使肩周炎患者疼痛和功能活动积分显著降低,肩周炎症状和体征得到改善。在治疗的两疗程结束时,循经按摩组在总体疗效、镇痛疗效和功能活动改善疗效方面,均优于其他两组;针刺条口组在总体疗效和功能活动改善疗效方面,优于循经针刺组,而镇痛疗效与循经针刺组差异不显著。在第一次治疗结束时,循经按摩组在即刻镇痛和功能活动改善方面,均优于其他两组;针刺条口组与循经针刺组差异不显著。结论:1、针刺条口穴能有效缓解肩周炎病人的肩部疼痛症状,改善肩关节活动功能,验证了条口穴治疗肩臂痛的基础主治作用。2、通过针刺条口穴治疗肩周炎,在改善肩关节活动功能方面优于循经针刺法,提示在肩周炎的治疗上,远端取穴能提高疗效。3、三种疗法之中,循经按摩法疗效最好,提示针对病灶进行的局部按摩治疗以及被动活动肩关节,起到了针刺无法替代的作用。4、在肩周炎的治疗过程中,功能锻炼至关重要。坚持功能锻炼,不但疗效好,且不易复发。更多还原

【Abstract】 The objective of this thesis is to study the basic therapeutic function of acupoint. It takes verification trail of ST 38(Tiaokou) about its basic therapeutic function against shoulder pain, so as to make out objective and scientific estimate and provide therapeutic evidence for clinical practice.The first part reviews and analyzes the clinical materials concerning the recent developments of the treatment of scapulohumeral periarthritis. It is found that non-drug treatment is widely used and has predominace against drug treatment and operation. Meanwhile, we should pay attention to the process of collecting clinical information, including subjective symptom, physical sign, useful examination, while we are carrying out clinical trials.The second part reviews the clinical materials concerning the treatment of using ST 38(Tiaokou) for scapulohumeral periarthritis and approach the origin of this treatment. We conclude that ST 38(Tiaokou) is the effective acupoint for scapulohumeral periarthritis and has been accepted by both doctors and patients. But there is neither exact records about its origin nor randomized controlling trial about it. It is necessary to study and research it.So, we make this project to verificate the basic therapeutic function of ST 38(Tiaokou) against shoulder pain. The third part is the report of the clinical trial.Methods: It took randomize and controlling as the principles of clinical trails. Patients of scapulohumeral periarthritis who matchs the diagnose standards will be divided to three groups—40 patients each group, totally 120 patients. These patients will accept different treatment, including acupuncture at ST 38(Tiaokou), massage and routine acupuncture. We select shoulder pain and shoulder activity as observing index. The index will be quantizated and statistically treated to arrive at conclusion.Results: All of three kinds of treatment can relieve pain and improve shoulder activity for patients of scapulohumeral periarthritis. After two courses of treatment, the group of massage turned out to be the best treatment according to total effect, effect of easing pain and improving shoulder activity. The group of acupuncture at ST 38(Tiaokou) created better effect than the other group in terms of total effect and effect更多还原