隔盐灸配合温针灸治疗虚证良性前列腺增生症的临床研究

发布时间：2018-05-15 21:16

本文选题：前列腺增生症 + 对照研究　；参考：《第二军医大学》2016年硕士论文

【摘要】：研究背景:良性前列腺增生症(benign prostatic hyperplasia,BPH)是中老年男性常见的泌尿外科疾病之一,通常表现为前列腺的体积增大及下尿路症状(lower urinary tract symptoms,LUTS)。BPH的治疗方法目前主要有保守治疗和手术治疗两种,但两种治疗方法均存在很多不足,急需探索更加有效、安全、方便的治疗方法。针灸对于缓解下尿路症状有很好的疗效,但缺乏严格的临床研究结论,治疗方法可重复性差,规范性差,标准化程度低,极大地影响了针灸方法的推广发展。目的:探讨神阙穴隔盐灸配合温针灸治疗BPH的有效性和安全性。并通过临床实验设计为中医针灸疗法提供规范与标准化的治疗依据。方法:采用前瞻性、随机、对照研究,选取50岁以上良性前列腺增生症患者作为研究对象,受试者均来自长海医院中医针灸门诊、泌尿科门诊就诊患者,共观察90例。采用神阙穴隔盐灸配合三阴交穴温针灸治疗良性前列腺增生症为治疗组,以单纯西药(非那雄胺组、盐酸坦洛新缓释胶囊)组为对照。治疗组每日予以针灸治疗1次,每周连续治疗5天,休息2天。对照组按常规剂量每日用药。以上各组均以4周作为1个疗程,3个疗程后记录各组的疗效。主要测量指标:前列腺体积、最大尿流率、平均尿流率、国际前列腺症状评分、生活质量评分、残余尿量、尿常规、中医症候、病情轻重分级等。结果:治疗组显愈率66.67%;能明显改善前列腺增生患者临床症状,残余尿量改善优于西药,前列腺体积的缩小疗效与非那雄胺片相当;起效期短与盐酸坦洛新缓释胶囊近似;治疗前后临床主要测量指标(夜尿次数、I-PSS评分、QOL评分、Qmax、残余尿量)差异有统计学意义(P0.001),治疗效果优于或等同于对照组,没有明显不良反应。结论:1、神阙穴隔盐灸配合温针灸能够有效缓解良性BPH的临床症状;2、针灸起效较快,患者夜尿次数减少,明显改善BPH患者生活质量;3、针灸对前列腺体积缩小疗效与非那雄胺片相当;4、副作用小,是一种安全的疗法。因此,本研究通过临床对照的方法,证明隔盐灸配合三阴交温针灸治疗具有针对良性前列腺增生的广阔前景。
[Abstract]:Background: benign prostatic hyperplasia (BPH) is one of the most common urological diseases in middle-aged and elderly men. At present, the main treatment methods of lower urinary tract symptomsof LUTSU. BPH are conservative treatment and surgical treatment. However, there are many deficiencies in the two treatment methods, so it is urgent to explore more effective and safe treatment methods. A convenient treatment. Acupuncture and moxibustion have good effect on relieving lower urinary tract symptoms, but lack of strict clinical research conclusion, poor repeatability, poor standardization and low standardization of treatment methods, which greatly affect the popularization and development of acupuncture and moxibustion methods. Objective: to explore the efficacy and safety of shenque point salt-separated moxibustion combined with warm acupuncture in the treatment of BPH. And through the clinical experiment design to provide the standard and standardized treatment basis for the acupuncture and moxibustion therapy of traditional Chinese medicine. Methods: a prospective, randomized, controlled study was conducted in 90 patients with benign prostatic hyperplasia (BPH) over 50 years of age. The subjects were all from the clinic of acupuncture and moxibustion of traditional Chinese medicine and the outpatient department of urology of Changhai Hospital. The treatment group of benign prostatic hyperplasia was treated with shenque point salt-separated moxibustion combined with Sanyinjiao point warming acupuncture and moxibustion, and the control group was treated with only western medicine (fenasteride group, Tanluoxin hydrochloride sustained release capsule) group. The treatment group was treated with acupuncture and moxibustion once a day, 5 days a week, rest for 2 days. The control group was treated daily with routine dosage. All the above groups took 4 weeks as a course of treatment. After 3 courses of treatment, the curative effect of each group was recorded. Main outcome measures: prostate volume, maximum flow rate, mean flow rate, international prostate symptom score, quality of life score, residual urine volume, routine urethra, TCM symptoms, severity of the disease and so on. Results: in the treatment group, the apparent recovery rate was 66.67%, the clinical symptoms of the patients with prostatic hyperplasia were significantly improved, the residual urine volume was improved better than that of western medicine, the reduction effect of prostate volume was similar to that of fenasteride tablets, the short effective period was similar to that of Tanluoxin hydrochloride sustained-release capsule. Before and after treatment, there were significant differences in the main clinical measures (nocturnal urine frequency, I-PSS score, QOL score, Qmaxand residual urine volume). The therapeutic effect was better than or equal to that of the control group, and there was no obvious adverse reaction. ConclusionThe salt-separated moxibustion at Shenque point combined with warm acupuncture can effectively alleviate the clinical symptoms of benign BPH, acupuncture and moxibustion can take effect quickly, and the times of nocturnal urine of the patients are decreased. The effect of acupuncture and moxibustion on the reduction of prostate volume is equivalent to that of fenasteride tablets, and the side effect is small. It is a safe treatment. Therefore, this study proved that salt-separated moxibustion combined with Sanyinjiao warming acupuncture has a broad prospect for benign prostatic hyperplasia.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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