Clinical effect of midnight-noon ebb-flow of ear acupoint pressing bean on improving yang-deficiency constitution and clinical curative effect of early threatened abortion with kidney-deficiency syndrome
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摘要:
目的 评价子午流注择时耳穴压豆对肾虚型早期先兆流产患者的阳虚体质和中医证候积分的影响,观察其临床效果,为临床上对该病的治疗提供循证依据。 方法 选取2020年1—9月期间宁波市中医院妇科治疗的70例阳虚体质肾虚型早期先兆流产患者,使用随机数表法将患者分为对照组(35例)与研究组(35例),对照组给予常规中西药物治疗(西药黄体酮注射液20 mg或40 mg肌注+中药寿胎丸加减口服);研究组在常规中西药物治疗基础上给予子午流注择时耳穴压豆。比较2组肾虚型早期先兆流产患者治疗前后的中医体质辨识量表阳虚体质评分及早期先兆流产中医证候积分、阳虚体质改善率及治疗有效率。 结果 研究组阳虚体质评分为(26.77±12.52)分,明显低于对照组[(38.54±13.94)分,t=3.717,P<0.01];研究组中医证候积分为0(0,1),低于对照组[1(0,2),Z=-2.543,P<0.05];研究组阳虚体质改善率、总有效率分别为62.86%、91.43%,显著高于对照组(28.57%、65.71%,χ2=8.289、6.873,均P<0.01)。 结论 子午流注择时耳穴压豆对提高肾虚型早期先兆流产的保胎患者具有较好的疗效,能改善阳虚体质,减轻临床症状,可作为中医外治方法在临床应用与推广。 Abstract:Objective To evaluate the effect of midnight-noon ebb-flow on Yang deficiency constitution and TCM syndrome score of patients with early threatened abortion of kidney deficiency type, observe its clinical effect and provide evidence-based basis for clinical practice. Methods Seventy patients with early threatened abortion with yang and kidney deficiency who were admitted at the Department of Gynecology of Ningbo Municipal Hospital of TCM from January 2020 to September 2020 were selected. Random numbers were generated by SPSS according to the admission sequence number, and patients were randomly divided into the control group (35 cases) and study group (35 cases). The control group was given conventional Chinese and Western medicine treatment (Western medicine: 20 mg progesterone injection or 40 mg intramuscular injection+Chinese medicine Shoutaiwan plus or minus oral), and the study group was given midnight-noon ebb-flow of ear acupoint pressing bean on the basis of conventional Chinese and Western medicine treatment. The scores of Yang deficiency constitution on the TCM Physique Identification Scale, the scores of TCM syndromes of early threatened abortion, the improvement rate of yang deficiency physique and the effective rate of treatment were compared between the two groups before and after treatment. Results The Yang deficiency constitution score of the study group was (26.77±12.52) points, which was significantly lower than that of the control group (38.54±13.94) points (t=3.717, P < 0.01), the median and quartile of TCM syndrome in the study group were 0 (0, 1), which were lower than those in the control group [1(0, 2), Z=-2.543, P < 0.05]. The improvement rate and total effective rate of Yang deficiency physique in the study group were 62.86% and 91.43% respectively, which were significantly higher than those in the control group (28.57% and 65.71%, χ2=8.289 and 6.873, both P < 0.01). Conclusion Midnight-noon ebb-flow of ear acupoint pressing bean at the selected time can improve the constitution of yang deficiency and reduce the clinical symptoms of patients with early threatened abortion of kidney deficiency type. It can be used and promoted as an external treatment method of Chinese medicine. -
表 1 2组阳虚体质肾虚型早期先兆流产患者一般资料比较
Table 1. Comparison of general data between two groups of patients with early threatened abortion of yang-deficiency constitution and kidney-deficiency type
组别 例数 年龄(x±s,岁) 孕周(x±s,周) 流产次数[M(P25, P75), 次] 对照组 35 30.76±4.86 6.36±1.25 2(1,2) 研究组 35 28.84±3.76 6.44±1.94 1(0,1) 统计量 1.849a 0.205a -1.683b P值 0.069 0.838 0.092 注:a为t值,b为Z值。 表 2 2组阳虚体质肾虚型早期先兆流产患者治疗前后阳虚体质评分比较(x±s,分)
Table 2. Comparison of Yang-deficiency constitution scores before and after treatment in two groups of patients with early threatened abortion of Yang-deficiency constitution and kidney-deficiency type (x±s, points)
组别 例数 治疗前 治疗后 t值 P值 对照组 35 55.66±12.82 38.54±13.94 5.247 <0.001 研究组 35 56.69±12.13 26.77±12.52 7.510 <0.001 t值 -0.345 3.717 P值 0.731 <0.001 表 3 2组阳虚体质肾虚型早期先兆流产患者治疗前后中医证候积分比较[M(P25, P75), 分]
Table 3. Comparison of TCM syndrome scores before and after treatment in two groups of patients with early threatened abortion due to Yang-deficiency constitution and kidney-deficiency [M(P25, P75), points]
组别 例数 治疗前 治疗后 Z值 P值 对照组 35 13(4,21) 1(0,2) -3.655 <0.001 研究组 35 12(5,16) 0(0,1) -4.232 <0.001 Z值 -0.694 -2.543 P值 0.488 0.011 表 4 2组阳虚体质肾虚型早期先兆流产患者临床疗效比较
Table 4. Comparison of clinical efficacy of early threatened abortion patients with Yang-deficiency and kidney-deficiency
组别 例数 痊愈(例) 显效(例) 有效(例) 无效(例) 总有效率(%) 对照组 35 17 2 4 12 65.71(23/35) 研究组 35 30 1 1 3 91.43(32/35) 注:2组总有效率比较,χ2=6.873,P=0.009。 -
[1] 罗颂平, 刘雁峰. 中医妇科学[M]. 3版. 北京: 人民卫生出版社, 2016: 170-174.LUO S P, LIU Y F. Gynecology of traditional chinese medicine[M]. 3 Edition. Beijing: People's Medical Publishing House, 2016: 170-174. [2] 李静颖. 600例早期先兆流产患者中医体质类型调查研究[J]. 浙江中医杂志, 2018, 53(6): 401-402. doi: 10.3969/j.issn.0411-8421.2018.06.006LI J Y. Investigation on TCM constitution types of 600 patients with early threatened abortion[J]. Zhejiang Journal of Traditional Chinese Medicine, 2018, 53(6): 401-402. doi: 10.3969/j.issn.0411-8421.2018.06.006 [3] 李静颖, 周建平. 早期先兆流产患者心理自评与中医体质的相关性研究[J]. 中华现代护理杂志, 2019, 25(4): 453-456. doi: 10.3760/cma.j.issn.1674-2907.2019.04.016LI J Y, ZHOU J P. Study on the correlation between psychological self-assessment and TCM constitution in early threatened abortion patients[J]. Chinese Journal of Modern Nursing, 2019, 25(4): 453-456. doi: 10.3760/cma.j.issn.1674-2907.2019.04.016 [4] 张静, 方晓红. 妊娠恶阻患者中医体质与临床证型及耳穴埋豆的干预分析[J]. 中国妇幼保健, 2019, 34(3): 493-495. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201903004.htmZHANG J, FANG X H. The intervention analysis of TCM constitution and clinical syndrome types of patients with malignant obstruction of pregnancy and auricular point embedding[J]. aternal and Child Health Care of China, 2019, 34(3): 493-495. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201903004.htm [5] 谢幸, 苟文丽. 妇产科学[M]. 8版. 北京: 人民卫生出版社, 2013: 47-48.XIE X, GOU WL. Obstetrics and Gynecology[M]. 8 Edition. Beijing: People's Medical Publishing House, 2013, 47-48. [6] 中华中医药学会. 中医体质分类与判定(ZYYXH/T157-2009)[J]. 世界中西医结合杂志, 2009, 4(4): 303-304. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX200904037.htmChina Association of Chinese Medicine. Classification and Determination of Constitution in TCM(ZYYXH/T157-2009)[J]. World Journal of Integrated Traditional and Western Medicine, 2009, 4(4): 303-304. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX200904037.htm [7] 郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 253-258.ZHEN X Y. Guidelines for clinical research on new drugs of traditional Chinese medicine[M]. Beijing: China Pharmaceutical Science and Technology Press, 2002: 253-258. [8] 刘丽春, 王淑敏. 胎漏、胎动不安中医证型与体质的相关性研究[J]. 中医药导报, 2017, 23(4): 105-107. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB201704035.htmLIU L C, WANG S M. Study on correlation between TCM Syndrome types of fetal leakage and dyskinesia and constitution[J]. Guiding Journal of Traditional Chinese Medicine and Pharmacy, 2017, 23(4): 105-107. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB201704035.htm [9] 彭艳, 郭秀蕊, 杨新鸣, 等. 中医体质学说应用于妇科疾病探讨[J]. 现代中西医结合杂志, 2019, 28(9): 1007-1010. doi: 10.3969/j.issn.1008-8849.2019.09.027PENG Y, GUO X R, YANG X M, et al. Application of TCM constitution theory in gynecological diseases[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2019, 28(9): 1007-1010. doi: 10.3969/j.issn.1008-8849.2019.09.027 [10] 黄玉蕊, 颜杨芬, 郭宇玲. 分析护理干预对孕早期先兆流产保胎患者焦虑情绪及睡眠质量的影响[J]. 中国实用医药, 2019, 14(4): 173-174. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201904099.htmHUANG R Y, YAN Y F, GUO Y L. Effect of nursing intervention on anxiety and sleep quality of patients with threatened abortion in early pregnancy[J]. China Practical Medical, 2019, 14(4): 173-174. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201904099.htm [11] 苏伟, 李晓丹, 叶文. 体外受精-胚胎移植后先兆流产患者不良情绪与社会支持的相关性[J]. 护理实践与研究, 2020, 17(5): 90-92. doi: 10.3969/j.issn.1672-9676.2020.05.035SHU W, LI X D, YE W. Correlation between adverse emotions and social supports in patients with threatened abortion after in vitro fertilization and embryo transfer[J]. Nursing Practice and Research, 2020, 17(5): 90-92. doi: 10.3969/j.issn.1672-9676.2020.05.035 [12] 王鹏, 张英杰. "治未病"思想在妇科疾病防治中的应用[J]. 成都中医药大学学报, 2019, 42(2): 16-19. https://www.cnki.com.cn/Article/CJFDTOTAL-CDZY201902005.htmWANG P, ZHANG Y J. Application of idea of "Preventive Treatment of Disease" in prevention and treatment of gynecological diseases[J]. Journal of Chengdu University of Traditional Chinese Medicine, 2019, 42(2): 16-19. https://www.cnki.com.cn/Article/CJFDTOTAL-CDZY201902005.htm [13] 陈萌, 于永铎, 隋楠, 等. 基于子午流注理论探讨化瘀通便汤治疗慢传输型便秘的临床研究[J]. 辽宁中医杂志, 2020, 47(2): 143-144. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY202002051.htmCHEN M, YU Y Z, SUI N, et al. Clinical research of Huayu Tongbian Decoction in treatment of slow transit constipation based on theory of midnight-noon ebb-flow[J]. Liaoning Journal of Traditional Chinese Medicine, 2020, 47(2): 143-144. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY202002051.htm [14] 潘美开, 关楚华, 莫晓程. 子午流注择时补肾方熏洗配合五行音乐对早期先兆流产患者的影响[J]. 中国临床护理, 2020, 12(5): 445-447. doi: 10.3969/j.issn.1674-3768.2020.05.019PAN M K, GUAN C H, MO X C. The influence of kidney-tonifying prescription fumigation combined with five-element music on patients with early threatened abortion during midnight-noon flow injection[J]. Chinese Clinical Nursing, 2020, 12(5): 445-447. doi: 10.3969/j.issn.1674-3768.2020.05.019 [15] 范美庆, 章静, 王超. 五音疗法配合子午流注择时中药热罨包在改善肝胃不和型餐后不适综合征中的临床应用[J]. 中国现代医生, 2020, 58(23): 173-176. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202023045.htmFAN M Q, ZHANG J, WANG C. Clinical application of five notes therapy combined with midnight-noon ebb-flow-instructed chrono traditional Chinese medicine hot package to improving postprandial discomfort syndrome of liver-stomach disharmo-ny type[J]. China Modern Doctor, 2020, 58(23): 173-176. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202023045.htm [16] 桂屏, 叶淑华, 谢玉英, 等. 子午流注择时穴位贴敷对妇科腹腔镜术后患者胃肠功能的影响[J]. 中华护理杂志, 2020, 55(9): 1376-1380. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202009023.htmGUI P, YE S H, XIE Y Y, et al. Effects of acupoint application therapy based on midnight-noon ebb-flow for gastrointestinal function in patients undergoing gynecological laparoscopy[J]. Chinese Journal of Nursing, 2020, 55(9): 1376-1380. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202009023.htm [17] 吴梦婷, 赵娜. 子午流注针法治疗中风后抑郁50例临床研究[J]. 江苏中医药, 2020, 52(8): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY202008023.htmWU M T, ZHAO N. Clinical Study on 50 cases of post - stroke depression treated by midnight-noon flow acupuncture[J]. Jiangsu Journal of Traditional Chinese Medicine, 2020, 52(8): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY202008023.htm [18] 龙玲芳, 祁玲玲. 子午流注开穴法对薄型子宫内膜患者妊娠结局的影响[J]. 广州医药, 2020, 51(4): 32-35. https://www.cnki.com.cn/Article/CJFDTOTAL-GZYY202004007.htmLONG L F, QI L L. Effects of selection points by earth meridian ebb-flowing rule on pregnancy outcome of infertile women suffering from thin endometrium[J]. Guangzhou Medical Journal, 2020, 51(4): 32-35. https://www.cnki.com.cn/Article/CJFDTOTAL-GZYY202004007.htm [19] 吴袁元, 戴梦成, 方朝晖, 等. 方朝晖运用"阳化气, 阴成形"理论联合耳穴埋豆治疗多囊卵巢综合征经验[J]. 陕西中医药大学学报, 2019, 42(1): 23-26. https://www.cnki.com.cn/Article/CJFDTOTAL-SXXY201901009.htmWU Y Y, DAI M C, FANG C H, et al. Fang Zhaohui' s experience in treating polycystic ovary syndrome with "Yang Hua Qi, Yin Shaping" theory combined with ear acupoint embedding bean[J]. Journal of Shaanxi College of Traditional Chinese Medicine, 2019, 42(1): 23-26. https://www.cnki.com.cn/Article/CJFDTOTAL-SXXY201901009.htm [20] 代培方, 穆欣, 任蓁. 子午流注理论在中医护理技术中的应用进展[J]. 北京中医药, 2019, 38(10): 992-994. https://www.cnki.com.cn/Article/CJFDTOTAL-BJZO201910013.htmDAI P F, MU X, REN Z. The application progress of midnight-noon ebb-flow theory in TCM nursing technology[J]. Beijing Journal of Traditional Chinese Medicine, 2019, 38(10): 992-994. https://www.cnki.com.cn/Article/CJFDTOTAL-BJZO201910013.htm -

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