【作者】 刘海燕；

【导师】 傅杰英；

【作者基本信息】 广州中医药大学 ， 中医学， 2011， 硕士

【摘要】 研究目的本研究通过探讨阳虚体质与痰瘀型痤疮发生的相关性,对两组阳虚质痰瘀型痤疮的患者治疗前后的症状、体质积分进行比较,客观评价针灸调理阳虚体质治疗痰瘀型痤疮的临床疗效,以期为调理体质治疗痤疮的有效性提供临床依据。研究方法采用随机对照的方法,将符合诊断标准的61例阳虚质痰瘀型痤疮患者随机分为治疗组(调体组31例)和对照组(传统针刺组30例)。①两组初诊时均给予背部刮痧,找到颜色最红紫的痧印(1到3处)进行刺络拔罐,出适量瘀黑血液；②如面部有成熟且较大的脓疱、囊肿,则两组均给予皮损局部处理：脓疱、囊肿2-3个,75%酒精常规消毒后,用5号注射针头挑刺,再用两根医用棉签对挤,彻底清除脓疱、囊肿内容物,最后用安尔碘Ⅲ消毒皮损处,1周1次；③两组均给予对证针刺取穴：中脘,足三里、曲池、丰隆、血海、膈俞(均双侧),只针不灸；④治疗组加调体取穴：神阙、关元、气海,脾俞、肾俞(均双侧)。神阙隔盐隔姜灸,关元、肾俞与气海、脾俞交替使用温针灸。隔日1次,1周3次,1个月为一疗程,连续治疗3个疗程后观察总体疗效。采用SPSS13.0统计软件包进行统计学分析,计量资料采用T检验,计数资料采用卡方检验,等级资料采用非参数检验。研究结果治疗组与对照组总有效率分别为93.10%和71.43%,经比较,差异有统计学意义(P<0.05)。在痤疮皮损改善方面,治疗组和对照组治疗前后的痤疮综合分级评分均有明显下降,两组比较,差异有统计学意义(P<0.05),说明治疗组改善痤疮的总体疗效明显优于对照组。在阳虚体质改善方面,治疗组治疗前后阳虚体质条目平均转化分有显著性差异(P<0.05),对照组治疗前后无明显变化(P>0.05)。两组治疗后体质积分相比,治疗组明显低于对照组(P<0.05),说明治疗组对于患者的阳虚体质状况改善效果优于对照组。研究结论针灸调体治疗与传统对证针刺治疗阳虚体质的痰瘀型痤疮方面均取得了一定的疗效,但通过本研究发现调理体质疗法在临床疗效、改善患者具体症状、体征方面都明显优于传统对证针刺法。因此,调理阳虚体质治疗痰瘀型痤疮更能改善患者症状、体征,扭转病势,从而促进疾病向治愈方向发展,是临床上值得重视、推广的安全而有效的治疗方法。更多还原

【Abstract】 ObjectiveThough this study, to explore the relativities between Yang-deficiency Constitution and the formation of phlegm-stasis congealment of acne, and to observe and make a comparison of two groups of patients with Yang-deficiency Constitutional phlegm-stasis acne in their symptoms and Yang-deficiency Constitution conversion points taken both before and after the treatment. To assess objectively clinical efficacy of treating phlegm-stasis congealment of acne by improving Yang-Deficiency Constitution, and to provide clinical evidence of treating acne by regulating imbalanced constitution.MethodsAdopt randomized control method, randomly divided 61 Yang-deficiency Constitutional phlegm-stasis acne patients into treatmeant group (regulate imbalanced constitution group with 31 patients) and control group (traditional acupuncture group with 30 patients).①Scraping the patient’s back, and then finding two or three parts of the crimson measles by blood-letting and cupping therapy, were applied at the first time treatment.②The damaged-skin lesions were given regional treatment:choosing two to three matured facial pustules or cysts, after sterilization with 75% alcohol, and then, pricking with size-5 injection needle and pressing with two cotton swabs are to get out of the pustules or fat emboli, pus, stagnant blood of cysts. Using iodineⅢis to disinfect the damaged-skin lesions which had been given regional treatment finally.This treatment was given one time each week.③Two groups were given the traditional differentiation acupoints respectively:Zhongwan (RN12),Zusanli (ST36),Quchi (LI11), Fenglong (ST40), Xuehai (SP10),Geshu (BL17) (bilateral parts of body). These acupoints were not cauterized, but needle punching.④Treatment group plus regulating imbalanced constitution points:Shenque (RN8), Guanyuan (RN4),Qihai (RN6),Pishu (BL20), Shenshu (BL23) (the latter two are bilateral parts of body). Moxibustion on salt and ginger was used on Shenque (RN8). Guanyuan (RN4) and Shenshu (BL23) or Qihai (RN6) and Pishu (BL20) were dealt with Warming Needle Moxibustion alternately. All the patients were given treatment three times every week, with every other day. One month as a course, and courses of treatment lasted for three months. Overall efficacy was observed after three courses. SPSS 13.0 software packages were used to analysis all the data. Count data was analyzed by Chi-Square Test, measurement data by T-test, and level data by Non-parametric test.ResultsTotal effective rate of the treatment group was 93.10%, and it was 71.43% in the control group. There was statistical significant difference between the two groups (P<0.05). Improvement of damaged-skin lesions:the treatment group and the control group were significantly reduced damaged-lesion integration compared before and after treatment from GAGS. It was a significant difference between the two (P<0.05), which meant that the constitution-regulating treatment made patients’damaged-skin lesions improved. In conversion points of Yang-deficiency Constitution items, constitution integration decreased significantly in the treatment group (P<0.05),but didn’t decrease significantly in the control group(P>0.05). There was a statistical difference within the treatment group itself (P<0.05), compared the integrals before and after the treatment. Conversion points of the two groups were compared, and there was significant difference between them (P<0.05), which meant that the constitution-regulating treatment made patients’constitution improved.ConclusionBoth the treatment and the control group got satisfying therapeutic effects, but the treatment group worked better in improving symptoms, physical signs of the phlegm-stasis congealment acne patients, so as the yang-deficiency Constitution meliorated. Accordingly, the constitution-regulating therapy reacted on the patients’phlegm-stasis congealment acne changes so that to improve symptoms and physical signs. Yang-deficiency constitution-regulating therapy could turn the tide and was an effective, safe therapy to cure phlegm-stasis congealment of acne.更多还原