本文選題：膝關(guān)節(jié)骨性關(guān)節(jié)炎(KOA) + 關(guān)節(jié)鏡清理手術(shù)��； 參考：《湖北中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：背景:膝關(guān)節(jié)骨性關(guān)節(jié)炎(knee osteoarthritis,KOA)是在世界上最常見的一種關(guān)節(jié)相關(guān)的疾病,是非常常見的關(guān)節(jié)炎方式和引發(fā)慢性關(guān)節(jié)殘疾病變的第一重要的因素。又被稱為退行性關(guān)節(jié)炎,肥大或者增生性關(guān)節(jié)炎,退行性骨關(guān)節(jié)疾病。臨床特征是為關(guān)節(jié)軟骨的被破壞,變性和骨質(zhì)增生,而最主要的臨床特點(diǎn)是關(guān)節(jié)的變形、疼痛、活動(dòng)度降低和關(guān)節(jié)功能受到一定限制。在當(dāng)今世界范圍內(nèi),KOA對(duì)于我們?nèi)祟惖耐{正在與日俱增,有效的防治該疾病正在成為臨床上各個(gè)學(xué)者和專家研究和重視的課題。在當(dāng)前的臨床治療中,還沒有發(fā)現(xiàn)對(duì)此癥的特效治療手段和方法,因此,進(jìn)行試驗(yàn)和研究,使用中西醫(yī)結(jié)合治療的方法治療該病,開拓一種治療的新思路就有了尤為重要的臨床意義。目的:經(jīng)過試驗(yàn)的臨床觀察來相互比較單純的膝關(guān)節(jié)鏡清理手術(shù)(對(duì)照組)和中醫(yī)針灸刺法結(jié)合膝關(guān)節(jié)鏡清理術(shù)(治療組)治療KOA,評(píng)價(jià)和觀察膝關(guān)節(jié)鏡清理手術(shù)結(jié)合中醫(yī)針灸刺法對(duì)于臨床治療KOA的療效[1],從而延伸出對(duì)于治療該病過程中使用中西醫(yī)結(jié)合治療的療效肯定,也有利于繼續(xù)推廣中西醫(yī)結(jié)合治療在臨床上的應(yīng)用。方法:選取宜昌市一醫(yī)院2013年8月一2014年2月骨科的門診和住院患者,其中診斷為膝關(guān)節(jié)退化性骨性關(guān)節(jié)炎,符合實(shí)驗(yàn)病歷納入標(biāo)準(zhǔn)并且入選為實(shí)驗(yàn)對(duì)象的患者120例,其中男64例,女56例,年齡為38—76歲,平均59.42歲。病程最短10月,最長10年,平均4.50年,單膝發(fā)病48例,雙膝發(fā)病72例。嚴(yán)格地按照收入和排除的具體相關(guān)標(biāo)準(zhǔn),使用照隨機(jī)的分組方法,分為2個(gè)組,一個(gè)組為治療組,一個(gè)組為對(duì)照組,治療組60例病人,對(duì)照組60例,治療組為手術(shù)結(jié)合針灸針刺治療,對(duì)照組為單純手術(shù)治療。經(jīng)過相同療程治療后,進(jìn)行隨訪和復(fù)查,并且記錄觀察指標(biāo),每組患者的評(píng)價(jià)標(biāo)準(zhǔn)都以JOA評(píng)分和VAS視覺評(píng)分為準(zhǔn)。結(jié)果:1.在VAS視覺評(píng)分方面[2],治療組治療前后互相比較,有了明顯的好轉(zhuǎn),對(duì)照組也有了明顯的改善(兩組p值都0.05),而治療組的效果優(yōu)于對(duì)照組的治療效果(p0.05)。2.在JOA評(píng)分方面[3],兩組治療前后組內(nèi)對(duì)比也都有了改善和好轉(zhuǎn),而治療組的效果明顯要好于對(duì)照組的治療效果(p0.05)。結(jié)論:具體試驗(yàn)組比對(duì)照組的疼痛VAS評(píng)分上和膝關(guān)節(jié)功能分級(jí)上都有了顯著的好轉(zhuǎn),這就一定程度上說明了關(guān)節(jié)鏡清理手術(shù)后配合中醫(yī)針灸治療方法確實(shí)能夠有效地減輕患者手術(shù)后的關(guān)節(jié)疼痛和腫脹,也能夠使得患者在術(shù)后的恢復(fù)速度更快,表明了中醫(yī)針灸療法不僅可以鞏固關(guān)節(jié)鏡清理術(shù)的治療效果,更可以和現(xiàn)代手術(shù)相輔相成,達(dá)到一加一大于二的加成效果,事半功倍。該臨床實(shí)驗(yàn)把現(xiàn)代西方醫(yī)學(xué)的手術(shù)治療手段和祖國傳統(tǒng)的特色治療方法有效而充分的結(jié)合,使兩個(gè)本風(fēng)馬牛不相及的治療思想共同地發(fā)揮出作用,取二者之精華,雙效共現(xiàn),從而起到更加良好的的治療效果。
[Abstract]:Background: knee osteoarthritis (KOA) is the most common joint related disease in the world. It is a very common form of arthritis and the first important factor in the cause of chronic joint disability. It is also known as degenerative arthritis, hypertrophic or proliferative arthritis, and degenerative osteoarthrosis. The main clinical features of articular cartilage are deformability, degeneration and hyperosteogeny, and the most important clinical features are joint deformation, pain, reduction of activity and joint function. In today's world, the threat of KOA to our human being is increasing, and effective prevention and control of the disease is becoming a clinical scholar and expert. In the current clinical treatment, no special therapeutic means and methods have been found in the current clinical treatment. Therefore, it is very important to use the method of combining traditional Chinese and Western medicine to treat the disease and to develop a new idea of treatment. Compared with pure knee arthroscopy (control group) and traditional Chinese medicine acupuncture and acupuncture combined with knee arthroscopy (treatment group) treatment of KOA, the curative effect of knee arthroscopy cleaning operation combined with traditional Chinese medicine acupuncture method for clinical treatment of KOA was evaluated and observed, and the curative effect of combination of traditional Chinese and Western medicine in the treatment of the disease was affirmed, and the curative effect was affirmed for the treatment of the disease during the treatment of the disease. It is also beneficial to continue to promote the clinical application of integrated traditional Chinese and Western medicine. Methods: the outpatient and hospitalized patients in Department of orthopedics, Yichang, August 2013 1, February 2014, were diagnosed as degenerative osteoarthritis of the knee joint. 120 patients were eligible for the experimental medical records and were selected as the subjects, including 64 males and 56 females. The age ranged from 38 to 76 years, with an average of 59.42 years. The shortest course of disease was October, the longest 10 years, an average of 4.50 years, 48 cases of single knee and 72 cases of double knee. According to the specific standards of income and exclusion, the treatment group was divided into 2 groups, one group was the treatment group, the other was the control group, the treatment group 60 patients, and the control group 60 cases, the treatment was treated. The group was treated with acupuncture and moxibustion with acupuncture, and the control group was treated with simple operation. After the same course of treatment, follow up and review, and record the observation index, the evaluation criteria of each group were based on JOA and VAS visual score. Results: 1. in the VAS visual score [2], the treatment group compared with each other before and after treatment. The control group also had a significant improvement (two groups of P values were 0.05), and the effect of the treatment group was better than that of the control group (P0.05).2. in the JOA score [3], the two groups before and after treatment were also improved and improved, and the treatment group was better than the treatment group (P0.05). Conclusion: the specific test group was compared with the control group. The pain VAS score of the group and the classification of the knee joint function have improved significantly. To a certain extent, it can be explained that the acupuncture treatment with traditional Chinese medicine after arthroscopy can effectively reduce the pain and swelling of the joint after the operation, and can also make the patient recover faster after the operation, indicating the traditional Chinese medicine needle. The moxibustion therapy can not only consolidate the therapeutic effect of arthroscopic debridement, but also complement the modern operation to achieve one plus one greater than two addition effect. The therapeutic ideas together play a role in taking the essence of the two, and achieving a better therapeutic effect.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.4

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本文編號(hào)：1982593