【作者】 偶鹰飞；

【导师】 李艳慧；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2012， 硕士

【摘要】 目的：客观评价天灸疗法治疗非急性期虚证哮喘的临床疗效,比较辨证取穴组及常规取穴组的疗效优劣,探讨天灸疗法辨证取穴治疗该病的临床价值及推广意义。方法：采用随机对照的研究方法,将符合纳入标准的60例非急性期哮喘患者分为辨证取穴组(试验组)与常规取穴组(对照组),试验组按辨证取穴,对照组按附院天灸常规取穴。两组患者均在初伏、中伏、末伏各治疗一次,共治疗三次。采用哮喘病人生存质量评定表(AQLQ)、哮喘控制测试量表(ACT)及哮喘症状积分表进行疗效评价,分别于治疗前、治疗后(完成三次三伏天灸治疗)及6个月后随访三个时间点进行量表评定。结果：两组患者治疗前基线资料比较,经统计学分析具有可比性(P>0.05)。经三次三伏天灸治疗,试验组治疗后与治疗前比较,AQLQ积分、ACT积分提高,哮喘症状积分降低,差异均有统计学意义(P<0.01),6个月后与治疗后比较,AQLQ积分、ACT积分有所下降,哮喘症状积分有所升高,差异均有统计学意义(P<0.01),但6个月后与治疗前比较,AQLQ积分、ACT积分仍然提高,哮喘症状积分仍然降低,差异均有统计学意义(P<0.01),对照组治疗后与治疗前比较,AQLQ积分、ACT积分提高,哮喘症状积分降低,差异均有统计学意义(P<0.01),6个月后与治疗后比较,AQLQ积分、ACT积分下降,哮喘症状积分升高,差异均有统计学意义(P<0.01),6个月后与治疗前比较,AQLQ积分、ACT积分虽有提高,哮喘症状积分虽有降低,但差异均无统计学意义(P>0.05),不同评定时间,AQLQ积分、ACT积分、哮喘症状积分两组间变化趋势比较,差异均有统计学意义(P<0.05)。提示试验组与对照组均能提高非急性期哮喘患者生存质量、控制哮喘发作,缓解哮喘症状,但试验组疗效优于对照组,且试验组的疗效维持时间长于对照组。结论：针对非急性期虚证哮喘患者,辨证取穴与常规取穴均能提高哮喘病人生存质量,控制哮喘发作,缓解哮喘症状,但相比常规取穴,辨证取穴效果更优,疗效维持时间更长,同时辨证取穴也符合了中医学辨证论治基本特点,故当大力提倡并应用于临床。更多还原

【Abstract】 ObjectiveObjective evaluation of the clinical efficacy of Tianjiu Therapy on asthma with deficient syndrome in non-acute phase. By comparing the Dialectical Acupoints Group with the Conventional Acupoints Group, we explore the clinical value and the significance of popularization of the Tianjiu Therapy on this disease by Acupoints selection based on symdrome differentiation.MethodAdopting random and compared research methods, sixty cases that met the inclusion criteria are divided into two groups, Symdrome Different Acupoints Group(Experimental Group) and Conventional Acupoints Group(Control Group). The Experimental Group selected acupoints based on symdrome differentiation, while the Control Group selected acupoints according to conventional acupoints of affiliated hospital. All patients in the two groups were treated three times, each treatment in Chufu, Zhongfu, Mofu. To evaluat the efficacy We adopted the Asthma Quality of Life Questionnaire, the Asthma Control Test and the Sympt-om of Asthma score, then filled the scales at the time of Before-treatment, After-treatment, complete three treatments, and Six-months-after-treatment.ResultsBaseline data of the two groups before treatment were comparable(P>0.05) by statistical analysis. After three treatments by Sanfu Tianjiu Therapy, Afte-r-treatment of Experimental Group compared with Before-treatment, the AQLQ score and ACT score were higher, the Symptom of Asthma score was lower, the differences were statistically significant (P<0.01), Six-months-after-treatm-ent compared with Afer-treatment, the AQLQ score and ACT score were decreased, the Symptom of Asthma score was increased, the differences were statistically significant (P<0.01), but Six-months-after-treatment compared with Before-tr eatment, the AQLQ score and ACT score were still higher, the Symptom of Asthma score was still lower, the differences were statistically significant (P<0.01), while Afer-treatment of Control Group compared with Before treatment, the AQLQ score and ACT score were higher, the Symptom of Asthma score was lower, the differences were statistically significant (P<0.01), Six-months-after-treat-ment compared with Afer-treatment, the AQLQ score and ACT score were decreased, the Symptom of Asthma score was increased, the differences were statistically significant (P<0.01), Six-months-after-treatment compared with Be fore-treatm-ent, although the AQLQ score and the ACT score were higher, the Symptom of Asthma score was lower, the differences were not statistically significant (P>0.05). Compared with different assessments,the differences between the two groups of the improvement trends of AQLQ score, ACT score and the Symptom of Asthma score were statistically significant (P<0.05). Those suggested that both the Experimental Group and Control Group can improve the AQLQ score and ACT score, reduce the Symptom of Asthma score. Hower, Experimental Group is better than Control Group, and the efficacy of Experimental Group was maintained longer than Control Group.ConclusionFor asthma patients with deficient symdrome in non-acute phase, both the Acupoints Selection based on symdrome differentiation and Acupoints Selection based on convention can significantly improve patients’life quality, enhance asthma control, and ease asthma symptoms. But the efficacy of Acupoints select-ion based on symdrome differentiation is better and maintained longer than the_Acupoints Selection based on convention, while Acupoints Selection based on symdrome differentiation is in line with the basic characteristics of the TCM, which is called treatment based on symdrome diffentiation. So, it should be strongly advocated and used in the clinical.更多还原