肩三针温针灸结合穴位敷贴治疗肩周炎的临床研究
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摘要
研究目的：
应用肩三针温针灸结合穴位贴敷治疗肩周炎的临床观察,并对此方法与传统普通针刺疗法对肩周炎的客观疗效进行总结比较,以期对此作出系统、客观、科学的疗效评价,试图探究一个行之有效、经济安全的治疗肩周炎的优佳方法,以减轻患者的痛苦、提高其生活质量,为临床治疗肩周炎提供科学依据。
研究方法：
将53例符合研究要求的肩周炎患者,采用随机数字表法随机分成两组：治疗组(肩三针温针灸结合穴位贴敷组)和对照组(常规针刺组),其中治疗组27例,对照组26例。2组病例患者的病情、病程、年龄等基本情况具有可比性。(1)治疗组取穴：肩三针(肩髃、肩前、肩后),肩前区疼痛较剧烈者,加鱼际、阳陵泉；肩峰端疼痛较剧烈者,加合谷、臂臑；肩胛区及肩后疼痛较剧者,加天宗、后溪。肩三针三穴采用温针灸结合穴位敷贴法,患者取坐位,常规消毒后,医者手持毫针直刺入0.8～1寸,针刺得气后,取约2 cm长的艾条一段,套在针柄之上,艾条的尾端距皮肤2～3cm,留针30分钟后起针,穴位敷贴每次针灸后操作。其余各穴采用普通针刺法。(2)对照组取穴：肩髃、肩髎、肩贞、天宗、阿是穴,配穴同治疗组；治疗方法采用普通针刺法。温针灸及普通针刺隔日1次,穴位敷贴每次针灸后操作,嘱患者4小时后自行去除药膏,以上疗法3次为一疗程,治疗4个疗程。观察治疗组与对照组之间的临床疗效及两组肩关节疼痛指标的变化及肩关节功能的改善情况。
研究结果：
(1)肩三针温针灸结合穴位贴敷和常规针刺治疗肩周炎都有良好的疗效,治疗组总有效率均为96.3%,对照组总有效率88.46%,两组疗效结果经χ2检验,两组比较P<0.05,表明治疗组采用的方法在提高治愈率方面明显优于对照组疗法。
(2)两组患者治疗前、后肩关节疼痛VAS评分比较,两组患者病例治疗后肩关节疼痛VAS评分均较治疗前有显著降低(P<0.05),治疗组与对照组相比,两组病例的VAS评分有显著差异(P=0.034,P<0.05)。
(3)两组患者治疗前、后肩关节功能评分比较,两组患者病例治疗后肩关节功能评分均较治疗前有显著提高(P<0.05),治疗组与对照组相比,两组病例的肩关节功能评分有显著差异(P=0.0016,P<0.05)。
结论：
(1)本课题研究证明,肩三针温针灸结合穴位敷贴及普通针刺法治疗肩周炎疗效确切,均可有效的缓解肩关节疼痛、改善肩关节功能。
(2)肩三针温针灸结合穴位敷贴组和普通针刺法组两组间的疗效比较,经治疗后,治疗组的VAS评分较对照组显著降低,而治疗组的肩关节功能评分较对照组显著提高,结果表明,肩三针温针灸结合穴位敷贴治疗肩周炎较普通针刺法疗效更佳,值得临床推广应用。
Objective:
To observe the clinical effects of treating scapulohumeral periarthritis by the therapy of warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders, meanwhile to compare the clinical effects of the therapy of Warm Needle-Moxibustion combined with Acupoint Application and conventional acupuncture methods. Try to find a effective, economic and safe way to treat the such patients. The effective method can light the side effect of medical, decrease the recurrence rate, elevate the life quality and survival rate, lessen the patients' economic burden and so on.
Methods:
Fifty-three cases of scapulohumeral periarthritis received the treatment who met the clinical research requirements were randomly divided into two groups, which including Warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders group (Treatment group,27cases), conventional acupuncture group (control group,26cases). The information of the patients of twogroups, such as duration, age and other basic situations have no significant differences. (1) Treatment group Acupoint:three points on the shoulders(Jianyu, Jianqian, Jianhou), if the patients have a more severe pain in the front of the shoulder, take Yuji and Yanglingquan points, if the patients have a more severe pain in the acromion, take Hegu and Binao points, if the patients have a more severe pain in the Scapular area, take Tianzong and Houxi points, The three points on the shoulders take the method of Warm Needle-Moxibustion, the other points take the conventional acupuncture methods. (2)control group Acupoint:Jianyu, Jianliao, Jianzhen, Tianzong, Ashi points. Other points are the same as the treatment group. these points all take the conventional acupuncture methods. The frequency is once 2days, 3 times is one course, the observation time is 4 courses.
Results:
(1) The therapy of warm Needle-Moxibustion combined with Acupoint Application and that of the conventional acupuncture all have good curative effect. The total effective rate is:the warm-needle acupuncture 96.3%; the control group 88.46%.It has the statistically significant(P<0.05), which shows the therapy of warm Needle-Moxibustion combined with Acupoint Application has the best effect.
(2) Diversification in VAS:Compared with scores before the treatment, there were significant differences in VAS in two groups(P<0.05). Compared between the two groups, after 4 courses therapies, there were significant differences in VAS (P=0.034, P<0.05).
(3) Diversification in the score of the function of shoulders:Compared with scores before the treatment, there were significant differences in the function of shoulders in two groups (P<0.05). Compared between the two groups, after 4 courses therapies, there were significant differences in score of the function of shoulders (P=0.0016, P<0.05).
Conclusion:
(1) The two methods of warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders and the conventional acupuncture are effective in treating scapulohumeral periarthritis. Both of them can alleviate pain and improve shoulder function.
(2) The curative effect of the two methods has significant differences between them, that is to say, the method of warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders is more effective than conventional acupuncture.
应用肩三针温针灸结合穴位贴敷治疗肩周炎的临床观察,并对此方法与传统普通针刺疗法对肩周炎的客观疗效进行总结比较,以期对此作出系统、客观、科学的疗效评价,试图探究一个行之有效、经济安全的治疗肩周炎的优佳方法,以减轻患者的痛苦、提高其生活质量,为临床治疗肩周炎提供科学依据。
研究方法：
将53例符合研究要求的肩周炎患者,采用随机数字表法随机分成两组：治疗组(肩三针温针灸结合穴位贴敷组)和对照组(常规针刺组),其中治疗组27例,对照组26例。2组病例患者的病情、病程、年龄等基本情况具有可比性。(1)治疗组取穴：肩三针(肩髃、肩前、肩后),肩前区疼痛较剧烈者,加鱼际、阳陵泉；肩峰端疼痛较剧烈者,加合谷、臂臑；肩胛区及肩后疼痛较剧者,加天宗、后溪。肩三针三穴采用温针灸结合穴位敷贴法,患者取坐位,常规消毒后,医者手持毫针直刺入0.8～1寸,针刺得气后,取约2 cm长的艾条一段,套在针柄之上,艾条的尾端距皮肤2～3cm,留针30分钟后起针,穴位敷贴每次针灸后操作。其余各穴采用普通针刺法。(2)对照组取穴：肩髃、肩髎、肩贞、天宗、阿是穴,配穴同治疗组；治疗方法采用普通针刺法。温针灸及普通针刺隔日1次,穴位敷贴每次针灸后操作,嘱患者4小时后自行去除药膏,以上疗法3次为一疗程,治疗4个疗程。观察治疗组与对照组之间的临床疗效及两组肩关节疼痛指标的变化及肩关节功能的改善情况。
研究结果：
(1)肩三针温针灸结合穴位贴敷和常规针刺治疗肩周炎都有良好的疗效,治疗组总有效率均为96.3%,对照组总有效率88.46%,两组疗效结果经χ2检验,两组比较P<0.05,表明治疗组采用的方法在提高治愈率方面明显优于对照组疗法。
(2)两组患者治疗前、后肩关节疼痛VAS评分比较,两组患者病例治疗后肩关节疼痛VAS评分均较治疗前有显著降低(P<0.05),治疗组与对照组相比,两组病例的VAS评分有显著差异(P=0.034,P<0.05)。
(3)两组患者治疗前、后肩关节功能评分比较,两组患者病例治疗后肩关节功能评分均较治疗前有显著提高(P<0.05),治疗组与对照组相比,两组病例的肩关节功能评分有显著差异(P=0.0016,P<0.05)。
结论：
(1)本课题研究证明,肩三针温针灸结合穴位敷贴及普通针刺法治疗肩周炎疗效确切,均可有效的缓解肩关节疼痛、改善肩关节功能。
(2)肩三针温针灸结合穴位敷贴组和普通针刺法组两组间的疗效比较,经治疗后,治疗组的VAS评分较对照组显著降低,而治疗组的肩关节功能评分较对照组显著提高,结果表明,肩三针温针灸结合穴位敷贴治疗肩周炎较普通针刺法疗效更佳,值得临床推广应用。
Objective:
To observe the clinical effects of treating scapulohumeral periarthritis by the therapy of warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders, meanwhile to compare the clinical effects of the therapy of Warm Needle-Moxibustion combined with Acupoint Application and conventional acupuncture methods. Try to find a effective, economic and safe way to treat the such patients. The effective method can light the side effect of medical, decrease the recurrence rate, elevate the life quality and survival rate, lessen the patients' economic burden and so on.
Methods:
Fifty-three cases of scapulohumeral periarthritis received the treatment who met the clinical research requirements were randomly divided into two groups, which including Warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders group (Treatment group,27cases), conventional acupuncture group (control group,26cases). The information of the patients of twogroups, such as duration, age and other basic situations have no significant differences. (1) Treatment group Acupoint:three points on the shoulders(Jianyu, Jianqian, Jianhou), if the patients have a more severe pain in the front of the shoulder, take Yuji and Yanglingquan points, if the patients have a more severe pain in the acromion, take Hegu and Binao points, if the patients have a more severe pain in the Scapular area, take Tianzong and Houxi points, The three points on the shoulders take the method of Warm Needle-Moxibustion, the other points take the conventional acupuncture methods. (2)control group Acupoint:Jianyu, Jianliao, Jianzhen, Tianzong, Ashi points. Other points are the same as the treatment group. these points all take the conventional acupuncture methods. The frequency is once 2days, 3 times is one course, the observation time is 4 courses.
Results:
(1) The therapy of warm Needle-Moxibustion combined with Acupoint Application and that of the conventional acupuncture all have good curative effect. The total effective rate is:the warm-needle acupuncture 96.3%; the control group 88.46%.It has the statistically significant(P<0.05), which shows the therapy of warm Needle-Moxibustion combined with Acupoint Application has the best effect.
(2) Diversification in VAS:Compared with scores before the treatment, there were significant differences in VAS in two groups(P<0.05). Compared between the two groups, after 4 courses therapies, there were significant differences in VAS (P=0.034, P<0.05).
(3) Diversification in the score of the function of shoulders:Compared with scores before the treatment, there were significant differences in the function of shoulders in two groups (P<0.05). Compared between the two groups, after 4 courses therapies, there were significant differences in score of the function of shoulders (P=0.0016, P<0.05).
Conclusion:
(1) The two methods of warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders and the conventional acupuncture are effective in treating scapulohumeral periarthritis. Both of them can alleviate pain and improve shoulder function.
(2) The curative effect of the two methods has significant differences between them, that is to say, the method of warm Needle-Moxibustion combined with Acupoint Application at three points on the shoulders is more effective than conventional acupuncture.
引文
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