本文選題：舒筋消腫方 + 膝　； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:觀察舒筋消腫方聯(lián)合膝關(guān)節(jié)鏡下關(guān)節(jié)清理術(shù)治療中早期膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床療效,探討舒筋消腫方聯(lián)合膝關(guān)節(jié)鏡下關(guān)節(jié)清理術(shù)治療中早期膝關(guān)節(jié)骨性關(guān)節(jié)炎的機(jī)理。方法:將符合《中華人民共和國中醫(yī)藥行業(yè)標(biāo)準(zhǔn)·中醫(yī)病癥診斷療效標(biāo)準(zhǔn)·骨傷科》的120例住院病人通過隨機(jī)數(shù)字表法分為2組,每組60例,分別為對(duì)照組和聯(lián)合清理術(shù)組。對(duì)照組60例中,男性25例,女性35例,平均年齡(x±S下同)45.0±5.1歲;聯(lián)合清理術(shù)組60例中,男性18例,女性42例。平均年齡42.0±4.8歲。兩組患者的一般情況無統(tǒng)計(jì)學(xué)差別。對(duì)照組入院第三日在腰硬聯(lián)合麻醉下行“膝關(guān)節(jié)鏡下關(guān)節(jié)清理術(shù)”;聯(lián)合清理術(shù)組予膝關(guān)節(jié)鏡下關(guān)節(jié)清理術(shù),術(shù)后第一日服用舒筋消腫方:桃仁15 g、紅花15 g、漢防己20 g、土茯苓30 g、酒大黃15 g、木瓜20 g、澤蘭15 g、鹽車前子30 g、川牛膝9 g、獨(dú)活10 g、三七粉3 g、生薏苡仁30 g、茯苓15 g、生黃芩9 g、連翹12 g、澤瀉15 g、桂枝6 g,水煎取汁400ml,分早晚兩次口服。麻醉消退后即行股四頭肌等長收縮練習(xí),行直腿抬高訓(xùn)練,術(shù)后第1-3日再下地活動(dòng)。舒筋消腫方服用14天,2組治療后均進(jìn)行相應(yīng)的功能鍛煉。觀察指標(biāo)包括反應(yīng)手術(shù)療效的指標(biāo):膝關(guān)節(jié)周徑術(shù)后第一日和術(shù)后兩周的差值(單位:cm),術(shù)后下地時(shí)間d(單位:天),VAS評(píng)分,HSS評(píng)分。分別統(tǒng)計(jì)治療前后兩組患者膝關(guān)節(jié)周徑術(shù)后第一日和術(shù)后兩周的差值,觀察兩組患者的術(shù)后最早下地的時(shí)間,及分別在術(shù)后2周、6周后對(duì)兩組病人進(jìn)行隨訪,統(tǒng)計(jì)兩組患者的VAS疼痛評(píng)分及HSS膝關(guān)節(jié)評(píng)分,將兩組數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,術(shù)前術(shù)后膝關(guān)節(jié)壓痛點(diǎn),術(shù)后下地時(shí)間、術(shù)前術(shù)后的VAS評(píng)分,HSS評(píng)分進(jìn)行組間及組內(nèi)比較。結(jié)果:1兩組治療前膝關(guān)節(jié)周徑變化情況比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組術(shù)后第一天、術(shù)后2周膝關(guān)節(jié)周徑與術(shù)前比較有顯著統(tǒng)計(jì)學(xué)意義(P0.05);聯(lián)合清理術(shù)組患者術(shù)后第一天、術(shù)后2周膝關(guān)節(jié)周徑明顯變化,與術(shù)前比較有顯著統(tǒng)計(jì)學(xué)意義(P0.05);聯(lián)合清理術(shù)組術(shù)后第一天、術(shù)后2周膝關(guān)節(jié)周徑,小于對(duì)照組,有顯著統(tǒng)計(jì)學(xué)意義(P0.05);2兩組患者術(shù)后最早下地時(shí)間無明顯差異,無統(tǒng)計(jì)學(xué)意義(P0.05);3分別在術(shù)前、2周、6周后對(duì)兩組病人以問卷調(diào)查的形式進(jìn)行隨訪,得到VAS疼痛評(píng)分,兩組患者在2周、6周后的VAS評(píng)分組內(nèi)比較及組間比較均具有差異,具有統(tǒng)計(jì)學(xué)意義(P0.05);4分別在術(shù)前、2周、6周后對(duì)兩組病人以問卷調(diào)查的形式進(jìn)行隨訪,得到HSS評(píng)分,兩組患者在2周、6周后的HSS評(píng)分組內(nèi)比較及組間比較均具有差異,具有統(tǒng)計(jì)學(xué)意義(P0.05);5對(duì)照組治療14d后臨床療效率為86.67%,聯(lián)合清理術(shù)組為95.00%,兩組臨床療效率比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);6聯(lián)合清理術(shù)組治療14d后并發(fā)癥發(fā)生率為5.00%,對(duì)照組為3.33%,兩組治療14d后并發(fā)癥發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(P0.05);結(jié)論:中早期膝關(guān)節(jié)骨性關(guān)節(jié)炎患者在舒筋消腫方基礎(chǔ)上聯(lián)合膝關(guān)節(jié)鏡下關(guān)節(jié)清理術(shù)治療效果理想,能改善患者關(guān)節(jié)功能,減輕患者疼痛,提高臨床療效,并且不同治療方法的聯(lián)合使用不會(huì)增加并發(fā)癥發(fā)生率,值得推廣應(yīng)用。
[Abstract]:Objective: To observe the clinical effect of Shu Jin and knee arthroscopy combined with knee arthroscopy in the treatment of osteoarthritis of the knee joint, and to explore the mechanism of the treatment of osteoarthritis of the knee joint in the middle of the knee arthroscopy combined with the knee arthroscopy. Methods: it will be in accordance with the standard of Chinese medicine in People's Republic of China and the disease of traditional Chinese medicine. 120 patients in the orthopedics department of orthopedics were divided into 2 groups by random number table method, 60 cases in each group, the control group and the joint cleaning group. In the control group, 60 cases were male 25, female 35, the average age (x + S below) 45 + 5.1 years; in the joint cleaning group 60 cases, 18 males and 42 cases. Average age 42 + 4.8 years. There was no statistical difference in the general condition of the patients. The control group was treated with knee arthroscopy under combined spinal and hard anesthesia for third days. The joint cleaning group was given arthroscopic debridement of knee arthroscopy. The first day after the operation, it took Shu Jin to eliminate swelling: peach kernel 15 g, safflower 15 g, Han Fang 20 g, tuckahoe 30 g, wine rhubarb 15 g, papaya 20 g, jeresy 1 5 g, salt front son 30 g, kachyranthes 9 g, single live 10 g, 37 powder 3 G, raw coix seed 30 g, Poria cocos 15 g, raw Scutellaria 9 g, forsythia 12 g, Rhizoma rhizomata 15 g, cinnamon 6 g, decoct 400ml, before the anaesthesia, immediately leg elevation training, after the operation again next day after the operation. The 2 groups were treated with functional exercise after treatment. The observation index included the index of the response to the operation: the difference between the first day after the knee joint diameter and the two week after the operation (unit: cm), the D (unit: day), the VAS score, and the HSS score after the operation, and the difference between the first and the two weeks after the operation of the two groups of patients after the treatment, respectively. The two groups of patients were observed at the earliest post operation time, and the two groups were followed up at 2 weeks after the operation and 6 weeks after the operation. The VAS pain score and HSS knee score of the two groups were statistically analyzed. The two groups of data were statistically analyzed, the pain points of the knee joint before and after operation, the postoperative down time, the VAS score before and after the operation, and the HSS score were carried out. Results: 1 there was no significant difference in the change of the knee diameter of the two groups before treatment (P0.05); the knee diameter of the knee joint was statistically significant (P0.05) at the first day after operation and 2 weeks after the operation in the control group (P0.05). The knee joint diameter of the joint cleaning group Shu Houdi was obviously changed in one day after the operation, and compared with the preoperative comparison. There was significant statistical significance (P0.05); the first day after operation in the joint cleaning group and 2 weeks after the operation, the knee joint diameter was less than the control group (P0.05), and there was no significant difference between the 2 two groups at the earliest down time and no statistical significance (P0.05); 3 were followed up in the form of questionnaire survey in two groups of patients before, 2 weeks and 6 weeks after the operation. To get VAS pain score, two groups of patients in 2 weeks, 6 weeks after the VAS score group were compared and compared, with statistical significance (P0.05); 4 in pre operation, 2 weeks, 6 weeks after the two groups of patients in the form of questionnaire survey, the HSS score, two groups in the 2 week, 6 weeks after the HSS score group comparison and comparison between groups and comparison The difference was statistically significant (P0.05); the clinical therapeutic efficiency of the 5 control group was 86.67% after the treatment of 14d, the combined cleaning group was 95%, and the difference in the clinical therapeutic efficiency of the two groups was statistically significant (P0.05); the incidence of complications after the treatment of 14d in the 6 combined group was 5%, the control group was 3.33%, and the incidence of complications after the treatment of 14d was different in the two group. There is no statistical significance (P0.05). Conclusion: the effect of combined knee arthroscopy combined with knee arthroscopy for patients with osteoarthritis of the knee in the middle early stage is ideal, it can improve the function of the joints, relieve the pain and improve the clinical effect, and the combination of different treatment methods will not increase the incidence of complications, it is worth pushing. Wide application.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 袁普衛(wèi);康武林;李小群;董博;劉德玉;王偉卓;;骨性關(guān)節(jié)炎發(fā)病機(jī)制及相關(guān)細(xì)胞因子的研究進(jìn)展[J];中國矯形外科雜志;2016年11期

2 丁呈彪;周云;;膝骨性關(guān)節(jié)炎患者滑膜炎的發(fā)病機(jī)制及研究進(jìn)展[J];中國組織工程研究;2015年51期

3 王原愷;;中藥結(jié)合關(guān)節(jié)鏡手術(shù)治療膝關(guān)節(jié)骨性關(guān)節(jié)炎臨床觀察[J];新中醫(yī);2015年06期

4 彭仁通;;當(dāng)歸四逆湯合陽和湯防治奧沙利鉑所致神經(jīng)毒性療效觀察[J];中醫(yī)臨床研究;2015年12期

5 何金;;中醫(yī)外治法治療膝關(guān)節(jié)骨性關(guān)節(jié)炎研究進(jìn)展[J];實(shí)用中醫(yī)藥雜志;2015年04期

6 姚麗;肖志鋒;闞衛(wèi)兵;趙婧;劉婉;姜玉祥;謝殿洪;于為國;;功能鍛煉在膝關(guān)節(jié)骨性關(guān)節(jié)炎治療中的應(yīng)用[J];長春中醫(yī)藥大學(xué)學(xué)報(bào);2015年02期

7 葉冰;照日格圖;毛曉健;吳施國;吳榮祖;;吳萸當(dāng)歸四逆湯治療陽虛肝郁型不孕癥20例臨床觀察[J];四川中醫(yī);2015年04期

8 李廣恒;戴\戎;;膝關(guān)節(jié)骨性關(guān)節(jié)炎分子發(fā)病機(jī)制和治療展望[J];鄭州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2015年02期

9 趙建罡;高志國;馬立學(xué);欒景斌;張偉東;孫承斌;;膝關(guān)節(jié)鏡下關(guān)節(jié)清理聯(lián)合髕骨周圍去神經(jīng)化術(shù)治療髕股關(guān)節(jié)炎膝前痛[J];中華創(chuàng)傷骨科雜志;2015年02期

10 張明;王鐵軍;劉書茂;黃東明;李輝;高飛;李悅;杜堯;;玻璃酸鈉對(duì)骨關(guān)節(jié)炎患者膝關(guān)節(jié)液中miR-140表達(dá)的影響[J];實(shí)用骨科雜志;2014年12期

，

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