【摘要】：目的：探討膝關(guān)節(jié)骨性關(guān)節(jié)炎的中西醫(yī)研究進(jìn)展,觀察改良海桐皮湯熏洗配合玻璃酸鈉關(guān)節(jié)腔注射治療早中期膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床療效及安全性,探討其作用機(jī)理,探索中西醫(yī)治療本病的新思路和新方法,同時為臨床中醫(yī)治療膝關(guān)節(jié)骨性關(guān)節(jié)炎提供客觀的科學(xué)依據(jù)。方法：選取60例符合標(biāo)準(zhǔn)的患者,將其隨機(jī)分為治療組與對照組,其中治療組34例,對照組26例。治療組采用改良海桐皮湯熏洗配合玻璃酸鈉注射液關(guān)節(jié)腔注射,對照組僅使用玻璃酸鈉注射液關(guān)節(jié)腔注射,1個月為一個療程。通過中醫(yī)癥狀評分評估兩組患者中醫(yī)癥狀的改善情況；采用VAS評分法評估兩組患者膝關(guān)節(jié)的疼痛程度的改善情況；使用Lysholm膝關(guān)節(jié)功能評分量表評估兩組患者膝關(guān)節(jié)功能活動的恢復(fù)情況。采用SPSS19.0軟件對本次研究數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)分析。結(jié)果：(1)基線資料分析：治療前兩組患者的基線資料及基本病情差異均無統(tǒng)計學(xué)意義(P0.01),在此基礎(chǔ)上進(jìn)行臨床試驗,可信度較高。(2)療效分析：①改善癥狀：從中醫(yī)癥狀積分來分析,治療結(jié)束后,治療組的癥狀積分由56.32分降至17.56分,對照組由58.15分降至30.08分。兩組組內(nèi)比較,P0.01,差異有統(tǒng)計學(xué)意義。兩組治療后組間比較,P0.01,差異有統(tǒng)計學(xué)意義。說明兩組均可改善癥狀,但治療組改善臨床癥狀的程度明顯優(yōu)于對照組；從中醫(yī)癥狀療效來分析,治療結(jié)束后,治療組的總有效率為94.12%,對照組的總有效率為76.92%。經(jīng)χ2檢驗,P=0.025,P0.05,兩組有效率差異有統(tǒng)計學(xué)意義,即治療組的療效優(yōu)于對照組。②減輕疼痛：從膝關(guān)節(jié)疼痛評分的變化來分析,治療結(jié)束后,治療組的疼痛積分由6.45分降至2.17分,對照組由6.49分降至4.57分。兩組組內(nèi)比較,P0.01,差異有統(tǒng)計學(xué)意義。兩組治療后組間比較,P0.01,差異有統(tǒng)計學(xué)意義。說明兩組均可減輕患者的疼痛,但是治療組減輕疼痛的效果更優(yōu)于對照組。③改善關(guān)節(jié)功能活動：從Lysholm膝關(guān)節(jié)功能評分的變化來分析,治療結(jié)束后,治療組的功能評分由58.24分升至80.32分,對照組由59.23分升至73.73分。兩組組內(nèi)比較,P0.01,差異具有統(tǒng)計學(xué)意義。兩組治療后組間比較,P0.01,差異具有統(tǒng)計學(xué)意義。說明兩組均能改善膝關(guān)節(jié)的功能活動,但是治療改善功能活動的效果優(yōu)于對照組。(3)安全性分析：治療期間觀察患者治療前后有無臨床感染及其他不適,定期監(jiān)測患者血常規(guī)、生化等檢查,均未見不良反應(yīng)及毒副作用。結(jié)論：導(dǎo)師以《醫(yī)宗金鑒·正骨心法要旨》中的海桐皮湯為基礎(chǔ),結(jié)合多年臨床經(jīng)驗,選取其中主要藥物組成協(xié)定方,使用中藥熏洗的方法,用以治療肢體功能活動障礙。本次課題研究證明,使用改良海桐皮湯熏洗配合玻璃酸鈉關(guān)節(jié)腔注射治療早中期的膝關(guān)節(jié)骨性關(guān)節(jié)炎對改善膝關(guān)節(jié)的中醫(yī)癥狀、緩解膝關(guān)節(jié)疼痛、消除膝關(guān)節(jié)腫脹以及恢復(fù)膝關(guān)節(jié)功能活動均有不錯的療效,安全性較好,具有一定臨床應(yīng)用的價值,值得深入研究。
[Abstract]:Objective: To investigate the progress of traditional Chinese and Western Medicine on osteoarthritis of knee joint, to observe the clinical efficacy and safety of modified hyaluronas fumigation and sodium hyaluronate injection in the treatment of knee osteoarthritis in the early and middle stages, explore its mechanism, explore new ideas and methods for the treatment of this disease by traditional Chinese medicine and traditional Chinese medicine, and treat the knee in clinical traditional Chinese medicine. Objective to provide an objective scientific basis for osteoarthritis of the joint. Methods: 60 patients were randomly divided into the treatment group and the control group, including 34 cases in the treatment group and 26 cases in the control group. The treatment group was treated with modified Haitong skin soup fumigation and Sodium Hyaluronate Injection joint injection, and the control group only used Sodium Hyaluronate Injection joint cavity. Injection, 1 months as a course of treatment. The improvement of TCM symptoms in two groups of patients was evaluated by TCM symptom score; the improvement of the pain degree of knee joint in two groups of patients was evaluated by VAS score; and the recovery of functional activity of knee joint in the two groups was evaluated using the Lysholm knee function score scale. The SPSS19.0 software was used. Statistical analysis of the data. Results: (1) baseline data analysis: the baseline data and basic condition difference of the two groups before treatment were not statistically significant (P0.01), and on the basis of the clinical trials, the reliability was higher. (2) the analysis of the curative effect: (1) the improvement of the symptoms: from the TCM symptom score, after the treatment ended, the treatment was treated. The symptom score of the group was reduced from 56.32 points to 17.56 points, and the control group was reduced from 58.15 to 30.08. The difference between the two groups was statistically significant. The difference was statistically significant between the two groups after treatment. The difference between the two groups was statistically significant. The two groups could improve the symptoms, but the improvement of the clinical symptoms in the treatment group was obviously superior to the control group; from the traditional Chinese medicine symptoms, the treatment group was significantly better than the control group. The symptoms of the treatment group were significantly better than the control group; from the traditional Chinese medicine symptoms, the symptoms were significantly better than the control group. After the treatment, the total effective rate of the treatment group was 94.12%, the total effective rate of the control group was 76.92%. by chi 2 test, P=0.025, P0.05, the two groups had significant difference in efficiency, that is, the curative effect of the treatment group was better than the control group. The integral from 6.45 points to 2.17 points, the control group from 6.49 to 4.57 points. The two group comparison, P0.01, the difference has statistical significance. Two groups after treatment group comparison, P0.01, the difference has statistical significance. The two groups can reduce the pain of the patients, but the treatment group to alleviate pain is better than the control group. Thirdly, improve joint functional activity: improve the effect of joint function: From the change of Lysholm knee function score, after the treatment, the function score of the treatment group was from 58.24 to 80.32, and the control group was from 59.23 to 73.73. The two group was compared, P0.01, the difference has statistical significance. The two groups after treatment group comparison, P0.01, difference has statistical significance. It shows that two groups can improve the knee joint. Functional activities were better than those of the control group. (3) safety analysis: during the treatment, there were no clinical infection and other discomfort before and after treatment, regular monitoring of patients' blood routine, biochemical examination, and no adverse reactions and side effects. On the basis of the Haitong skin soup, combined with many years of clinical experience, the main drug components are selected and used to treat the dysfunction of limb function. This study has proved that the modified hyaluronas and sodium hyaluronate are used for the treatment of knee osteoarthritis in the early and middle stages to improve the knee osteoarthritis. The TCM symptoms of joint have good curative effect on relieving knee pain, eliminating swelling of knee joint and restoring the function of knee joint. It has good safety and value of clinical application. It is worth studying in depth.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R684.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 楊艷杰;張麗娟;甄君;歐建英;;關(guān)節(jié)腔注射加針灸治療膝關(guān)節(jié)腫痛的臨床觀察[J];中國實用醫(yī)藥;2010年23期

2 湯曉清;王維佳;;關(guān)節(jié)腔注射治療膝關(guān)節(jié)骨性關(guān)節(jié)炎研究進(jìn)展[J];醫(yī)學(xué)綜述;2011年23期

3 魯海;謝國平;魏凌峰;趙傳喜;劉文剛;耿永智;;關(guān)節(jié)腔注射治療膝關(guān)節(jié)骨性關(guān)節(jié)炎療效觀察[J];山西中醫(yī);2012年10期

4 劉亞碧;;5例肩關(guān)節(jié)腔注射阿爾治臨床分析[J];重慶醫(yī)學(xué);2006年10期

5 麥志松;羅莉;;穩(wěn)定鉭墊加透明質(zhì)酸鈉關(guān)節(jié)腔注射治療不可復(fù)性盤前移位26例[J];廣西醫(yī)科大學(xué)學(xué)報;2006年02期

6 秦渭志;魏合偉;張志海;;中藥離子導(dǎo)入配合曲安奈德關(guān)節(jié)腔注射治療膝關(guān)節(jié)骨性關(guān)節(jié)炎78例療效觀察[J];新中醫(yī);2006年10期

7 喬永明;劉俊杰;牟鴻;王慶華;付秀蘭;;透明質(zhì)酸鈉關(guān)節(jié)腔注射聯(lián)合手法復(fù)位治療急性不可復(fù)性盤前移位34例療效觀察[J];山東醫(yī)藥;2008年48期

8 謝廣中;梅林軍;劉治軍;;推拿配合關(guān)節(jié)腔注射治療膝骨性關(guān)節(jié)炎44例療效觀察[J];新中醫(yī);2008年07期

9 沈長青;鄭小令;林遠(yuǎn);;臭氧關(guān)節(jié)腔注射治療退行性膝關(guān)節(jié)炎療效觀察[J];海南醫(yī)學(xué);2010年02期

10 肖璐;陳志鵬;蔡寶昌;李偉東;;用于關(guān)節(jié)腔注射的緩控釋系統(tǒng)研究進(jìn)展[J];中國醫(yī)院藥學(xué)雜志;2011年09期

相關(guān)會議論文 前10條

1 吳菱;狄亞珍;馬田瑞;李蘊言;陳圓玲;;幼年特發(fā)性關(guān)節(jié)炎關(guān)節(jié)腔注射激素治療療效觀察[A];中華醫(yī)學(xué)會第十七次全國兒科學(xué)術(shù)大會論文匯編（下冊）[C];2012年

2 吳菱;狄亞珍;馬田瑞;李蘊言;陳圓玲;;幼年特發(fā)性關(guān)節(jié)炎關(guān)節(jié)腔注射激素治療療效觀察[A];2012年浙江省風(fēng)濕病學(xué)學(xué)術(shù)年會論文集[C];2012年

3 王江雪;高玉;樊瑜波;;納米材料經(jīng)關(guān)節(jié)腔注射后在生物體內(nèi)的轉(zhuǎn)運[A];中國力學(xué)學(xué)會學(xué)術(shù)大會'2009論文摘要集[C];2009年

4 趙海龍;謝君國;;針灸配合關(guān)節(jié)腔注射及封閉治療膝關(guān)節(jié)骨性關(guān)節(jié)炎72例[A];全國針灸臨床適宜技術(shù)推廣研討會暨甘肅省針灸學(xué)會2013年學(xué)術(shù)年會論文集[C];2013年

5 成有生;;阿爾治關(guān)節(jié)腔注射治療骨關(guān)節(jié)炎205例療效觀察[A];中國中西醫(yī)結(jié)合學(xué)會脊柱醫(yī)學(xué)專業(yè)委員會2008年學(xué)術(shù)會議論文匯編[C];2008年

6 汪一琦;汪蕾;;紫外線照射綜合藥物冶療膝關(guān)節(jié)骨性關(guān)節(jié)炎療效觀察[A];中華醫(yī)學(xué)會第九次全國物理醫(yī)學(xué)與康復(fù)學(xué)學(xué)術(shù)會議論文集[C];2007年

7 李兆寶;黃明勇;;功能訓(xùn)練配合關(guān)節(jié)腔注射鎮(zhèn)痛液及溫針治療膝骨關(guān)節(jié)炎的療效觀察[A];全國第二屆針刀治療膝關(guān)節(jié)病學(xué)術(shù)研討會中國針灸學(xué)會針灸針刀科普講座論文匯編[C];2012年

8 吳群;梁鳳霞;;針刀配合關(guān)節(jié)腔注射丹參針治療股骨頭缺血性壞死的臨床觀察[A];全國第三屆針刀治療膝關(guān)節(jié)病學(xué)術(shù)研討會論文匯編[C];2013年

9 李華南;;透明質(zhì)酸鈉關(guān)節(jié)腔注射加蘇木煎熏洗治療膝關(guān)節(jié)骨性關(guān)節(jié)炎[A];全國第七屆農(nóng)村基層中西醫(yī)結(jié)合學(xué)術(shù)暨工作交流會論文匯編集[C];2002年

10 孜拉牙提·牙生;帕孜來提·帕哈爾丁;;關(guān)節(jié)腔注射施沛特的體會[A];全國門、急診護(hù)理學(xué)術(shù)交流暨專題講座會議論文匯編[C];2006年

相關(guān)重要報紙文章 前1條

1 廣東省人民醫(yī)院風(fēng)濕免疫科 崔陽;細(xì)致的管理體現(xiàn)對生命的尊重[N];健康報;2011年

相關(guān)博士學(xué)位論文 前3條

1 邵華榮;關(guān)節(jié)腔注射黃原膠動物體內(nèi)藥代動力學(xué)研究[D];山東大學(xué);2015年

2 楊錦華;刺五加關(guān)節(jié)腔注射干預(yù)兔膝骨性關(guān)節(jié)炎的實驗研究[D];湖北中醫(yī)學(xué)院;2009年

3 韓冠英;黃原膠注射液的研制及其對實驗性骨關(guān)節(jié)炎療效和作用機(jī)制的研究[D];山東大學(xué);2012年

相關(guān)碩士學(xué)位論文 前10條

1 劉寧寧;臭氧關(guān)節(jié)腔注射對CIA大鼠療效以及RKL/OPG系統(tǒng)與趨化因子作用機(jī)制的研究[D];山西醫(yī)科大學(xué);2016年

2 吳俊杰;改良海桐皮湯熏洗聯(lián)合玻璃酸鈉關(guān)節(jié)腔注射治療早中期的膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床研究[D];南京中醫(yī)藥大學(xué);2016年

3 蔡穎;正清風(fēng)痛寧關(guān)節(jié)腔注射對膠原誘導(dǎo)性關(guān)節(jié)炎的影響及刺激性研究[D];湖南中醫(yī)藥大學(xué);2007年

4 孫必強;正清風(fēng)痛寧關(guān)節(jié)腔注射治療骨關(guān)節(jié)炎實驗研究[D];湖南中醫(yī)藥大學(xué);2007年

5 張全彬;骨髓間充質(zhì)干細(xì)胞關(guān)節(jié)腔注射治療兔早期類風(fēng)濕性關(guān)節(jié)炎的實驗研究[D];南京醫(yī)科大學(xué);2009年

6 張學(xué)志;關(guān)節(jié)清理術(shù)結(jié)合膝康注射液關(guān)節(jié)腔注射治療重度退行性膝關(guān)節(jié)病的臨床研究[D];黑龍江中醫(yī)藥大學(xué);2006年

7 王運彩;膝關(guān)節(jié)腔注射丹參注射液合中藥導(dǎo)入治療膝骨關(guān)節(jié)炎的臨床觀察[D];黑龍江中醫(yī)藥大學(xué);2014年

8 莫麗都爾;關(guān)節(jié)腔注射用甲氨蝶呤緩釋微球的研究[D];中國協(xié)和醫(yī)科大學(xué);2007年

9 王紹錢;關(guān)節(jié)腔注射氨甲環(huán)酸對全膝關(guān)節(jié)置換術(shù)后的影響[D];安徽醫(yī)科大學(xué);2014年

10 吳璐璐;三聯(lián)療法治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床研究[D];湖北中醫(yī)藥大學(xué);2011年

，

本文編號：2153739