本文關(guān)鍵詞：不同療法干預(yù)瘀血阻滯型膝骨關(guān)節(jié)炎的臨床療效觀察　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 膝骨關(guān)節(jié)炎 針刀 膝關(guān)節(jié)炎治療儀 針灸 臨床療效

【摘要】：目的:探討針刀、膝關(guān)節(jié)炎治療儀、針灸干預(yù)瘀血阻滯型膝骨關(guān)節(jié)炎的臨床療效差異性,為探尋一種療效穩(wěn)定、可靠的瘀血阻滯型膝骨關(guān)節(jié)炎治療方法提供臨床依據(jù)。方法:將120例患者隨機(jī)分為針刀組30例、膝關(guān)節(jié)炎治療儀組30例、針灸組30例及對照組30例。針刀組取血海、梁丘、陰陵泉、陽陵泉、鶴頂穴及髕周壓痛點(diǎn)、內(nèi)外側(cè)副韌帶、髕韌帶起止點(diǎn)進(jìn)行針刀松解剝離粘連攣縮,每周1次,5次為1個(gè)療程;膝關(guān)節(jié)炎治療儀組將治療儀電極片貼于膝關(guān)節(jié)內(nèi)外膝眼處,根據(jù)病情和病人耐受情況,調(diào)節(jié)輸出脈沖合適的強(qiáng)度,每天1次,每次30分鐘,連續(xù)治療30天為一個(gè)療程;針灸組針刺血海穴、梁丘穴、陰陵泉、陽陵泉、犢鼻穴、鶴頂穴,每天1次,每次30分鐘,連續(xù)治療30天為一個(gè)療程;對照組行關(guān)節(jié)腔內(nèi)注射玻璃酸鈉注射液治療,每周1次,5次為1個(gè)療程。四組治療前后VAS評分、膝關(guān)節(jié)運(yùn)動功能、臨床癥狀積分進(jìn)行對比,對臨床總體療效、控顯率及總有效率評估,并行統(tǒng)計(jì)學(xué)分析。結(jié)果:在入組的120例患者中,最后完成研究114例,針刀組29例、膝關(guān)節(jié)炎治療儀組29例、針灸組28例及對照組28例。1.VAS評分比較:療程完成后,針刀組、膝關(guān)節(jié)炎治療儀組、針灸組及對照組治療后VAS評分均較治療前顯著降低(P0.01),四組組間治療后有統(tǒng)計(jì)學(xué)差異(P0.01)。VAS評分降低程度比較:四組組間差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中針刀組明顯高于對照組(P0.01),并高于針灸組(P0.05)均有統(tǒng)計(jì)學(xué)意義;其余兩兩比較無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。2.膝關(guān)節(jié)運(yùn)動功能比較:療程結(jié)束后,四組患者治療后膝關(guān)節(jié)運(yùn)動功能評分均明顯高于治療前(P0.01);針刀組膝關(guān)節(jié)運(yùn)動功能評分增加程度明顯高于其余三組(P0.01),膝關(guān)節(jié)炎治療儀組高于對照組(P0.05),膝關(guān)節(jié)炎治療儀組雖高于針灸組,針灸組也要高于對照組,但差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。3.臨床癥狀比較:療程結(jié)束后,治療后四組膝關(guān)節(jié)臨床癥狀積分均明顯低于治療前(P0.01)。降低程度組間比較:針刀組、膝關(guān)節(jié)炎治療儀組膝關(guān)節(jié)臨床癥狀積分降低程度均明顯高于對照組(P0.01),有顯著差異;針刀組高于針灸組(P0.05),有統(tǒng)計(jì)學(xué)意義;針刀組高于膝關(guān)節(jié)炎治療儀組、針灸組雖高于對照組,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)4.臨床療效比較:療程結(jié)束后,四組臨床療效分級比較經(jīng)Kruskal-WallisH秩和檢驗(yàn)顯示差異有統(tǒng)計(jì)學(xué)意義(P0.05)。四組控顯率顯著差別,經(jīng)卡方檢驗(yàn)顯示有差別(P0.05);四組總有效率比較經(jīng)卡方檢驗(yàn)分析顯示差異無統(tǒng)計(jì)學(xué)意義(P0.05)。臨床療效分級及控顯率比較均有差異,針刀療法明顯優(yōu)于其他三組療效,膝關(guān)節(jié)炎治療儀組較針灸組、對照組療效好,針灸組較對照組效佳。結(jié)論:1.針刀、膝關(guān)節(jié)炎治療儀、針灸、關(guān)節(jié)腔注射玻璃酸鈉治療膝骨關(guān)節(jié)炎均有效。2.針刀療法治療瘀血阻滯型膝骨關(guān)節(jié)炎在改善疼痛、關(guān)節(jié)運(yùn)動功能及臨床癥狀等方面優(yōu)于膝關(guān)節(jié)炎治療儀、針灸、關(guān)節(jié)腔注射玻璃酸鈉。3.針刀療法治療瘀血阻滯型膝骨關(guān)節(jié)炎臨床療效較好,值得臨床推廣。
[Abstract]:Objective: To investigate the knife, knee osteoarthritis treatment, clinical curative effect of blood stasis type of knee osteoarthritis of the acupuncture intervention, to explore a stable curative effect, to provide reliable clinical evidence of blood stasis type of knee osteoarthritis treatment. Methods: 120 patients were randomly divided into treatment group of 30 cases of knee joint in treatment group 30 cases, 30 cases of acupuncture group and 30 cases in the control group. Treatment group take Xuehai, Liangqiu, yinlingquan, Yanglingquan, heding acupoints and patellar aroundtender points, medial and lateral collateral ligament, patellar ligament of acupotomy stripping adhesion contracture, 1 times a week for 5 times the 1 course of treatment; knee osteoarthritis treatment group will therapeutic instrument electrode is attached to the knee joint and knee eye, according to the disease and patient tolerance, adjust the output pulse of appropriate strength, 1 times a day, every 30 minutes, for 30 days as a course of treatment; acupuncture group acupuncture Xuehai, Liangqiu, Yin Ling Quan, Yang Ling Stephen, Dubi acupoint, heding acupoints, 1 times a day, every 30 minutes, for 30 days as a course of treatment; the control group underwent intra-articular injection of Sodium Hyaluronate Injection treatment, 1 times a week, 5 times for 1 course. VAS scores of the four groups before and after treatment, the knee joint motion function, clinical symptoms integral comparison, on the general clinical curative effect, the control rate and the total efficiency evaluation, the results were statistically analyzed. Results: in 120 patients, finally completed the study in 114 cases, 29 cases of treatment group, knee osteoarthritis treatment group 29 cases, acupuncture group 28 cases and control group 28 cases.1.VAS score: treatment after the completion of the treatment of knee osteoarthritis Acupotomy group, instrument group, acupuncture group and control group after treatment VAS scores were significantly lower than before treatment (P0.01), between the four groups after treatment, there were significant differences in.VAS score (P0.01) reduce the degree of comparison: the difference between the four groups had statistical significance (P0.05), which the needle knife group was significantly higher In the control group (P0.01), and higher than the acupuncture group (P0.05) had statistical significance; the remaining 22 is no significant difference between.2. (P0.05) knee joint motion function: after the end of treatment, four groups of patients after treatment of knee joint function score were significantly higher than those before treatment (P0.01); Acupotomy group of knee joint motion function the score increase was significantly higher than the other three groups (P0.01), knee arthritis treatment group than in control group (P0.05), knee osteoarthritis treatment group was higher than the acupuncture group, acupuncture group was higher than that of the control group, but the differences were not statistically significant (P0.05) compared with.3. clinical symptoms: after treatment, after treatment four groups of knee joint clinical symptom scores were significantly lower than that before treatment (P0.01). To reduce the degree of comparison between groups: Acupotomy group, knee osteoarthritis treatment instrument group knee clinical symptom score decreased significantly than the control group (P0.01), there was significant difference; Acupotomy group Higher than the acupuncture group (P0.05), there was statistical significance; Acupotomy group was higher than that of knee osteoarthritis treatment group, acupuncture group was higher than control group, but the difference was not statistically significant (P0.05) comparison of 4. clinical efficacy: after treatment, the clinical efficacy of the four groups were compared by Kruskal-WallisH test showed that there was a statistically significant difference (P0.05) four. The control rate was significant difference by chi square test showed difference (P0.05); the total efficiency of four groups by chi square test analysis showed no significant difference (P0.05). Clinical classification and control rate were difference, acupuncture therapy was significantly better than the other three groups, osteoarthritis of the knee treatment group compared with the acupuncture group, the control group has good curative effect, good effect of acupuncture and moxibustion group than in the control group. Conclusion: 1. acupuncture, knee osteoarthritis treatment, acupuncture, needle knife.2. were effective therapy in the treatment of blood stasis type of knee joint cavity injection of sodium hyaluronate for treatment of knee osteoarthritis Arthritis is superior to the treatment of knee osteoarthritis in improving pain, joint movement function and clinical symptoms. Acupuncture, intraarticular injection of sodium hyaluronate,.3. needle knife therapy has better clinical efficacy in treating blood stasis type knee osteoarthritis, and is worthy of clinical promotion.

【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.9

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