本文選題：膝骨性關(guān)節(jié)炎 + KOA　； 參考：《福建中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：采用三維有限元模型結(jié)合三維步態(tài)分析系統(tǒng)觀察電針治療膝骨性關(guān)節(jié)炎后內(nèi)、外側(cè)半月板應(yīng)力的變化情況,分析膝關(guān)節(jié)治療前后行走時(shí)生物力學(xué)改變及其可能因素,為評(píng)價(jià)膝骨性關(guān)節(jié)炎的康復(fù)療效提供客觀的生物力學(xué)依據(jù),也為今后進(jìn)一步研究針灸的康復(fù)機(jī)制提供基礎(chǔ)。研究方法：1.拍攝1男1女志愿者膝關(guān)節(jié)MRI影像,使用Mimics、Geomagic、 Ansys等軟件對(duì)4例膝關(guān)節(jié)核磁影像進(jìn)行有限元模型的建立。獲取兩名志愿者的三維步態(tài)數(shù)據(jù),并導(dǎo)入有限元模型中建立膝關(guān)節(jié)動(dòng)態(tài)有限元模型,最后進(jìn)行驗(yàn)證。2.將26例來自康復(fù)醫(yī)院及社區(qū)符合標(biāo)準(zhǔn)的膝骨性關(guān)節(jié)炎患者隨機(jī)分成試驗(yàn)組和對(duì)照組,每組13例。試驗(yàn)組進(jìn)行電針干預(yù),1天/次,連續(xù)治療10天。對(duì)照組給予氟比洛芬巴布膏,1天一片,連續(xù)敷貼10天。在治療前和治療后分別對(duì)兩組患者進(jìn)行WOMAC量表及內(nèi)、外側(cè)半月板應(yīng)力指標(biāo)方面的評(píng)定。結(jié)果：1.建立了4例膝關(guān)節(jié)有限元模型,并結(jié)合三維步態(tài)分析數(shù)據(jù),將固態(tài)三維有限元模型轉(zhuǎn)換為動(dòng)態(tài)有限元模型。對(duì)模型進(jìn)行驗(yàn)證,得到的結(jié)果及數(shù)據(jù)可信度高,可以應(yīng)用在臨床研究中。2.療程結(jié)束后試驗(yàn)組和對(duì)照組的WOMAC評(píng)分較治療前均顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；治療后試驗(yàn)組的WOMAC疼痛評(píng)分較對(duì)照組顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。說明試驗(yàn)組與對(duì)照組對(duì)改善膝骨性關(guān)節(jié)炎患者的臨床癥狀均有療效,且試驗(yàn)組對(duì)于疼痛的改善更為顯著。3.療程結(jié)束后,對(duì)生物力學(xué)指標(biāo)進(jìn)行分析,試驗(yàn)組和對(duì)照組內(nèi)、外側(cè)半月板應(yīng)力較治療前均有顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。說明試驗(yàn)組與對(duì)照組均能改善膝骨性關(guān)節(jié)炎內(nèi)部的生物力學(xué)環(huán)境,降低半月板應(yīng)力。結(jié)論：1.建立的膝關(guān)節(jié)動(dòng)態(tài)有限元模型能很好反映出人體在步行過程中半月板應(yīng)力的變化情況,通過計(jì)算機(jī)能對(duì)人體膝關(guān)節(jié)的生物力學(xué)環(huán)境進(jìn)行仿真模擬。2.電針治療膝骨性關(guān)節(jié)炎能緩解疼痛,同時(shí)降低半月板應(yīng)力,可以用動(dòng)態(tài)有限元模型對(duì)該病療效進(jìn)行評(píng)估。
[Abstract]:Objective: to observe the stress changes of medial and lateral meniscus after electroacupuncture treatment of knee osteoarthritis by using three-dimensional finite element model and three-dimensional gait analysis system, and to analyze the biomechanical changes and possible factors of walking before and after knee joint treatment. It provides an objective biomechanical basis for evaluating the rehabilitation effect of knee osteoarthritis and provides a basis for further study on the rehabilitation mechanism of acupuncture and moxibustion. Research method: 1. The MRI images of knee joint of 1 male and 1 female volunteer were taken. The finite element model of 4 cases of knee joint nuclear magnetic imaging was established with the software of Mimicsl Geomagic and Ansys. The 3D gait data of two volunteers were obtained, and the dynamic finite element model of knee joint was established in the finite element model. Twenty-six patients with knee osteoarthritis from rehabilitation hospital and community were randomly divided into experimental group and control group with 13 cases in each group. The experimental group was treated with electroacupuncture for 10 days. The control group was treated with flurbiprofen buccal ointment for 10 days. WOMAC scale and stress index of medial and lateral meniscus were evaluated before and after treatment. The result is 1: 1. Four finite element models of knee joint were established, and the solid three-dimensional finite element model was transformed into a dynamic finite element model based on the three-dimensional gait analysis data. The results and data are reliable and can be used in clinical research. 2. After the course of treatment, the WOMAC scores of the trial group and the control group were significantly lower than before treatment, the difference was statistically significant (P0.05); after treatment, the WOMAC pain score of the experimental group was significantly lower than that of the control group, the difference was statistically significant (P0.05). The results showed that both the experimental group and the control group were effective in improving the clinical symptoms of patients with knee osteoarthritis, and the improvement of pain in the trial group was more significant than that in the control group. After the course of treatment, the biomechanical indexes were analyzed, the stress of lateral meniscus in the experimental group and control group were significantly lower than before treatment, the difference was statistically significant (P0.05). The results showed that both the experimental group and the control group could improve the biomechanical environment and reduce the stress of meniscus in knee osteoarthritis. Conclusion 1. The dynamic finite element model of knee joint can well reflect the change of meniscus stress during walking. The biomechanical environment of knee joint can be simulated by computer. Electroacupuncture treatment of knee osteoarthritis can relieve pain and reduce meniscus stress. Dynamic finite element model can be used to evaluate the curative effect of the disease.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R684.3;R49

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張立國(guó),王爽一;膝骨性關(guān)節(jié)炎的綜合治療[J];青島醫(yī)藥衛(wèi)生;2005年05期

2 羅輝;姜韞霞;;防治膝骨性關(guān)節(jié)炎:從身邊做起[J];中國(guó)醫(yī)藥指南;2005年12期

3 洋崇軍;徐志明;曾凡;彭建;;活絡(luò)膏護(hù)膝治療膝骨性關(guān)節(jié)炎80例[J];中醫(yī)雜志;2007年02期

4 史忠和;;推拿結(jié)合中藥治療膝骨性關(guān)節(jié)炎50例臨床報(bào)道[J];四川中醫(yī);2007年10期

5 吳信玉;;康膝湯結(jié)合西藥治療膝骨性關(guān)節(jié)炎療效觀察[J];中國(guó)社區(qū)醫(yī)師;2008年02期

6 林棟;肖林榕;;膝骨性關(guān)節(jié)炎治療現(xiàn)狀[J];山東中醫(yī)藥大學(xué)學(xué)報(bào);2009年05期

7 范艷華;;中西醫(yī)治療膝骨性關(guān)節(jié)炎臨床體會(huì)[J];中國(guó)現(xiàn)代藥物應(yīng)用;2009年24期

8 王晶石;劉良軍;;手法配合中藥塌漬治療膝骨性關(guān)節(jié)炎[J];當(dāng)代醫(yī)學(xué);2010年12期

9 袁普衛(wèi);劉德玉;;膝骨性關(guān)節(jié)炎的中醫(yī)預(yù)防思路[J];遼寧中醫(yī)雜志;2010年08期

10 曲安龍;李雅楠;;電針配合中藥治療膝骨性關(guān)節(jié)炎62例[J];吉林中醫(yī)藥;2010年08期

相關(guān)會(huì)議論文 前10條

1 熊越海;熊暑霖;;從肝腎辨證治療膝骨性關(guān)節(jié)炎60例[A];第十四屆全國(guó)中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會(huì)論文集[C];2006年

2 張紅林;;消痛散外敷治療膝骨性關(guān)節(jié)炎[A];甘肅省中醫(yī)藥學(xué)會(huì)2010年會(huì)員代表大會(huì)暨學(xué)術(shù)年會(huì)論文匯編[C];2010年

3 潘玉祥;張兆奎;肖亞平;;追風(fēng)活絡(luò)液加火療法治療膝骨性關(guān)節(jié)炎的臨床觀察[A];貴州省中西醫(yī)結(jié)合學(xué)會(huì)骨傷分會(huì)第二次學(xué)術(shù)交流會(huì)議論文匯編[C];2011年

4 李江濤;楊南萍;王玲;陳永濤;王忠明;謝其冰;;國(guó)產(chǎn)鹽酸氨基葡萄糖片治療膝骨性關(guān)節(jié)炎臨床觀察[A];首屆全國(guó)中青年風(fēng)濕病學(xué)學(xué)術(shù)大會(huì)論文匯編[C];2004年

5 韓林;;中西醫(yī)多元療法治療膝骨性關(guān)節(jié)炎[A];第七屆中華中醫(yī)藥學(xué)會(huì)中醫(yī)外治學(xué)術(shù)年會(huì)論文匯編[C];2011年

6 劉英明;艾發(fā)源;白洪文;;杜熟藥衣治療膝骨性關(guān)節(jié)炎280例療效觀察[A];第九屆全國(guó)骨質(zhì)疏松年會(huì)暨第六屆全國(guó)鈣劑年會(huì)會(huì)議文集[C];2003年

7 黃家亮;;推拿配合超激光治療膝骨性關(guān)節(jié)炎56例[A];第一屆全國(guó)骨礦研究年會(huì)會(huì)議文集[C];2002年

8 李盛華;喬斌;周明旺;敬平福;;中醫(yī)藥防治膝骨性關(guān)節(jié)炎優(yōu)勢(shì)探討[A];第三屆全國(guó)中西醫(yī)結(jié)合骨科微創(chuàng)學(xué)術(shù)交流會(huì)論文匯編[C];2013年

9 李珍;田軍;李樹林;;針刀結(jié)合手法治療膝骨性關(guān)節(jié)炎43例療效觀察[A];全國(guó)第七屆農(nóng)村基層中西醫(yī)結(jié)合學(xué)術(shù)暨工作交流會(huì)論文匯編集[C];2002年

10 周光輝;;電針治療膝骨性關(guān)節(jié)炎的臨床研究[A];第四屆全國(guó)康復(fù)治療學(xué)術(shù)大會(huì)論文摘要匯編[C];2004年

相關(guān)重要報(bào)紙文章 前5條

1 程ho 中國(guó)中醫(yī)科學(xué)院望京醫(yī)院;引膝骨性關(guān)節(jié)炎“現(xiàn)身”的8大因素[N];中國(guó)中醫(yī)藥報(bào);2012年

2 陜西中醫(yī)學(xué)院骨傷研究所 袁普衛(wèi)　郝陽(yáng)泉 楚向東;劉德玉治療 膝骨性關(guān)節(jié)炎[N];中國(guó)中醫(yī)藥報(bào);2010年

3 中國(guó)中醫(yī)科學(xué)院望京醫(yī)院 程ho;膝骨性關(guān)節(jié)炎的預(yù)警信號(hào)[N];中國(guó)中醫(yī)藥報(bào);2012年

4 賀棟;膝骨性關(guān)節(jié)炎不用“換關(guān)節(jié)”[N];人民政協(xié)報(bào);2006年

5 陳書連;膝骨性關(guān)節(jié)炎手術(shù)選擇有講究[N];家庭醫(yī)生報(bào);2005年

相關(guān)博士學(xué)位論文 前10條

1 莫永豪;溫針灸治療膝骨性關(guān)節(jié)炎的臨床療效觀察[D];廣州中醫(yī)藥大學(xué);2015年

2 黃Y醮，

本文編號(hào)：2064727