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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳秀熙(Hsiu-Hsi Chen) | |
dc.contributor.author | Yu-Ching Chen | en |
dc.contributor.author | 陳郁菁 | zh_TW |
dc.date.accessioned | 2021-06-17T01:28:26Z | - |
dc.date.available | 2020-08-26 | |
dc.date.copyright | 2020-08-26 | |
dc.date.issued | 2020 | |
dc.date.submitted | 2020-08-19 | |
dc.identifier.citation | 王渟瑜,謝麗貞(2019)拔罐後印記的判讀和應用,新醫學雜誌 2(1), 23-26 木下晴都,代田文彥,經絡與穴道 2001/11 p191 古玫生,嚴明芳,陳秀熙,謝麗貞,(2019)科學拔罐-安全而有效的拔罐負壓,新醫學雜誌2(2), 73-79 謝麗貞(2011)拔罐的真相, 台北:知音出版社, 146-147 謝麗貞(2011) 探索《難經》的奧秘, 台北:知音出版社,第二刷, 74-77 謝麗貞 (2019) 拔罐、穴壓與練氣的關聯 新醫學雜誌2(1), 3-5 謝麗貞(2017) 拔罐的科學實務,台北:知音出版社, 29-44 Badillo R. Francis D. (2014) Diagnosis and treatment of gastroesophageal disease, World J Gastrointest Pharmacol Ther. 2014 Aug 6;5(3):105-12 Dalbir S. Sandhu and Ronnie Fass (2018) Current trends in the management of Gastroesophaegeal reflux, Gut and Liver,Vol.12, No.1, Jan 2018,7-16 Li D., Zhu L., Liu D. Acupunture for refractory gastro-oesophageal reflux disease: a systematic review and meta-analysis protocol, BMJOpen 2019;9:e030713.doi:10.1136/bmjopen-2019-030713 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/67339 | - |
dc.description.abstract | 研究背景 胃食道逆流是一種常見的胃部慢性疾病,因其慢性且反覆發作之特性而影響病患生活品質,儘管近代醫學進步,但因其反覆發作特性因此不能輕易藉由外科手術治療。傳統醫學中對於胃食道逆流也有許多種類的治療,氣功點穴拔罐由於不具侵入性且可依適當間隔反覆施行,因此我們想以實證方式驗證穴壓拔罐對於治療胃食道逆流的效益。 材料與方法 本研究以來自吉錠診所就診且具有參與意願的病人做為研究對象,在門診主治醫師問診之後,於民國107年9~10月間,總共收錄了158位病患。拔罐以『瞬吸可調式吸引力拔罐裝置』施行予與胃消化功能相關的三個穴位,包括中脘穴(CV12)、胸椎第3節(T3)上的穴道和胸椎第7節(T7)上的穴道,並紀錄拔罐後印記以判定病患胃部功能異常的嚴重度(印記嚴重程度分為五級);以穴壓配合拔罐在三次時間點進行,第一次不給予穴道按壓直接拔罐 (測量I),約一個月後第二次給予穴壓偵測再配合治療及拔罐 (測量II),約六個月後第三次給予穴壓偵測再配合治療及拔罐 (測量III)。並以羅吉斯迴歸分析探討治療後六個月個案印記嚴重程度(級數)的變化(測量III相較於測量II)是否會低於第一次給予點穴治療後印記嚴重程度的變化(測量II相較於測量I),並且檢視治療效益是否會被個人基本人口學變項及胃病相關表癥變項所修飾。另以線性迴歸分析比較印記級數的變化。 結果 對CV12呈現第II級以上定義為嚴重的情況,測量III相對於測量II在嚴重等級變化的可能性較低但並未達統計上顯著差異(Odds Ratio (OR)為0.53 (95% Confidence Interval (CI): 0.24-1.18);對T3第III級以上及第IV級以上定義為嚴重者,測量III相對於測量II在嚴重等級變化的可能性較高但並未達統計上顯著差異,其勝算比分別為1.74 (95% CI: 0.77-3.92)及1.11 (95% CI: 0.30-4.02);對T7第III級以上及第IV級以上定義為嚴重者,測量III相對於測量II在嚴重等級變化的可能性則是具統計上顯著差異較低,其勝算比分別為0.31 (95% CI: 0.13-0.72)及0.15 (95% CI: 0.06-0.38)。上述T7的治療效益在細部的分層分析上發現對女性、大學以下教育程度、其他職業、無胃病史、持續症狀期間超過十年、有胃脹、胃酸逆流症狀、沒有就診者,在第三次穴壓拔罐治療後也都有印記嚴重程度顯著的減輕。另外,連續印記分數的分析可以呈現CV12的治療效益上,且在分層分析上亦有較多分層可呈現出顯著差異,唯此分析結果在T3依然沒有差異。 結論 本研究以實證的方法證實利用科學化的點穴拔罐方法可以有效改進胃食道逆流的拔罐後印記表癥,尤其在T7穴位上的表現更為明顯。 | zh_TW |
dc.description.abstract | Background GERD is a commonly diagnosed chronic gastric disorder characterized with its prominent nature of high degree of repetitive recurrence which significantly impacts the quality of life. Despite the great advancement in modern medicine, treatment modalities to cure GERD remain limited as surgery is not considered a feasible option in treating GERD due to the disease’s unpredictable recurring nature. As the potential remedy, several non-invasive modalities of Chinese traditional medicine that can be administered repetitively at a defined interval are attempted by the medical community in treating GERD, when newly diagnosed and recurrence. These treatment modalities include Qi, acupressure, and cupping. Hence the intent of this study is to examine the efficacy of acupressure and cupping in treating patients with GERD through empirical research. Material Methodology A total of 158 research participants were voluntarily recruited for this research in September and October 2018. The participants were first medically evaluated by the attending physician at the Ji-Ding Clinic. A cupping system of “adjustable immediate suction device” was used to apply the cupping modality on the three acupoints commonly recognized as affecting the human gastric digestive function: Zhongwan CV12 (middle epigastrium), T3 (over the third thoracic spine ), and T7 (over the seventh thoracic spine ). The post-cupping imprints were recorded to determine the severity of gastric functional abnormalities experienced by each participant. For each acupoint treated (C12, T3, and T7), the imprinting data was categorized into levels 1 through 5 to define the severity of gastric functional abnormalities experienced by each research participants based on the coloration observed after each administration of cupping treatment ranging from normal skin color (level I, minimum impairment) to dark ecchymosis (level V, most severely impaired gastric function). The treatment modalities of acupoint identification and acupressure were administered in conjunction with cupping in 2 out of the 3 treatments provided to the participants. Data was collected longitudinally at the first treatment (cupping only without acupressure, measure I), the second treatment (a month after the first treatment, cupping and acupressure, measure II), and the third treatment (6 months after the first treatment, cupping and acupressure, measure III). The efficacy of these traditional modalities in treating GERD is evaluated empirically via statistical analysis. Logistic regression was employed to detect potential improvement on imprinting severity over the treatment duration of 6 months by comparing measure III to measure II to measure I. It is also used to examine whether the treatment efficacy is affected by certain variables including demographic characteristics and disease symptoms. In addition, linear regression was employed to analyze potential changes in imprinting severity levels. Result In the groups of CV12 level II and above (defined as the high severity group), comparing to measure II, measure III showed a lowered severity that is not statistically supported as significant (odds ratio (OR) is 0.53, 95% Confidence Interval (CI): 0.24-1.18); In the groups of T3 level III and above (the high severity group), comparing to measure II, measure III showed a higher severity that is also not considered statistically significant (odds ratio (OR) is 0.74 (95% CI: 0.77-3.92) for level III and 1.11 (95% CI: 0.30-4.02) for level IV); In the groups of T7 level III and above (defined as the high severity group), measure III showed a lowered severity with statistical significance detected (Odd ratio is 0.31 (95% CI: 0.13-0.72) for level III and 0.15 (95% CI: 0.06-0.38) for level IV)。Additional data stratification was conducted to further understand the therapeutic efficacy observed among the T7 group described above. The analysis revealed statistically significant positive impact; however, the observation is not repeated in the T3 group. Conclusion This research was able to empirically validate that acupressure and acupoint cupping treatment modalities, when administered scientifically, may effectively improve the imprinting symptoms experienced by patients diagnosed with GERD. The therapeutic efficacy is specifically prominent when the said treatment modalities are administered on acupoint T7. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T01:28:26Z (GMT). No. of bitstreams: 1 U0001-1608202011405000.pdf: 1894931 bytes, checksum: a5635436e916db93f94b22799121729d (MD5) Previous issue date: 2020 | en |
dc.description.tableofcontents | 口試委員審定書 誌謝 中文摘要 ......................................... i 英文摘要 .........................................iii 第一章 研究背景 3 1.1 實習單位特色與簡介 3 1.2 研究背景及起源 3 第二章 文獻回顧 5 2.1 飲食及生活型態調整 5 2.2 藥物治療 5 2.3 外科手術治療 6 2.4 Endoluminal therapy for GERD (內視鏡腔內治療) 7 第三章 材料與方法 9 3.1 研究個案招募 9 3.2 拔罐治療介入方法 9 3.3 結果量測 10 3.4 統計方法 10 第四章 結果 13 第五章 討論 40 參考文獻 44 | |
dc.language.iso | zh-TW | |
dc.title | 使用穴壓拔罐治療胃食道逆流之療效評估 | zh_TW |
dc.title | Evaluation of the Treatment Efficacy on GERD with Acupressure, Cupping and Its Imprinting | en |
dc.type | Thesis | |
dc.date.schoolyear | 108-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 嚴明芳(Ming-Fang Yen),謝麗貞(Li-Chen Hsieh) | |
dc.subject.keyword | 胃食道逆流,穴壓,拔罐,印記,瞬吸可調式吸引力拔罐裝置,穴位, | zh_TW |
dc.subject.keyword | GERD,Acupressure,Cupping,Imprint,Acupoint, | en |
dc.relation.page | 45 | |
dc.identifier.doi | 10.6342/NTU202003568 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2020-08-19 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
顯示於系所單位: | 公共衛生碩士學位學程 |
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