【作者】 刘丹；

【导师】 李敏；

【作者基本信息】 广州中医药大学 ， 针灸推拿学（专业学位）， 2018， 硕士

【摘要】 目的:观察比较隔药盐灸神阙穴结合常规针刺与常规针刺两种方法治疗慢性泄泻(脾肾阳虚型)的临床疗效,初步探讨隔药盐灸神阙穴结合常规针刺治疗慢性泄泻(脾肾阳虚)的优势,旨在探索行之有效的治疗方案,从而更好的应用于临床,减轻患者的痛苦。方法:选取广东省第二中医院脾胃科门诊及病房中符合纳入标准的患者纳入研究,通过随机对照试验方法对纳入研究的60例慢性泄泻(脾肾阳虚型)患者进行分组,按1:1的比例随机分为观察组(隔药盐神阙穴组)30例与对照组(常规针刺组)30例。对照组选取天枢、足三里、上巨虚、三阴交、命门、脾俞、肾俞、大肠俞进行常规针刺,除命门外,所有穴位均取双侧。观察组在对照组的基础上加用隔药盐灸神阙穴,药盐采用吴茱萸研末成粉同精细炒盐混合而成,两组患者均隔日治疗1次,以4周为1个疗程。观察两组治疗前后中医症状积分及疗效变化,运用SPSS19.0进行统计学分析。结果:1治疗前两组患者的年龄、性别、病程、中医症状积分均无统计学意义,具有可比性(P>0.05)。2、两组患者在治疗后的中医症状总积分及单症状积分较治疗前比较,均P<0.05,具有统计学意义,提示观察组与对照组均能改善患者腹痛、大便泄泻、形寒肢冷、腰膝酸软、肠鸣、饮食减少、乏力等临床症状。3、两组患者疗程结束后,隔药盐灸神阙穴观察组患者中医症状总积分及单症状积分均优于常规针刺对照组,均P<0.05,具有统计学意义,提示观察组在改善腹痛、大便泄泻、形寒肢冷、腰膝酸软、肠鸣、饮食减少、乏力等临床症状方面优于对照组。4、在总体疗效上,两组总疗效比较差异具有统计学意义(P<0.05),隔药盐灸神阙穴组总有效率为93.3%,常规针刺组的总有效率为66.7%。结论:隔药盐灸神阙穴组和常规针刺组两组的治疗方法均能有效改善慢性泄泻(脾肾阳虚型)的临床症状,但总体疗效上,隔药盐灸神阙穴组疗效更好,更特别的突出了隔药盐灸神阙穴治疗慢性泄泻(脾肾阳虚型)的临床疗效,可在临床上加以推广。更多还原

【Abstract】 Objective:To observe the clinical effect of two kinds treating Yang Deficiency of Spleen and Kidney Type’s Diarrhea by Moxibustion with Chinese herbal medicine and salt at Shenque acupoint combined with acupuncture,and compared with acupuncture,to discuss the advantage of the method and explore the effective treatments,so doctors could make better clinical services and greater ease the suffer of patients.MethodsAll cases in the research are from the department of spleen and stomach ward of the second central hospital of Guangdong Province.60 cases which are meeting study criteria are randomly divided into observation group 30 cases and control group 30 cases in clinic order with Excel,the observation group30 cases were given Moxibustion with Chinese herbal medicine and salt at Shenque acupoint combined with acupuncture,while the control group 30 cases were given acupuncture.The master points of the control group include tianshu,zusanli,shangjuxu,sanyinjiao,mingmen,pishu,shenshu and dachangshu.All the points were selected on both sides except mingmen point and given acupuncture.The ones in the control group were given acupuncture,while the ones in the observation group were added Moxibustion with Chinese herbal medicine and salt at Shenque acupoint based on the treatment of the control group.The herbal medicine salt was made from the powder of wuzhuyu and salt.The two groups were treated every other day at a time and four weeks is a course of treatment,observe the two groups before and after treatment of TCM syndrome integrals and the total clinical efficacy.The data was analyzed by SPSS19.0.Results1.The age,sex,course of disease and TCM syndrome integrals before treatment were statistically significant(P>0.05).2.Total TCM syndrome integrals and single TCM syndrome integral of the two groups after the end of treatment compared with before treatment were P<0.05,statistically significant.This suggested both groups could improve clinical symptoms such as abdominal pain,diarrhea,cold limbs cold,soreness and weakness of waist and knees,borborygmus,eating less,lacking in strength.3.After the end of treatment,Total TCM syndrome integrals and single TCM syndrome integral of the observation group were better than those of the control group.The difference between the two groups was statistically significant(P<0.05).This suggested the observation group was superior to single acupuncture in improving clinical symptoms such as abdominal pain,diarrhea,cold limbs cold,soreness and weakness of waist and knees,borborygmus,eating less,lacking in strength.4.In terms of overall efficacy,the difference between the two groups was statistically significant(P<0.05),the total effective rate of the observation group was 93.3% and the total effective rate of the control group was 66.7%.ConclusionThe two groups of Moxibustion with Chinese herbal medicine and salt at Shenque acupoint combined with acupuncture and acupuncture on treating Yang Deficiency of Spleen and Kidney Diarrhea both have good curative effect.Look from total clinical result,we can think Moxibustion with Chinese herbal medicine and salt at Shenque acupoint combined with acupuncture is superior to single acupuncture,explaining the method of Moxibustion with Chinese herbal medicine and salt at Shenque acupoint combined with acupuncture on treating Yang Deficiency of Spleen and Kidney Type’s Diarrhea is more particularly prominent,so it deserved applying and promoting in clinical work.更多还原