本文關(guān)鍵詞： 慢性膝關(guān)節(jié)滑膜炎 關(guān)節(jié)鏡清理術(shù) 辨證論治 中藥 膝關(guān)節(jié)功能鍛煉　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本文通過(guò)回顧性分析研究關(guān)節(jié)清理聯(lián)合鏡下滑膜辨證治療氣滯血瘀型慢性膝關(guān)節(jié)滑膜炎,探討辨證論治治療滑膜炎的作用機(jī)理,尋求一種治療慢性膝關(guān)節(jié)滑膜炎更加有效、經(jīng)濟(jì)實(shí)用的方法。方法:收集湖北省中醫(yī)院骨傷科(花園山院區(qū))從2015年03月到2016年03月住院治療的符合研究納入標(biāo)準(zhǔn)的氣滯血瘀型慢性膝關(guān)節(jié)滑膜炎患者,總共48例,分為治療組24例,對(duì)照組24例。其中治療組為關(guān)節(jié)清理聯(lián)合辨證方身痛逐瘀湯加減治療,術(shù)后第二天口服身痛逐瘀湯加減,水煎服,日一劑,分早晚兩次口服,連續(xù)服用21天;對(duì)照組為關(guān)節(jié)清理聯(lián)合滑膜炎顆粒治療法,術(shù)后口服滑膜炎顆粒,每日3次,每次1袋,亦連續(xù)用藥21天。兩組患者均在術(shù)后第二天開始行膝關(guān)節(jié)功能鍛煉。治療21天后,運(yùn)用Bristol膝關(guān)節(jié)功能評(píng)分,觀察患者治療前后膝關(guān)節(jié)疼痛、屈伸功能及腫脹程度的改善情況,各治療小組之間行對(duì)比分析,所得數(shù)據(jù)用SPSS19.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:兩組患者在入院時(shí)Bristol膝關(guān)節(jié)評(píng)分經(jīng)過(guò)分析,P㧐0.05,無(wú)明顯統(tǒng)計(jì)學(xué)意義,具有可比性。手術(shù)患者術(shù)后未見切口感染、延遲愈合等不良反應(yīng)。各組患者治療前后的Bristol膝關(guān)節(jié)評(píng)分比較,P㩳0.05,表明兩種治療方法治療膝關(guān)節(jié)滑膜炎都有效;兩組患者治療后Bristol膝關(guān)節(jié)評(píng)分比較,P0.05,表明治療組的療效優(yōu)于對(duì)照組;治療組與對(duì)照組的遠(yuǎn)期療效比較,得出P0.05,表明兩組的遠(yuǎn)期療效無(wú)明顯差異。結(jié)論:上述治療方法都能夠治療慢性膝關(guān)節(jié)滑膜炎,但治療組的近期療效較好,恢復(fù)快,經(jīng)過(guò)一年修養(yǎng)鍛煉,兩組遠(yuǎn)期療效無(wú)明顯差別。關(guān)節(jié)清理術(shù)能夠直接清除關(guān)節(jié)內(nèi)病變滑膜,相較于傳統(tǒng)開放性手術(shù),具有創(chuàng)傷小、恢復(fù)快、易于患者接受等優(yōu)勢(shì),配合辨證方藥口服鞏固治療,促進(jìn)血液、淋巴循環(huán),改善關(guān)節(jié)內(nèi)生理環(huán)境,辨證后對(duì)癥用藥相較于直接予以常規(guī)藥物治療,療效更加顯著。通過(guò)關(guān)節(jié)清理聯(lián)合辨證方給藥,清理與調(diào)養(yǎng)相結(jié)合,標(biāo)本兼治,是一種值得在臨床上推廣的治療慢性膝關(guān)節(jié)滑膜炎的治療方法。
[Abstract]:Objective: to study the mechanism of joint debridement combined with synovium differentiation in treating chronic knee joint synovitis with qi stagnation and blood stasis. To seek a more effective treatment for chronic synovitis of the knee. Economic and practical methods. Methods: collection of orthopedics and trauma department of Hubei traditional Chinese medicine hospital (garden mountain hospital district). Patients with chronic knee joint synovitis with Qi stagnation and Blood stasis type who were hospitalized from March 2015 to March 2016 were included in the study. A total of 48 cases were divided into treatment group (n = 24) and control group (n = 24). Take orally twice in morning and evening for 21 days; The control group was treated with joint debridement combined with synovitis granules. Postoperative oral synovitis granules were given 3 times a day with 1 bag each time. After 21 days of treatment, Bristol score was used to observe the pain of knee joint before and after treatment. The improvement of flexion and extension function and swelling degree were compared among the treatment groups. The data were statistically analyzed by SPSS19.0 software. Results: the Bristol knee joint score of the two groups was analyzed at admission. 0. 05, no statistical significance, comparable. No postoperative incision infection, delayed healing and other adverse reactions. Comparison of Bristol knee score before and after treatment in each group. 0.05, indicating that both methods are effective in the treatment of synovitis of knee joint. The comparison of Bristol knee joint score between the two groups showed that the curative effect of the treatment group was better than that of the control group. Compared with the control group, the long-term curative effect of the treatment group and the control group, P0.05, indicating that there is no significant difference in the long-term efficacy between the two groups. Conclusion: the above treatment methods can treat chronic synovitis of knee joint. But the short-term curative effect of the treatment group is better and the recovery is fast. After one year training, there is no significant difference between the two groups. Joint debridement can directly clear the synovial membrane of the joint, compared with the traditional open surgery. With the advantages of small trauma, quick recovery and easy to be accepted by patients, combined with oral consolidation therapy of dialectical prescription, it can promote blood, lymphatic circulation and improve the physiological environment of joints. After syndrome differentiation, the therapeutic effect is more significant than that of direct routine medicine. Through joint cleaning combined with syndrome differentiation prescription, the combination of cleaning and nourishing, both the symptoms and the symptoms are treated. It is a method worth popularizing in clinical treatment of chronic knee joint synovitis.
【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】：2017
【分類號(hào)】：R274.9

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