CAJ | 학술논문

背景:疼痛症在临床上极为常见,目前应用针灸治疗具有较好的效果.然而针灸疗法方法甚多,各有所长,认识不同针法对疼痛症治疗的疗效差异,在临床上具有重要意义.1999年,应厄瓜多尔医学疼痛学会的要求,开展此项观察.目的:观察不同针法对不同疾病疼痛症的疗效差异.设计:随机对照观察.单位:厄瓜多尔三军总医院疼痛科,成都军区总医院中医科、外一科.对象:选择1999-05/2000-11厄瓜多尔三军总医院疼痛科门诊腰肌劳损、增生性脊柱炎患者360例,其中腰肌劳损179例,增生性脊柱炎181例.随机对两类疾病患者进行分组,即腰肌劳损皮肤针组88例,体针组91例;增生性脊柱炎皮肤针组92例,体针组89例.方法:分别运用皮肤针、体针对上述疾病患者进行治疗,并同时对治疗前后患者症状加以观察.隔日治疗1次,腰肌劳损5次为基本疗程,增生性脊柱炎则为7次.治疗结果按Budzynski疼痛分级标准进行评定,统计方法采用MEPS统计软件处理数据.主要观察指标:皮肤针、体针组对腰肌劳损、增生性脊柱炎治疗前后患者疼痛症状缓解情况,并对同种疗法治疗异病、不同疗法治疗同病的疗效、疗程进行相关分析.结果:观察病例366例,剔除病例6例,实际完成完整病例360例.①皮肤针、体针疗法治疗后患者的疼痛分级均较治疗前减轻(P＜0.01).②皮肤针对腰肌劳损、增生性脊柱炎治疗,以腰肌劳损疗效明显(P＜0.01);皮肤针对腰肌劳损治疗疗效优于体针组(P＜0.05).③体针组增生性脊柱炎疼痛分级Ⅰ级者明显高于皮肤针组,但总疗效差异不显著(P＞0.05).④两组患者疼痛分级减少1个等级时,平均治疗次数皮肤针组少于体针组(P＜0.05).结论:皮肤针与体针对增生性脊柱炎、腰肌劳损两类疾病疼痛症的治疗上,均有较好疗效,其中,以皮肤针对软组织损伤疗效明显,且起效迅速;体针对增生性脊柱炎患者疼痛改善上较皮肤针更为彻底. 揹景:疼痛癥在臨床上極為常見,目前應用針灸治療具有較好的效果.然而針灸療法方法甚多,各有所長,認識不同針法對疼痛癥治療的療效差異,在臨床上具有重要意義.1999年,應阨瓜多爾醫學疼痛學會的要求,開展此項觀察.目的:觀察不同針法對不同疾病疼痛癥的療效差異.設計:隨機對照觀察.單位:阨瓜多爾三軍總醫院疼痛科,成都軍區總醫院中醫科、外一科.對象:選擇1999-05/2000-11阨瓜多爾三軍總醫院疼痛科門診腰肌勞損、增生性脊柱炎患者360例,其中腰肌勞損179例,增生性脊柱炎181例.隨機對兩類疾病患者進行分組,即腰肌勞損皮膚針組88例,體針組91例;增生性脊柱炎皮膚針組92例,體針組89例.方法:分彆運用皮膚針、體針對上述疾病患者進行治療,併同時對治療前後患者癥狀加以觀察.隔日治療1次,腰肌勞損5次為基本療程,增生性脊柱炎則為7次.治療結果按Budzynski疼痛分級標準進行評定,統計方法採用MEPS統計軟件處理數據.主要觀察指標:皮膚針、體針組對腰肌勞損、增生性脊柱炎治療前後患者疼痛癥狀緩解情況,併對同種療法治療異病、不同療法治療同病的療效、療程進行相關分析.結果:觀察病例366例,剔除病例6例,實際完成完整病例360例.①皮膚針、體針療法治療後患者的疼痛分級均較治療前減輕(P＜0.01).②皮膚針對腰肌勞損、增生性脊柱炎治療,以腰肌勞損療效明顯(P＜0.01);皮膚針對腰肌勞損治療療效優于體針組(P＜0.05).③體針組增生性脊柱炎疼痛分級Ⅰ級者明顯高于皮膚針組,但總療效差異不顯著(P＞0.05).④兩組患者疼痛分級減少1箇等級時,平均治療次數皮膚針組少于體針組(P＜0.05).結論:皮膚針與體針對增生性脊柱炎、腰肌勞損兩類疾病疼痛癥的治療上,均有較好療效,其中,以皮膚針對軟組織損傷療效明顯,且起效迅速;體針對增生性脊柱炎患者疼痛改善上較皮膚針更為徹底.
배경:동통증재림상상겁위상견,목전응용침구치료구유교호적효과.연이침구요법방법심다,각유소장,인식불동침법대동통증치료적료효차이,재림상상구유중요의의.1999년,응액과다이의학동통학회적요구,개전차항관찰.목적:관찰불동침법대불동질병동통증적료효차이.설계:수궤대조관찰.단위:액과다이삼군총의원동통과,성도군구총의원중의과、외일과.대상:선택1999-05/2000-11액과다이삼군총의원동통과문진요기로손、증생성척주염환자360례,기중요기로손179례,증생성척주염181례.수궤대량류질병환자진행분조,즉요기로손피부침조88례,체침조91례;증생성척주염피부침조92례,체침조89례.방법:분별운용피부침、체침대상술질병환자진행치료,병동시대치료전후환자증상가이관찰.격일치료1차,요기로손5차위기본료정,증생성척주염칙위7차.치료결과안Budzynski동통분급표준진행평정,통계방법채용MEPS통계연건처리수거.주요관찰지표:피부침、체침조대요기로손、증생성척주염치료전후환자동통증상완해정황,병대동충요법치료이병、불동요법치료동병적료효、료정진행상관분석.결과:관찰병례366례,척제병례6례,실제완성완정병례360례.①피부침、체침요법치료후환자적동통분급균교치료전감경(P＜0.01).②피부침대요기로손、증생성척주염치료,이요기로손료효명현(P＜0.01);피부침대요기로손치료료효우우체침조(P＜0.05).③체침조증생성척주염동통분급Ⅰ급자명현고우피부침조,단총료효차이불현저(P＞0.05).④량조환자동통분급감소1개등급시,평균치료차수피부침조소우체침조(P＜0.05).결론:피부침여체침대증생성척주염、요기로손량류질병동통증적치료상,균유교호료효,기중,이피부침대연조직손상료효명현,차기효신속;체침대증생성척주염환자동통개선상교피부침경위철저.
BACKGROUND:Pain is the extremely common disease in clinic. At present, acupuncture provides good therapeutic effect on it. But, there are many methods in acupuncture with various advantages individually.To understand the differences in therapeutic effects on pain with various needling techniques is significant in clinic. In 1999, the relevant observation was carried on in the demand of Ecuadorian Medical Pain Association.OBJECTIVE: To observe the differences in therapeutic effects on pain with various needling techniques.DESIGN: Randomized controlled observation was designed.SETTING: Department of Pain, Hospital General de las FF. AA. Quito, Ecuador, Department of Traditional Chinese Medicine and 1st Department of Surgery, General Hospital of Chengdu MilitaryArea Command of Chinese PLA.PARTICIPANTS: Totally 360 cases of lumber strain and hyperplastic spondylitis were selected in Department of Pain, Clinic of Ecuadorian 3rd Military General Hospital from May 1999 to November 2000, in which,179 cases were lumber strain and 181 cases were hyperplastic spondylitis.The groups were randomized in two kinds of diseases, named for lumber strain, dermal-needling group (88 cases) and body-acupuncture group (91cases); for hyperplastic spondylitis, dermal-needling group (92 cases) and body-acupuncture group (89 cases).METHODS: Dermal needling and body acupuncture were used to treat the diseases respectively and the symptom changes were observed before and after treatment simultaneously. The treatment was given once every two days. 5 treatments made one basic course for lumber strain and 7 treatments for hyperplastic spondylitis. The treating results were evaluated according to Budzynski grading criteria on pain. MEPS statistical software was used for statistical management of data.MAIN OUTCOME MEASURES: Pain relieving before and after treatment with dermal needling and body acupuncture for lumber strain and hyperplastic spondylitis was evaluated. Correlative analysis on therapeutic effects and course of treatment for different diseases with same therapy and on same disease with different therapies were carried on.RFSULTS: Altogether 366 cases were observed and 6 of them were excluded. Totally, 360 cases finished the experiment. ① The severity was alleviated in pain grading after treatment with dermal needling and body acupuncture compared with that before the treatment (P ＜ 0.01). ② In treatment of lumber strain and hyperplastic spondylitis with dermal needling, the therapeutic effects on lumber strain were more remarkable (P ＜ 0.01). The therapeutic effects of dermal needling on lumber strain were superior to that of body acupuncture (P ＞ 0.05). ③ The therapeutic effects of body acupuncture group on pain of Ⅰ grade in hyperplastic spondylitis were remarkably better than that of dermal needling group,but the significant difference in the total therapeutic effects of two techniques did not present (P ＞ 0.05). ④ When pain grading was reduced by 1 level in two groups, the average times of treatment in dermal needling group were less than that in body-acupuncture group (P ＜ 0.05).CONCLUSION: Good therapeutic effects of dermal needling and body acupuncture are achieved for both hyperplastic spondylitis and lumber strain,in which, the therapeutic effects of dermal needling are remarkable on injury of soft tissue and achieved swiftly; body acupuncture improves pain in hyperplastic spondylitis more radically compared with dermal needling.