远近取穴透天凉针法干预阑尾炎性包块临床研究

A Clinical Research on Intervention in Appendix Inflammatory Mass by Heavenly Cool-inducing Technique Adopted Distant and Neighboring Point Selection

目的探讨透天凉针法远、近部取穴治疗阑尾炎性包块临床疗效及其差异性。方法将80例阑尾炎性包块证属肠痈热毒者采用随机数字表法随机分为对照组、远部组、近部组及联合组各20例。对照组予西医常规治疗,远部组(合谷、阑尾)、近部组(阿是穴、右侧天枢)及联合组(前两者相加)在对照组基础上在不同腧穴施予透天凉针法,共治疗14 d。各组于治疗前后分别测量阑尾炎性包块最长径及三维体积,检测血清白细胞、C-反应蛋白(CRP)水平,评价临床疗效。结果与治疗前比较,各组包块最长径、三维体积、白细胞及CRP均降低,且远部组、近部组及联合组均低于对照组,联合组最低(P<0.05,P<0.01),远部组、近部组比较差异无统计学意义(P>0.05)。远部组、近部组及联合组无效病例数皆少于对照组,联合组无效病例最少(P<0.05,P<0.01),远部组、近部组比较差异无统计学意义(P>0.05)。结论透天凉针法治疗阑尾炎性包块疗效显著,远近配穴较远、近部单独取穴疗效更优。

Objective To study the clinical efficacy and the difference of intervention in appendix inflammatory mass by heavenly cool-inducing technique adopted distant and neighboring point selection. Methods Eighty patients of the appendix inflammatory mass with toxic heat syndrome were randomly divided into control group, distant point selection group, neighboring point selection group, and combined group, 20 cases in each group. The control group adopted the conventional western medicine treatment. On the basis of control group, the rest 3 acupuncture groups adopted the heavenly cool-inducing technique for 14 d. The distant point selection group chose Hegu point and Lanwei point;the neighboring point selection group chose Ashi point and Tianshu point （right）;the combined group put them together. The longest diameter and three-dimensional volume of inflammatory mass were determined before and after treatment. The serum levels of white blood cells, C-reactive protein were determined at the same time, and then the clinical effective was estimated. Results The longest diameter, three-dimensional volume of inflammatory mass, the serum levels of white blood cells, and C-reactive protein of patients in 4 groups were reduced after treatment. The above indicators in patients of 3 acupuncture groups were lower than the ones in control group, the indicators in combined group were the lowest （P〈0.05, P〈0.01）, and there was no difference between distant and neighboring point selection groups （P〉0.05）. The invalid number of cases in 3 acupuncture groups were fewer than the one in control group, and the indicators in combined group were fewest （P〈0.05, P〈0.01）, with no difference between distant and neighboring point selection groups （P〉0.05）. Conclusion There is obvious therapeutic efficacy of heavenly cool-inducing technique to appendix inflammatory mass, while the combination of distant and neighboring point selection is better than the single methods.