發(fā)布時間：2018-06-08 10:35

  本文選題：PKP + 針灸　； 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:分析研究椎體后凸成形(PKP)術(shù)結(jié)合傳統(tǒng)針灸療法治療與單純行椎體后凸成形術(shù)比較治療原發(fā)性骨質(zhì)疏松性椎體壓縮性骨折(OVCF)的療效分析,探討在臨床上治療OVCF的最有效治療方案。方法:收集武漢市第一醫(yī)院自2014年2月至2015年2月完整治療處理的OVCF患者,一共72例,所有患者都為單一椎體骨折。患者主要表現(xiàn)為脊柱背部疼痛,翻身、起身等活動受限,咳嗽、打噴嚏癥狀加重。將所有處理的患者隨機進行分組比較,分為兩組,治療組(A組)為PKP結(jié)合針灸治療骨質(zhì)疏松性椎體壓縮性骨折患者,平均年齡(75.08±4.48)歲,對照組(B組)為單純PKP治療骨質(zhì)疏松性椎體壓縮性骨折患者,平均年齡(75.03±4.41)歲。其中A組男11例,女性25例,受傷椎體包括包括T71個,T82個,T91個,T103個,T117個,T128個,L17,L23,L32,L42。B組男性9例,女性27例,受傷椎體包括T61個,T72個,T81個,T92個,T103個,T116個,T128個,L17,L21,L32,L43。A組在PKP術(shù)后根據(jù)患者情況進行針灸治療。B組不做任何處理。所有患者在術(shù)前均完善相關(guān)檢查,排除手術(shù)絕對禁忌癥,降低手術(shù)風(fēng)險。術(shù)后均予以對癥治療,臥床休息,抗炎抗感染,佩戴腰圍,指導(dǎo)功能鍛煉,補鈣抗骨質(zhì)疏松治療。分析對照比較兩組患者年齡、性別、受傷椎體分布、VAS評分、ODI指數(shù)、Cobb角,比較兩組患者在術(shù)前、術(shù)后3天、術(shù)后1個月、術(shù)后6個月、術(shù)后12個月區(qū)別,并對治療組和對照組進行統(tǒng)計學(xué)分析研究。結(jié)果:手術(shù)及針灸治療都順利完成,都獲得12個月的隨訪。A組和B組在性別、年齡、受傷椎體、Cobb角,術(shù)前VAS評分、ODI指數(shù)等方面比較,無統(tǒng)計學(xué)差異(P0.05),說明兩組在術(shù)前基本情況上無明顯差異性,兩組患者具有可比性。兩組在術(shù)前與術(shù)后Cobb角比較上,差異有統(tǒng)計學(xué)意義(P0.05),兩組在術(shù)后各個時間點上相比,差異無統(tǒng)計學(xué)意義(P0.05),說明兩組患者PKP手術(shù)治療效果有效,但針灸療法并不能改善患者Cobb角。在VAS評分及ODI指數(shù)的對比上,A組、B組兩組患者術(shù)后與術(shù)前比較,差別有統(tǒng)計學(xué)意義(P0.05),在術(shù)后1個月到術(shù)后6個月的VAS評分上對比,A組明顯優(yōu)于B組,差異有統(tǒng)計學(xué)意義(P0.05),而在術(shù)后6個月之后的隨訪收集中,兩組之間的VAS評分相比,差別無統(tǒng)計學(xué)意義(P0.05),說明針灸療法在短期內(nèi)有助于患者緩解疼痛,減少疼痛刺激,也可以幫助患者在短期內(nèi)進行康復(fù),符合當(dāng)前快速康復(fù)理念;在Oswestry功能障礙指數(shù)比較上,術(shù)后各個時間點上A組都要優(yōu)于B組,差別有統(tǒng)計學(xué)意義(P0.05),說明PKP結(jié)合針灸療法相比單純行PKP更能有效減輕患者疼痛,改善患者的生活質(zhì)量,有助于患者早起康復(fù),減輕家庭負(fù)擔(dān)。結(jié)論:PKP結(jié)合針灸治療原發(fā)性骨質(zhì)疏松椎體壓縮性骨折效果效明顯,能極大減輕患者腰背部疼痛,尤其在早期效果明顯,能使患者早期開展功能鍛煉,盡早改善患者生活質(zhì)量,是一種值得推薦的中西結(jié)合治療方法。
[Abstract]:Objective: to study the effect of kyphoplasty combined with traditional acupuncture and moxibustion in the treatment of primary osteoporotic vertebral compression fracture (OVCFF). To explore the most effective treatment for OVCF. Methods: a total of 72 patients with OVCF were collected from February 2014 to February 2015 in the first Hospital of Wuhan. All the patients were single vertebral fracture. The main symptoms of the patients were spinal back pain, turning over, rising and other restricted activities, cough, sneezing symptoms aggravated. All the patients were randomly divided into two groups. The treatment group was treated with PKP combined with acupuncture and moxibustion in the treatment of osteoporotic vertebral compression fracture. The average age was 75.08 鹵4.48 years old. Control group B (mean age of 75.03 鹵4.41) was treated with PKP alone. In group A, there were 11 males and 25 females. The injured vertebrae included T71, T82, T91, T91, T117, T117, T128, L17, L23, L32, L42.B, 9 males and 27 females. The injured vertebrae included T61, T72, T81, T92, T103, T116, T128, L17, L21, L32, L43.A, which were treated with acupuncture and moxibustion according to the patient's condition after PKP. Group B did not do any treatment. All patients were examined before operation to eliminate the absolute contraindication and reduce the risk of operation. All patients were treated with symptomatic treatment, bed rest, anti-inflammatory and anti-infection, waist circumference, functional exercise, calcium supplement and anti-osteoporosis treatment. Age, sex, VAS score and ODI (Cobb angle) were compared between the two groups before, 3 days after operation, 1 month after operation, 6 months after operation and 12 months after operation. And the treatment group and the control group were statistically analyzed. Results: the operation and acupuncture treatment were successfully completed, and 12 months follow-up was obtained between group A and group B in terms of sex, age, Cobb angle of injured vertebral body, preoperative VAS score and ODI index. There was no statistical difference between the two groups (P 0.05), which indicated that there was no significant difference between the two groups in the basic condition before operation, and the two groups were comparable. The difference between the two groups in preoperative and postoperative Cobb angle was statistically significant (P 0.05). There was no significant difference between the two groups at different time points after operation, which indicated that PKP operation was effective in the two groups, but acupuncture therapy could not improve the Cobb angle. The VAS score and ODI index in group A were significantly higher than those in group B after operation (P 0.05). The VAS scores in group A were significantly better than those in group B from 1 month to 6 months after operation. The difference was statistically significant (P 0.05). In the follow-up collection after 6 months, there was no significant difference in VAS score between the two groups, indicating that acupuncture therapy can help patients with pain relief and pain stimulation in a short period of time. It can also help patients recover in the short term, in line with the current concept of rapid recovery. Group A is better than group B at every time point in the Oswestry disability index. The difference was statistically significant (P 0.05), which indicated that PKP combined with acupuncture and moxibustion therapy could effectively relieve pain, improve the quality of life of patients, help patients recover early and lighten the burden of their families. Conclusion the effect of the treatment of vertebral compression fracture with 10% PKP combined with acupuncture and moxibustion is obvious, which can greatly reduce the pain in the back and waist of the patients, especially in the early stage. It can make the patients develop functional exercise early and improve the quality of life of the patients as early as possible. It is a recommended combination of Chinese and Western treatment.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

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本文編號：1995503