本文關(guān)鍵詞：加減羌活勝濕湯治療風(fēng)濕型膝骨關(guān)節(jié)炎的臨床療效觀察　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:通過觀察加減羌活勝濕湯對早中期風(fēng)濕型膝骨關(guān)節(jié)炎的癥狀改善情況,評價其對風(fēng)濕型膝骨關(guān)節(jié)炎的臨床療效和安全性,為臨床治療此種證型膝骨關(guān)節(jié)炎提供新的依據(jù)和選擇。方法:收集2015年10月-2016年10月就診于河南省洛陽正骨醫(yī)院膝關(guān)節(jié)病科的早中期風(fēng)濕型膝骨關(guān)節(jié)炎患者60例。以入組的先后順序,采用隨機數(shù)表法將研究病例隨機分為試驗組和對照組,每組各30例。其中試驗組服用加減羌活勝濕湯,對照組服用雙醋瑞因膠囊。兩組治療周期均為6周,于治療前、治療2周后、4周后和6周后等觀察時點,檢測并記錄入組病例50m行走后膝關(guān)節(jié)疼痛視覺模擬量表(VAS)評分、以及膝關(guān)節(jié)WOMAC指數(shù)評分和膝骨關(guān)節(jié)炎癥狀分級量化評分等各項療效評價指標(biāo)及相關(guān)安全性指標(biāo),采用尼莫地平法評價兩組總體療效。應(yīng)用SPSS20.0軟件進(jìn)行數(shù)據(jù)統(tǒng)計分析,比較兩組的療效和差異性。結(jié)果:治療前后不同觀察時點間VAS評分、WOMAC指數(shù)評分和膝骨關(guān)節(jié)炎癥狀評分比較,差異均有統(tǒng)計學(xué)意義(P0.05),存在時間效應(yīng)。兩組患者VAS評分、WOMAC指數(shù)評分和癥狀評分,組間差異有統(tǒng)計學(xué)意義(P0.05),存在分組效應(yīng)。治療2周后和4周后,試驗組VAS評分、WOMAC指數(shù)評分和癥狀評分均低于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。治療6周后,兩組VAS評分、WOMAC指數(shù)評分和癥狀評分比較,差異無統(tǒng)計學(xué)意義(P0.05)。分組因素和時間因素存在交互效應(yīng)(P0.05)。總體療效分析,試驗組3例痊愈,11例顯效,13例有效,3例無效,總有效率90%;對照組4例痊愈,10例顯效,14例有效,2例無效,總有效率93.3%。兩組總體療效比較無統(tǒng)計學(xué)差異(P0.05)。結(jié)論:本研究結(jié)果表明加減羌活勝濕湯和雙醋瑞因膠囊對治療早中期風(fēng)濕型膝骨關(guān)節(jié)炎均有較好的療效,均可明顯減輕膝骨關(guān)節(jié)炎患者的疼痛、改善患者的生活質(zhì)量。加減羌活勝濕湯可為早中期風(fēng)濕型膝骨關(guān)節(jié)炎的治療提供一種借鑒。
[Abstract]:Objective: To observe the modified Qianghuo Shengshi Decoction to improve the situation of early stage rheumatoid knee osteoarthritis symptoms, evaluation of rheumatic knee osteoarthritis clinical efficacy and safety, to provide a new basis for the selection of clinical syndromes in the treatment of knee osteoarthritis. Methods: from October 2015 to October in -2016 in Luoyang Bone-setting Hospital of Henan Province Department of the early stage of knee joint rheumatic patients with knee osteoarthritis in 60 cases. In the order of the group, using a random number table method to study cases were randomly divided into experimental group and control group, 30 cases in each group. The experimental group was given modified Qianghuo Shengshi decoction, the control group was given the treatment of Diacerein Capsules. Cycle two groups were 6 weeks. Before treatment, after 2 weeks of treatment, after 4 weeks and 6 weeks after the observation point, measure and record the patients after 50m walking knee pain visual analogue scale (VAS) score, the knee joint WOMAC Index score and knee osteoarthritis symptoms score of the clinical evaluation index and safety index, using nimodipine method to evaluate the overall efficacy of the two groups. SPSS20.0 software was used for statistical analysis of the data, and the curative effect were compared between the two groups before and after treatment. Results: the different observation points, VAS score, WOMAC index score and knee osteoarthritis symptoms scores, the differences were statistically significant (P0.05), the existence of time effect. Two groups of patients with VAS score, WOMAC index score and symptom score, there was significant difference between the groups (P0.05), there are effects. After 2 weeks of treatment and 4 weeks after the test group VAS score, WOMAC index scores and symptom scores were lower than the control group, the differences were statistically significant (P0.05). After 6 weeks of treatment, two groups of VAS score, WOMAC index score and symptom score, the difference was not statistically significant (P0.05). The grouping factors and There is an interaction effect between factors (P0.05). The overall curative effect analysis, test group 3 cases were cured, 11 cases were cured, 13 cases effective, 3 cases ineffective, the total efficiency of 90%; control group 4 cases were cured, 10 cases were cured, 14 cases effective, 2 cases ineffective, the total efficiency of 93.3%. two groups overall efficacy comparison statistical differences (P0.05). Conclusion: the results of this study show that the modified Qianghuo wet soup and Diacerein Capsules on the treatment of early stage rheumatoid knee osteoarthritis has good curative effect, can significantly reduce the pain of knee osteoarthritis patients, improve the patient's quality of life. And Qianghuo wet can provide a reference for treatment of early stage rheumatic knee osteoarthritis.

【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R274.9

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