【作者】 杨帆；

【导师】 王丽芹；

【作者基本信息】 黑龙江中医药大学 ， 护理（专业学位）， 2023， 硕士

【摘要】 目的:本研究在中西医理论的指导下,通过尝试热敏灸联合针刺的治疗方法,以期提高脑卒中患者下肢深静脉血栓的临床疗效,改善患者的预后。方法:本研究采用便利抽样法选取符合纳入标准的脑卒中后下肢深静脉血栓(血瘀湿重证)病人66例,随机分成对照组、试验组两组。对照组患者给予常规针刺治疗及护理;试验组在对照组的基础上加以热敏灸治疗,每日1次,连续灸5日,休息1日,每次灸疗总时长不超过30分钟,10次为一个疗程,共治疗两个疗程。应用VCSS(venous clinical severity score,VCSS)评分表、Villalta评分表、症状量化评分表,D2聚体指标对两组患者干预前和干预两个疗程后下肢深静脉血栓症状,体征的改变进行评价,综合评价两种治疗方案对脑卒中患者下肢深静脉血栓的临床疗效,运用统计学软件SPSS26.0对收集的数据进行分析。结果:1.干预前对两组患者基本资料、VCSS评分、Villalta评分、症状量化表各项评分、D2聚体指标及总分进行组间比较,经检验两组患者基线资料差异无统计学意义(P>0.05)。2.干预前后对两组患者VCSS评分、Villalta评分、症状量化表各项评分、D2聚体指标及总分进行组内比较,两组患者干预后症状及体征均有改善,D2聚体指标均下降,经检验差异有统计学意义(P<0.05)。3.干预两个疗程后,两组患者VCSS评分、Villalta评分、症状量化表各项评分、D2聚体指标及总分进行组间比较,与干预前相比评分降低(P<0.05),且试验组各项评分结果及D2聚体指标均优于对照组,经检验差异有统计学意义(P<0.05)。4.两组患者临床疗效总有效率分别为78.79%、96.97%,差异有统计学意义(P<0.05)。结论:1.热敏灸联合针刺治疗能有效改善血瘀湿重证患者的临床症状和体征,对患者的下肢功能有一定的改善。2.热敏灸联合针刺组治疗在缓解疼痛、改善水肿及下肢功能方面优于针刺组。3.热敏灸联合针刺组作为治疗下肢深静脉血栓的新方法,近期疗效明显,值得进一步研究和推广。更多还原

【Abstract】 Objective: To improve the clinical efficacy of deep venous thrombosis(DVT)of the lower extremities in stroke patients and enhance their prognosis by using thermal moxibustion in conjunction with post-acupuncture treatment under the guidance of Chinese and Western medical theories.Methods: A convenience sampling method was used to select 66 patients with DVT of the lower extremities(blood stasis and dampness)after stroke.The patients were then randomly divided into two groups: a control group and an experimental group.In the control group,conventional acupuncture treatment and care were provided,while in the experimental group,thermal moxibustion was administered based on the control group,once a day,continuous treatment for five days and take a day off,ten times in a course of treatment and need two courses of treatment,each moxibustion treatment did not exceed 30 hours in duration.In order to evaluate the clinical efficacy of the two treatment regimens on lower limb DVT in stroke patients,the VCSS scale,Villalta scale,symptom quantification scale,D2 polymer index were applied.Both groups were evaluated before and after two courses of intervention for symptoms and signs of lower limb DVT,and the collected data were analyzed using SPSS 26.0 statistical software.Result:1.Basic data,VCSS(venous clinical severity score,VCSS)scores,Villalta scores,quantified symptom scale scores,D2 polymer index and total scores of the two groups were compared before and after the intervention,and it was found the baseline data of the two groups were not statistically significant(P>0.05).2.Intra-group comparisons of VCSS scores,Villalta scores,quantified symptom scale scores,D2 polymer index and total scores were performed before and after the intervention,both groups showed improvement in symptoms and signs after intervention and all the D2 polymers decreased,and it was found that the differences were statistically significant(P< 0.05).3.After two courses of intervention,the VCSS scores,Villalta scores,quantified symptom scale scores,D2 polymer index and total scores of patients were compared between groups,and the scores decreased compared with those before the intervention(P<0.05),all the scores and D2 polymers of the experimental group were better than those of the control group,and the differences were statistically significant(P<0.05).4.The total effective rate of clinical efficacy in the control group and the experimental group was 78.79% and 96.97%,respectively,with statistically significant differences(P<0.05).Conclusions:1.When combined with acupuncture,thermal moxibustion can effectively improve the clinical symptoms and signs of patients suffering from heavy blood stasis and dampness,and enhance the function of their lower extremities.2.In terms of pain relief,improve the edema and lower limb function was superior to the control group.3.As a new technique for treating lower limb DVT,thermal moxibustion combined with acupuncture shows obvious short-term efficacy and deserves further study and promotion.更多还原