本文關(guān)鍵詞： 桂枝芍藥知母湯 寒濕痹阻 膝骨性關(guān)節(jié)炎 療效觀察　出處：《云南中醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過隨機(jī)對(duì)照臨床研究觀察桂枝芍藥知母湯加味治療寒濕痹阻型膝骨性關(guān)節(jié)炎的療效,為臨床運(yùn)用提供理論依據(jù)。方法:將符合納入標(biāo)準(zhǔn)的門診60例寒濕痹阻型膝骨性關(guān)節(jié)炎的病人,采用隨機(jī)數(shù)字表法分組,病例數(shù)按治療組:對(duì)照組=1:1進(jìn)行設(shè)計(jì)。治療組口服桂枝芍藥知母湯加味,對(duì)照組口服塞來昔布膠囊,2周為1個(gè)療程,連續(xù)治療2個(gè)療程。觀察治療前、治療1個(gè)療程后、治療2個(gè)療程后及治療結(jié)束后3個(gè)月的膝骨性關(guān)節(jié)炎中醫(yī)癥候量表、癥狀分級(jí)量化評(píng)分表、WOMAC評(píng)分,統(tǒng)計(jì)并比較和分析兩組治療寒濕痹阻型膝骨性關(guān)節(jié)炎的臨床療效。結(jié)果:(1)桂枝芍藥知母湯加味組和塞來昔布組均可以改善KOA患者的癥狀和體征,減輕疼痛,提高生活質(zhì)量。(2)治療結(jié)束時(shí)臨床療效比較:治療組總有效率86.67%,對(duì)照組總有效率83.33%,兩組療效比較差異無統(tǒng)計(jì)學(xué)意義(p0.05),桂枝芍藥知母湯加味與塞來昔布膠囊治療寒濕痹阻型KOA可能療效相當(dāng)。(3)治療1個(gè)療程結(jié)束時(shí),在患者臨床癥狀評(píng)分上,兩組都能不同程度地降低各評(píng)價(jià)量表及臨床癥狀積分(p0.05),兩組組間比較差異無統(tǒng)計(jì)學(xué)意義(p0.05),但從均數(shù)上分析,治療1個(gè)療程后,對(duì)照組改善情況優(yōu)于治療組。(4)治療2個(gè)療程結(jié)束時(shí),與治療前及治療1個(gè)療程比較,兩組都能不同程度地降低患者各評(píng)價(jià)量表及臨床癥狀積分(p0.05),提示桂枝芍藥知母湯加味與塞來昔布對(duì)KOA均有療效,且治療組療效較佳(p0.05,除疼痛外)。在疼痛評(píng)分上,組間比較無統(tǒng)計(jì)學(xué)差異(p0.05),治療組在改善疼痛方面不優(yōu)于對(duì)照組。(5)治療結(jié)束后3個(gè)月結(jié)果:與治療前比較,兩組均能有效降低各量表及臨床癥狀積分(p0.05);治療組優(yōu)于對(duì)照組(p0.05),提示桂枝芍藥知母湯加味與塞來昔布對(duì)KOA均具有長(zhǎng)期療效,其中桂枝芍藥知母湯加味治療組的長(zhǎng)期療效可能更優(yōu)。結(jié)論:桂枝芍藥知母湯加味治療寒濕痹阻型膝骨性關(guān)節(jié)炎有一定的近、遠(yuǎn)期臨床療效,能有效緩解患者的疼痛,減輕臨床癥狀及體征。塞來昔布組較桂枝芍藥知母湯加味組在疼痛治療方面起效快,近期療效更為明顯;而長(zhǎng)期療效比較桂枝芍藥知母湯加味組可能更為明顯。
[Abstract]:Objective: to observe the therapeutic effect of Guizhi-paeoniao Anemarrhenia decoction on cold-dampness arthralgia type knee osteoarthritis by randomized controlled clinical study. Methods: 60 cases of cold and dampness arthralgia type knee osteoarthritis were divided into two groups by random digital table method. The number of cases in the treatment group was designed according to the control group (1: 1). The treatment group was treated with celecoxib capsule for 2 weeks, and the control group was treated with celecoxib capsule for 2 weeks. Before and after one course of treatment, the treatment group was treated with celecoxib capsule. TCM symptom scale of knee osteoarthritis after 2 courses of treatment and 3 months after treatment. The clinical efficacy of the two groups in the treatment of cold and dampness arthralgia type osteoarthritis of knee was compared and analyzed. Results both the decoction group and celecoxib group could improve the symptoms and signs of patients with KOA and relieve the pain. Comparison of clinical efficacy at the end of the treatment: the total effective rate of the treatment group was 86.67 and the total effective rate of the control group was 83.33. There was no significant difference between the two groups in the curative effect. There was no significant difference between the two groups in the treatment of cold dampness. At the end of one course of treatment, the effect of arthralgia type KOA may be equivalent. In the clinical symptom score of the patients, the two groups can reduce the evaluation scale and the clinical symptom score in varying degrees. The difference between the two groups is not statistically significant (p 0.05). However, after one course of treatment, there is no significant difference between the two groups in the clinical symptom score, but after one course of treatment, there is no significant difference between the two groups. The improvement of the control group was better than that of the treatment group. Both groups were able to reduce each evaluation scale and clinical symptom score of the patients in varying degrees (p0.05), indicating that both the decoction and celecoxib had curative effect on KOA, and the therapeutic effect in the treatment group was better than that in the control group (P 0.05), except for pain. There was no significant difference between the two groups (p0.05). The treatment group was not superior to the control group in improving pain. The treatment group was superior to the control group (P 0.05), which indicated that both the decoction and celecoxib had long-term curative effect on KOA, and the treatment group was superior to the control group (P 0.05), and the treatment group was superior to the control group (P 0.05), which indicated that both the decoction and celecoxib had long-term curative effect on KOA. Conclusion: Guizhi-paeoniao Anemarrhena decoction has a short-term and long-term clinical effect on the treatment of cold and dampness obstruction knee osteoarthritis, and can effectively relieve the pain of the patients. The clinical symptoms and signs were alleviated. Celecoxib group was more effective in pain treatment than Guizhi paeoniao Anemarrhena Anemarrhena decoction group, but the long-term effect was more obvious than Guizhi paeoniao Anemarrhena chinensis decoction group.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R274.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 孫振新;楊矛;朱玲玲;程惠娟;王峰;;中醫(yī)藥治療膝骨關(guān)節(jié)炎研究進(jìn)展[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2017年01期

2 俞飛;費(fèi)駿;賴震;;膝關(guān)節(jié)骨性關(guān)節(jié)炎中醫(yī)藥研究進(jìn)展[J];浙江中西醫(yī)結(jié)合雜志;2016年01期

3 曲道煒;朱輝;艾華;;桂枝芍藥知母湯方證辨析[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2015年08期

4 辛小紅;張星平;巴哈爾;梁政亭;;由桂枝芍藥知母湯管窺張仲景對(duì)《素問·痹論》之發(fā)展[J];中華中醫(yī)藥雜志;2015年08期

5 單梅花;;桂枝芍藥知母湯治療膝骨性關(guān)節(jié)炎臨床觀察[J];中醫(yī)臨床研究;2015年20期

6 王曉冰;;中醫(yī)藥治療膝骨關(guān)節(jié)炎[J];實(shí)用中醫(yī)內(nèi)科雜志;2015年07期

7 李亞平;劉新輝;;活血通絡(luò)補(bǔ)腎方加減治療膝骨關(guān)節(jié)炎45例[J];湖南中醫(yī)雜志;2015年06期

8 王愛華;梁曉娟;;桂枝芍藥知母湯加減對(duì)痹證的治療[J];世界最新醫(yī)學(xué)信息文摘;2015年18期

9 劉小婷;張楚惠;張愛芳;;溫針配合推拿治療重度膝關(guān)節(jié)炎的護(hù)理體會(huì)[J];吉林醫(yī)學(xué);2015年04期

10 李竟;;溫針灸配合推拿治療膝關(guān)節(jié)骨性關(guān)節(jié)炎臨床研究[J];新中醫(yī);2015年01期

相關(guān)博士學(xué)位論文 前1條

1 董天華;膝關(guān)節(jié)骨性關(guān)節(jié)炎的基礎(chǔ)與臨床研究[D];河北醫(yī)科大學(xué);2016年

相關(guān)碩士學(xué)位論文 前3條

1 王開超;411例膝關(guān)節(jié)骨性關(guān)節(jié)炎患者的流行病學(xué)調(diào)查分析[D];山東中醫(yī)藥大學(xué);2015年

2 鄧鵬鵬;關(guān)節(jié)鏡術(shù)結(jié)合骨痹合劑治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床研究[D];云南中醫(yī)學(xué)院;2015年

3 林聰;基于數(shù)據(jù)挖掘?qū)ΜF(xiàn)代醫(yī)家應(yīng)用桂枝芍藥知母湯的方證研究[D];廣州中醫(yī)藥大學(xué);2015年

，

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