本文關(guān)鍵詞：赤木洗劑熏洗聯(lián)合PRP關(guān)節(jié)腔注射治療中老年膝骨性關(guān)節(jié)炎的臨床觀察　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： 赤木洗劑 膝骨性關(guān)節(jié)炎 富血小板血漿 IL-1 TNF-α

【摘要】：目的:觀察赤木洗劑熏洗聯(lián)合PRP關(guān)節(jié)腔注射對(duì)膝骨性關(guān)節(jié)炎的臨床療效,探討二者的協(xié)同作用,探索治療KOA的新方法。收集2016年1月至2016年8月山東文登整骨醫(yī)院就診骨關(guān)節(jié)科的65例膝骨性關(guān)節(jié)炎患者,采用前瞻性臨床對(duì)照對(duì)65例膝骨性關(guān)節(jié)炎病例進(jìn)行研究。根據(jù)病例選擇標(biāo)準(zhǔn)分為赤木洗劑熏洗聯(lián)合PRP關(guān)節(jié)腔注射組(實(shí)驗(yàn)組33例)和PRP關(guān)節(jié)腔注射組(對(duì)照組32例)。干預(yù)方法:實(shí)驗(yàn)組與對(duì)照組均予兩個(gè)療程共10次PRP關(guān)節(jié)腔注射治療,兩個(gè)療程間隔1個(gè)月。每個(gè)療程5針,1針/3天。實(shí)驗(yàn)組分別在兩個(gè)PRP注射療程結(jié)束后第3天起予赤木洗劑患膝關(guān)節(jié)熏洗,連續(xù)3周。對(duì)照組不予赤木洗劑熏洗。觀察實(shí)驗(yàn)組和對(duì)照組兩組患者膝關(guān)節(jié)疼痛程度及關(guān)節(jié)功能變化,以VAS疼痛評(píng)分及WOMAC膝關(guān)節(jié)功能評(píng)分對(duì)兩組患者膝關(guān)節(jié)疼痛程度及關(guān)節(jié)功能進(jìn)行評(píng)分并記錄,抽取關(guān)節(jié)液測(cè)定IL-1、TNF-α含量并記錄。研究觀察點(diǎn)設(shè)置在治療前、兩個(gè)療程治療結(jié)束后的三個(gè)月以及六個(gè)月。結(jié)果:①對(duì)兩組患者的一般情況、膝關(guān)節(jié)的疼痛程度和功能評(píng)分及IL-1、TNF-α含量進(jìn)行統(tǒng)計(jì)分析無(wú)顯著差異,有可比性;②兩個(gè)療程治療結(jié)束后三個(gè)月及六個(gè)月,實(shí)驗(yàn)組與對(duì)照組的VAS疼痛評(píng)分及WOMAC關(guān)節(jié)功能評(píng)分均較治療前減少,關(guān)節(jié)液中IL-1、TNF-α含量均減少,差異有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明兩組治療都有效果;③兩個(gè)療程治療結(jié)束后三個(gè)月及六個(gè)月,實(shí)驗(yàn)組與對(duì)照組比較,實(shí)驗(yàn)組VAS疼痛評(píng)分及WOMAC關(guān)節(jié)功能評(píng)分均較對(duì)照組減少,組間差異有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明實(shí)驗(yàn)組的療效好于對(duì)照組;④兩個(gè)療程治療結(jié)束后三個(gè)月,兩組患者IL-1、TNF-α含量比較,組間無(wú)統(tǒng)計(jì)學(xué)差異,治療結(jié)束后六個(gè)月,實(shí)驗(yàn)組患者IL-1、TNF-α含量比對(duì)照組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明實(shí)驗(yàn)組相對(duì)對(duì)照組療效更穩(wěn)定。結(jié)論:實(shí)驗(yàn)組治療KOA的療效優(yōu)于對(duì)照組,在療程結(jié)束后三個(gè)月及六個(gè)月實(shí)驗(yàn)組患者癥狀及關(guān)節(jié)功能較對(duì)照組顯現(xiàn)出更大的改善,實(shí)驗(yàn)組在療程結(jié)束六個(gè)月時(shí)IL-1、TNF-α含量比對(duì)照組低。證實(shí)了赤木洗劑熏洗聯(lián)合PRP關(guān)節(jié)腔注射治療膝骨性關(guān)節(jié)炎的協(xié)同作用,二者結(jié)合能在早期更大的改善臨床癥狀、膝關(guān)節(jié)功能,而且作用持久,不良反應(yīng)發(fā)生率低,操作簡(jiǎn)單,適合臨床開展。
[Abstract]:Objective: to observe the clinical effect of Chimu lotion combined with PRP injection in the treatment of knee osteoarthritis and to explore the synergistic effect of the two. From January 2016 to August 2016, 65 patients with knee osteoarthritis in Department of Orthopaedics and Arthritis, Shandong Wenden whole Bone Hospital, were collected. A prospective clinical control study of 65 cases of knee osteoarthritis was carried out. According to the criteria of case selection, the patients were divided into two groups (33 cases in the experimental group) treated by fumigation with Chimu lotion and PRP intraarticular injection (n = 33). Intervention method: both experimental group and control group were treated with PRP injection for 10 times. The interval between the two courses was one month. The experimental group was given fumigation of the knee joint with Chimu lotion from the third day after the end of the two PRP injection courses. For 3 weeks, the patients in the control group were not fumigated with Chimu lotion. The degree of knee joint pain and the function of the joint were observed in the experimental group and the control group. VAS pain score and WOMAC knee joint function score were used to score and record the degree of knee joint pain and joint function in both groups. IL-1 was measured in articular fluid. The observation point was set before treatment, three months after two courses of treatment and six months after treatment. There was no significant difference in pain degree and function score and IL-1TNF- 偽 content in knee joint. 2Three months and six months after the two courses of treatment, the VAS pain score and WOMAC joint function score of the experimental group and the control group were lower than those of the control group. IL-1 in the articular fluid was decreased. The content of TNF- 偽 decreased, and the difference was statistically significant (P 0.05). 3Three months and six months after two courses of treatment, the VAS pain score and WOMAC joint function score in the experimental group were lower than those in the control group. The difference between the two groups was statistically significant (P 0.05), which indicated that the effect of the experimental group was better than that of the control group. 4 three months after the two courses of treatment, the two groups of patients with IL-1TNF- 偽 content comparison, there is no statistical difference between the group, six months after the end of treatment, patients in the experimental group IL-1. The content of TNF- 偽 was lower than that of the control group, and the difference was statistically significant (P 0.05), which indicated that the curative effect of the experimental group was more stable than that of the control group. Conclusion: the therapeutic effect of the experimental group is better than that of the control group. The symptoms and joint function of the patients in the experimental group showed greater improvement than that in the control group three and six months after the end of the course of treatment, and IL-1 was found in the experimental group at the end of the treatment period of six months. The content of TNF- 偽 was lower than that of the control group, which confirmed the synergistic effect of Chimu lotion combined with PRP injection in the treatment of knee osteoarthritis. The combination of TNF- 偽 and TNF- 偽 could improve the clinical symptoms and function of knee joint in the early stage. And the effect is long, the adverse reaction rate is low, the operation is simple, suitable for clinical development.
【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】：2017
【分類號(hào)】：R684.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王松松;任晨暉;仲偉靜;王志文;;中醫(yī)治療肝腎虧虛、風(fēng)寒濕痹型中老年膝骨性關(guān)節(jié)炎近況[J];中醫(yī)藥臨床雜志;2016年12期

2 張建洛;楊宏濤;馮宏偉;高華;周百剛;;PRP聯(lián)合中藥治療膝骨性關(guān)節(jié)炎的臨床研究[J];臨床醫(yī)學(xué)研究與實(shí)踐;2016年23期

3 林嘉輝;陳炳藝;龍美兵;郭文韜;王和鳴;李楠;;龜甲膠和鹿角膠含藥血清對(duì)豚鼠骨關(guān)節(jié)炎軟骨細(xì)胞JNK及p38 MAPK基因表達(dá)的影響[J];中國(guó)中醫(yī)骨傷科雜志;2016年10期

4 姜玉祿;曹云友;;壯筋活血方對(duì)膝骨性關(guān)節(jié)炎患者血清TNF-α、IL-1β的影響及臨床療效[J];中成藥;2016年09期

5 劉連珍;李驊玫;李輝瑩;黃燃浩;;中藥熏洗、中藥離子導(dǎo)入加CPM綜合療法對(duì)膝關(guān)節(jié)功能障礙患者的作用效果分析[J];廣州醫(yī)藥;2016年05期

6 呂剛;楊宏;劉波;;祛痹湯治療膝骨關(guān)節(jié)炎的臨床觀察及其對(duì)血清中相關(guān)炎性因子的影響[J];世界中西醫(yī)結(jié)合雜志;2016年08期

7 劉仕琦;李菲;李俊蓮;羅秀夏;;威靈仙不同炮制品抗炎鎮(zhèn)痛作用的研究[J];山西中醫(yī)學(xué)院學(xué)報(bào);2016年04期

8 王鴻洲;熊昌盛;紀(jì)木強(qiáng);翁天才;曾文磊;許小志;;養(yǎng)血柔肝湯治療早期肝腎虧虛型膝骨性關(guān)節(jié)炎的療效觀察與作用機(jī)制[J];臨床醫(yī)藥文獻(xiàn)電子雜志;2016年27期

9 林強(qiáng);祁文兵;白明華;王明懷;于繼崗;彭頁(yè);;靈仙通絡(luò)方對(duì)C518大鼠膝關(guān)節(jié)退變軟骨細(xì)胞增殖、Ⅱ型膠原及基質(zhì)金屬蛋白酶-13表達(dá)的影響[J];湖南中醫(yī)藥大學(xué)學(xué)報(bào);2016年09期

10 袁林;郭燕慶;于洪波;于泓;呂慧利;李偉;滿振濤;孫水;;富血小板血漿治療Ⅱ-Ⅲ期膝骨關(guān)節(jié)炎的療效評(píng)價(jià)[J];中華關(guān)節(jié)外科雜志(電子版);2016年04期

相關(guān)碩士學(xué)位論文 前2條

1 張軍;自體富血小板血漿對(duì)兔膝關(guān)節(jié)軟骨Ⅱ度損傷修復(fù)作用研究[D];昆明醫(yī)科大學(xué);2016年

2 楊璐;桑枝化學(xué)成分及其抑制磷酸二酯酶4活性的研究[D];廣州中醫(yī)藥大學(xué);2015年

，

本文編號(hào)：1374732