本文選題：關(guān)節(jié)鏡清理術(shù) + 玻璃酸鈉�。� 參考：《湖北中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：研究目的:本課題通過回顧性分析研究關(guān)節(jié)鏡清理術(shù)加玻璃酸鈉注射配合膝關(guān)節(jié)功能鍛煉聯(lián)合中醫(yī)中藥治療中度膝關(guān)節(jié)骨關(guān)節(jié)炎,探討綜合法綜合治療中度膝關(guān)節(jié)炎的作用機(jī)理,尋求一種治療中度膝關(guān)節(jié)骨關(guān)節(jié)炎的確實(shí)有效、經(jīng)濟(jì)實(shí)用、易于臨床應(yīng)用和推廣的方法。研究方法:本研究病例均是選自2012年12月-2014年12月期間湖北省中醫(yī)院住院部骨傷科陳建鋒主任醫(yī)師收治的中度膝關(guān)節(jié)炎患者。根據(jù)疾病診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)以及排除標(biāo)準(zhǔn),選取其中的90例患者為分析研究對(duì)象,根據(jù)治療方法的不同,將其分為對(duì)照組A、對(duì)照組B和治療組C三組,每組各30例,病例研究對(duì)象為單側(cè)膝關(guān)節(jié),若患者為雙膝關(guān)節(jié)炎,則選取臨床表現(xiàn)相比較重的一側(cè)。所有病例患者入院均行系統(tǒng)的體格檢查和術(shù)前檢查,行膝關(guān)節(jié)清理術(shù)治療,術(shù)后指導(dǎo)其進(jìn)行患膝功能鍛煉。對(duì)照組A的治療方法是入院單純應(yīng)用膝關(guān)節(jié)鏡清理術(shù)治療,術(shù)后在醫(yī)師指導(dǎo)下配合膝關(guān)節(jié)功能鍛煉。對(duì)照組B是在對(duì)照組A的方法上增加玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療。治療組C是在對(duì)照組B的基礎(chǔ)上增加系統(tǒng)的中醫(yī)中藥辨證用藥進(jìn)行治療。觀察三組患者治療前和治療后患膝疼痛和關(guān)節(jié)活動(dòng)障礙癥狀的改善情況,應(yīng)用膝關(guān)節(jié)Lysholm評(píng)分系統(tǒng)對(duì)治療前后的膝關(guān)節(jié)功能做出評(píng)價(jià)。研究結(jié)果:治療結(jié)束后,根據(jù)隨訪結(jié)果,觀察、整理數(shù)據(jù),使用SPSS16.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。1、三組患者在治療前(入院時(shí))膝關(guān)節(jié)Lysholm評(píng)分比較:三組相比,P值0.05,無統(tǒng)計(jì)學(xué)意義,具有可比性。2、三組患者在治療后(最后一次隨訪)膝關(guān)節(jié)Lysholm評(píng)分比較(1)A、B兩組對(duì)比,P=0.0350.05,有顯著統(tǒng)計(jì)學(xué)差異,表明兩個(gè)對(duì)照組的方法治療中度膝關(guān)節(jié)骨關(guān)節(jié)炎效果明顯,并且對(duì)照組B的治療效果要優(yōu)于對(duì)照組A;(2)A、C兩組對(duì)比,P=0.0260.05,有顯著統(tǒng)計(jì)學(xué)差異,表明治療組的方法治療中度膝關(guān)節(jié)骨關(guān)節(jié)炎效果顯著,且其治療效果優(yōu)于對(duì)照組A;(3)B、C兩組對(duì)比,P=0.040.05,有顯著統(tǒng)計(jì)學(xué)差異,表明治療組C治療效果要優(yōu)于對(duì)照組B。研究結(jié)論:上述治療方法在臨床上均可用于中度膝關(guān)節(jié)骨關(guān)節(jié)炎的治療,而以關(guān)節(jié)鏡清理術(shù)加玻璃酸鈉注射配合中醫(yī)中藥辨證施治三種方法聯(lián)合的治療組,對(duì)中度膝關(guān)節(jié)炎臨床癥狀的治療,其效果明顯優(yōu)于單純的關(guān)節(jié)鏡清理術(shù)和關(guān)節(jié)鏡清理術(shù)加玻璃酸鈉注射治療。此三聯(lián)法治療中度膝關(guān)節(jié)骨關(guān)節(jié)炎,近期療效確切,相比較于人工膝關(guān)節(jié)表面置換術(shù)具有安全、費(fèi)用低、療程短、易于患者接受的優(yōu)勢(shì),值得在臨床上推廣。在臨床工作中可以根據(jù)不同的患者病情差異進(jìn)行應(yīng)用,三種方法配合治療,以達(dá)到預(yù)期的治療效果。
[Abstract]:Objective: to study retrospectively the treatment of moderate knee osteoarthritis by arthroscopic debridement, sodium hyaluronate injection and knee joint functional exercise combined with traditional Chinese medicine. To explore the mechanism of comprehensive treatment of moderate knee osteoarthritis and to seek a practical and effective method for the treatment of moderate knee osteoarthritis, which is easy to be applied and popularized in clinic. Methods: all cases were selected from the patients with moderate knee arthritis admitted from December 2012 to December 2014 in the Department of Orthopaedics and Trauma, Department of Orthopedics and Trauma, Hubei Provincial Hospital of traditional Chinese Medicine. According to the diagnostic criteria, inclusion criteria and exclusion criteria, 90 patients were selected as the study objects. According to the different treatment methods, the patients were divided into three groups: control group A, control group B and treatment group C, with 30 cases in each group. Case study object is unilateral knee joint, if the patient is bilateral knee arthritis, select the side with more severe clinical manifestation. All the patients underwent systemic physical examination and preoperative examination, knee joint debridement, and postoperative functional exercise of the affected knee. The treatment of control group A was treated by knee arthroscopy only, and combined with knee joint function exercise under the guidance of doctor. Control group B was treated with intraarticular injection of sodium hyaluronate. Treatment group C is based on the control group B to increase the system of traditional Chinese medicine syndrome differentiation drugs for treatment. To observe the improvement of knee pain and dyskinesia before and after treatment in three groups, and evaluate the knee joint function before and after treatment with Lysholm scoring system. Results: at the end of the treatment, according to the follow-up results, the data were analyzed by SPSS 16.0 software. The Lysholm score of knee joint in the three groups was compared before treatment (on admission): the P value of the three groups was 0.05, there was no significant difference between the three groups. The comparison of Lysholm score of knee joint after treatment (the last follow-up) showed that there was significant difference between two groups (P < 0.05), indicating that the treatment of moderate knee osteoarthritis in the two control groups was more effective than that in the control group. The therapeutic effect of the control group B was better than that of the control group (P < 0. 0260.05), indicating that the treatment of moderate knee osteoarthritis in the treatment group was more effective than that in the control group (P < 0. 0260.05). The therapeutic effect of the treatment group was better than that of the control group (P 0.040.05), which indicated that the effect of treatment group C was better than that of the control group (B). Conclusion: the above treatment methods can be used in the treatment of moderate knee osteoarthritis clinically, and the treatment group is treated with arthroscopic debridement and sodium hyaluronate injection combined with traditional Chinese medicine differentiation of symptoms and signs. The clinical symptoms of moderate knee arthritis were significantly better than those of arthroscopic debridement and arthroscopic debridement combined with sodium hyaluronate injection. The treatment of moderate knee osteoarthritis with this triple method is effective in the near future. Compared with artificial knee arthroplasty, it has the advantages of safety, low cost, short course of treatment and easy to be accepted by patients. It is worth popularizing in clinic. In clinical work, according to the different patients' condition, three methods can be used in combination to achieve the expected 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

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 姜升平;;正清風(fēng)痛寧注射液治療膝關(guān)節(jié)骨性關(guān)節(jié)炎40例臨床觀察[J];中醫(yī)藥導(dǎo)報(bào);2006年06期

2 鄒世恩;張紹芬;;雌激素對(duì)成骨細(xì)胞和破骨細(xì)胞凋亡的調(diào)節(jié)機(jī)制[J];現(xiàn)代婦產(chǎn)科進(jìn)展;2006年07期

3 虞冬生;周小敏;蔡錦成;朱康利;;小針刀合穴位注射治療膝骨性關(guān)節(jié)炎25例[J];浙江中醫(yī)雜志;2008年10期

4 曹曼林;李韻;白躍宏;;運(yùn)動(dòng)療法對(duì)膝關(guān)節(jié)骨性關(guān)節(jié)炎的治療作用[J];中國康復(fù);2010年03期

5 郭玉海;朱建林;林定坤;杜炎鑫;;參麥液關(guān)節(jié)腔內(nèi)注射對(duì)癥狀性膝關(guān)節(jié)骨性關(guān)節(jié)炎的近期臨床療效觀察[J];中醫(yī)正骨;2006年10期

6 俞延軍;;玻璃酸鈉聯(lián)合硫酸氨基葡萄糖治療膝骨性關(guān)節(jié)炎療效觀察[J];中醫(yī)正骨;2009年06期

7 丁英奇;劉英飛;李耀華;蘇心鏡;;關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療半月板損傷臨床療效觀察[J];疑難病雜志;2014年01期

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