發(fā)布時間：2018-06-28 11:32

  本文選題：獨活寄生湯 + 膝關(guān)節(jié)骨性關(guān)節(jié)炎��； 參考：《安徽中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的:通過觀察玻璃酸鈉關(guān)節(jié)腔注射配合口服獨活寄生湯在治療膝關(guān)節(jié)骨性關(guān)節(jié)炎患者治療前后及隨訪半年的關(guān)節(jié)功能評分,探討玻璃酸鈉關(guān)節(jié)腔注射和獨活寄生口服在治療膝骨關(guān)節(jié)炎的機(jī)制。方法:依據(jù)標(biāo)準(zhǔn)選取患者75例,年齡在41歲至70歲之間,均行膝關(guān)節(jié)正側(cè)位片,顯示關(guān)節(jié)間隙有不同程度狹窄,脛骨髁、股骨髁、髕骨有不同程度增生,抽血查類風(fēng)濕性因子,為陰性,關(guān)節(jié)疼痛癥狀較重,上下樓、運動后癥狀加重,均診斷為膝關(guān)節(jié)骨性關(guān)節(jié)炎。結(jié)合癥狀體征,未達(dá)手術(shù)指標(biāo),患者要求行保守治療。將患者隨機(jī)分為治療組和對照組I與對照組II,每組各25例,治療組予以玻璃酸鈉(玻璃酸鈉注射液采用山東博士倫福瑞達(dá)制藥有限公司生產(chǎn),商品名為施沛特)關(guān)節(jié)腔注射和口服獨活寄生湯,對照組I為單純玻璃酸鈉關(guān)節(jié)腔注射,對照組II為單純口服獨活寄生湯。玻璃酸鈉注射方法為每周1次,連用5周為一個療程。獨活寄生湯(獨活9g,其余中草藥飲片各6g,由安徽中醫(yī)藥大學(xué)第一附屬醫(yī)院藥劑室制備)的服用方法是每日1劑,水煎取汁,每次飯后半小時溫服,每日兩次。連續(xù)服用35天,為一療程。兩組方法于治療前后及治療半年后記錄患者的膝關(guān)節(jié)疼痛感覺,日本骨科協(xié)會評分及關(guān)節(jié)運動功能,對所觀察的結(jié)果進(jìn)行比較、分析。結(jié)果:1.三組患者治療前膝關(guān)節(jié)疼痛程度、性別、年齡等具有隨機(jī)性,經(jīng)配對t檢驗后,無顯著差異(P0.05);2.三組患者治療后及治療半年后,關(guān)節(jié)疼痛癥狀皆好于治療前,關(guān)節(jié)活動情況也好于治療前,有顯著性差異(P0.01或P0.05),從而表明三種治療方法均能治療膝關(guān)節(jié)骨性骨關(guān)節(jié)炎,但玻璃酸鈉關(guān)節(jié)腔注射配合獨活寄生湯和其它兩組相比,明顯優(yōu)于其它兩組,對膝關(guān)節(jié)骨性關(guān)節(jié)炎的治療更有臨床意義;3.治療組接受治療后及半年隨訪,關(guān)節(jié)活動度及關(guān)節(jié)疼痛情況明顯好于對照組I和對照組II(P0.01或P0.05)。結(jié)論:玻璃酸鈉關(guān)節(jié)腔注射配合獨活寄生湯對改善膝關(guān)節(jié)骨性關(guān)節(jié)炎患者的癥狀具有明顯效果,無明顯不良反應(yīng),患者關(guān)節(jié)疼痛癥狀消失或減輕,關(guān)節(jié)活動正常,且此安全、有效、價格經(jīng)濟(jì)、治療方便,值得臨床選用。
[Abstract]:Objective: to observe the joint function scores of patients with knee osteoarthritis before and after treatment with sodium hyaluronate injection and oral Duhuozheng decoction for half a year. To investigate the mechanism of sodium hyaluronate injection and oral parasitism in the treatment of knee osteoarthritis. Methods: 75 patients, aged from 41 to 70 years old, were selected according to the standard. All the patients underwent anterior and lateral knee joint radiographs. The results showed that the joint space was narrow, tibial condyle, femoral condyle and patella were proliferated in different degrees. All of them were diagnosed as osteoarthritis of knee joint. Combined with symptoms and signs, the patients did not reach the surgical targets, patients required conservative treatment. The patients were randomly divided into treatment group (n = 25), control group (n = 25) and control group (n = 25). The treatment group was treated with sodium hyaluronate (sodium hyaluronate injection). The commercial name is Shipeite) the articular cavity injection and the oral Duhuozheng decoction, the control group I is the simple hyaluronate sodium joint cavity injection, the control group II is the simple oral Duhuozhongtang. Sodium hyaluronate was injected once a week for 5 weeks as a course of treatment. Duhuo parasitic decoction (Duhuo 9g, other Chinese herbal medicines 6g each, prepared by the pharmacy room of the first affiliated Hospital of Anhui University of traditional Chinese Medicine) is taken 1 dose per day, decoction, half an hour after each meal, two times a day. Take it continuously for 35 days as a course of treatment. The knee joint pain, the score of Japanese Orthopedic Association and the function of joint movement were recorded before and after treatment and half a year after treatment. The results were compared and analyzed. The result is 1: 1. The degree of knee joint pain, sex, age and so on were random before treatment in the three groups. There was no significant difference after paired t test (P0.05). After treatment and half a year after treatment, the symptoms of joint pain in the three groups were better than those before treatment, and the joint motion was better than that before treatment (P0.01 or P0.05), which indicated that all the three treatments could treat osteoarthritis of knee joint. But the injection of sodium hyaluronate and Duhuozheng decoction were better than the other two groups, and the treatment of osteoarthritis of knee joint had more clinical significance. After treatment and half a year follow-up, the joint motion and joint pain in the treatment group were significantly better than those in the control group I and control group II (P0.01 or P0.05). Effective, economical price, convenient treatment, worthy of clinical selection.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R684.3

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