부산대학교 도서관

目的 观察耳穴揿针联合栀黄散穴位贴敷对胆石症患者的应用效果.方法 将120例患者随机分为A组:耳穴揿针组(40例),B组:穴位贴敷组(40例),C组:联合治疗组(40例).A组患者在常规西医治疗的基础上加用耳穴揿针治疗,按压4～6次/d,1～3 min/次,5 d 1个疗程,双耳交替操作.B组患者在常规西医治疗的基础上加用栀黄散穴位贴敷,贴敷于双侧胆俞穴、双侧肝俞穴、右侧期门穴、双侧阳陵泉穴,贴敷时间为4～6 h,2次/d,5 d 1个疗程.C组患者在常规西医治疗的基础上联合使用耳穴揿针和栀黄散穴位贴敷治疗.通过疼痛数值评分量表(NRS)比较3组患者治疗后0.5、1、2、24、48 h疼痛评分;治疗前后3组患者C反应蛋白(C-reactive protein,CRP)、胆红素、肝功能(ALT)变化情况;通过B超检查治疗前后胆囊收缩功能、胆囊壁厚度.结果 干预后3组患者疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度均低于干预前,胆囊收缩功能较干预前增加,差异具有统计学意义(P＜0.05),A组、B组两组患者干预后疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度、胆囊收缩功能比较,差异无统计学意义(P＞0.05).C组患者干预后疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度均低于A、B两组,胆囊收缩功能高于A、B两组,差异具有统计学意义(P＜0.05).结论 耳穴揿针和栀黄散穴位贴敷应用于胆石症患者,均可减轻患者的疼痛反应,降低炎症作用,促进肝功能恢复,增强胆囊收缩功能.将两者联合应用,临床疗效更加显著,能够加速患者康复,值得临床推广.
Objective To observe the effect of auricular acupoint pressing needle combined with Zhihuang Powder(栀黄散)acupoint application on patients with cholelithiasis.Methods A total of 120 patients were randomly divided into group A(40 ca-ses,auricular acupoint pressing),group B(40 cases,acupoint application),group C(40 cases,combined treatment group).The patients in group A were treated with auricular acupoint pressing needle on the basis of conventional western medicine.They were pressed 4～6 times a day for 1～3 minutes for each time,a course of treatment for 5 days,and their ears were operated alternate-ly.The patients in group C were treated with auricular acupoint pressing needle and Zhihuang Powder acupoint application on the basis of routine western medicine.The pain scores of the three groups at 0.5 h,1 h,2h,24h and 48 h after treatment were com-pared by numerical rating scale(NRS).The changes of C-reactive protein(CRP),bilirubin and liver function[alanine amin-otransferase(ALT)]in the three groups were observed before and after treatment,the gallbladder contraction function and gall-bladder wall thickness were examined by B-ultrasound before and after treatment.Results After treatment,the time-effect value of NRS,the levels of CRP,bilirubin and ALT and gallbladder wall thickness in the three groups were lower than those before treat-ment,but the gallbladder contraction function was higher than that before treatment.The differences were statistically significant(P＜0.05).There was no statistical significance in the time-effect value of pain score,the levels of CRP,bilirubin and ALT val-ue,gallbladder wall thickness or gallbladder contraction function in group A and group B after treatment(P＞0.05).The time-effect value of NRS,the levels of CRP,bilirubin and ALT and gallbladder wall thickness after treatment in group C were lower than those in group A and group B,but the gallbladder contraction function was higher than that in group A and group B.The differences were statistically significant(P＜0.05).Conclusion Auricular acupoint pressing needle and Zhihuang Powder acu-point application can reduce the pain reaction and the inflammatory reaction,promote the recovery of liver function and enhance the contractile function of gallbladder of the patients with cholelithiasis,and the combination of the two has more significant clini-cal effect and can accelerate the rehabilitation of patients,which is worthy of clinical promotion.