根据“以痛为腧”理论对肱二头肌长头肌腱炎针刺方案选择的研究

Study on Acupuncture Scheme Selection of Myotenositis of Long Head of Biceps Brachii Based on “Acupuncture at Pain Points”

目的根据"以痛为腧"理论,以视觉模拟评分法(VAS)及肩关节疾患治疗成绩判定标准(JOA)评分作为观察指标,观察传统针刺部位、阿是穴及经B超精确定位损伤部位3种针刺方案的疗效。方法选取江苏省中医院针灸康复科门诊就诊患者,随机分为传统针刺组、阿是穴组、B超定位针刺组,每组15例,共45例患者。分别选择传统针刺部位、阿是穴、B超定位损伤部位进行针刺治疗,每日1次,每周5次,10次为一个疗程,共观察2个疗程。结果 VAS评分:患者治疗后即时,传统针刺组与B超定位针刺组比较有统计学差异(P <0. 05);第1、第2疗程结束后,传统针刺组与其他2组比较皆有统计学差异(P <0. 05)。JOA评分:患者治疗后即时,传统针刺组与B超定位针刺组比较有统计学差异(P <0. 05);第1疗程结束后,传统针刺组与其他2组比较皆有统计学差异(P <0. 05);第2疗程结束后,传统针刺组与B超定位针刺组比较有统计学差异(P <0. 05)。结论阿是穴及B超定位损伤部位针刺,在缩短治疗周期,改善患者疼痛症状,改善关节活动度,改善肌力、耐久力及日常生活动作等功能方面较传统针刺方案有优势,B超定位损伤部位针刺方案在改善疼痛及日常生活动作等功能方面优势更为明显,而阿是穴在改善关节活动度方面要更有优势。

Objective According to the theory of"acupuncture at pain points",the therapeutic effects of three kinds of acupuncture schemes,i.e.traditional acupuncture,Ashi acupoints and B-mode ultrasonography,were observed by using visual analogue scale(VAS)and JOA score as observation indexes.Methods The outpatients of acupuncture and rehabilitation department of Jiangsu Province Hospital of Traditional Chinese Medicine were randomly divided into three groups as follows:traditional acupuncture group,Ashi acupoints group and B-mode ultrasound-guided acupuncture group.There were 15 patients in each group,with a total of 45 patients.Traditional needling sites,Ashi acupoints and B-mode ultrasound localized injured sites were selected for acupuncture treatment,once a day,five times a week,10 times a course of treatment,a total of two courses of treatment were observed.Results In terms of VAS score,immediately after treatment,there were significant differences between the traditional acupuncture group and the B-ultrasound-guided acupuncture group(P<0.05),after the first and second courses,there were significant differences between the traditional acupuncture group and the other two groups(P<0.05).In terms of JOA score,immediately after treatment,there was a statistical difference between the traditional acupuncture group and the B-ultrasound-guided acupuncture group(P<0.05),after the first course of treatment,there was a statistical difference between the traditional acupuncture group and the other two groups(P<0.05),and after the second course of treatment,there was a statistical difference between the traditional acupuncture group and the B-ultrasound-guided acupuncture group(P<0.05).Conclusion Acupuncture at Ashi acupoints and injured area by B-mode ultrasound has advantages over traditional acupuncture in shortening treatment period,improving pain symptoms of patients,improving joint mobility,improving muscle strength,endurance and daily activities.Acupuncture scheme for locating injured parts by B-mode ultrasound has more advantages in improving pain and daily activities,while Ashi acupoints has more advantages in improving joint mobility.