發(fā)布時間：2018-03-04 11:52

  本文選題：微針刀解結法　切入點：普通針刺　出處：《廣州中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:當今社會的現(xiàn)代化發(fā)展愈發(fā)迅猛,致使人們對自身生活質(zhì)量和身體健康狀況的要求漸漸提高,因此出現(xiàn)許多營養(yǎng)過剩的飲食習慣,而且科技的進步讓人們的體力勞動逐年減少,肥胖人數(shù)不斷攀升,超出正常范圍的體重給雙膝關節(jié)帶來的負荷也越來越大,導致膝骨性關節(jié)炎的患病率升高、患病年齡降低,明顯影響患者的生活質(zhì)量。當前治療該病的常用藥是非留體抗炎鎮(zhèn)痛口服藥,其療效較為明顯,可是會引起消化系統(tǒng)的不良反應;而現(xiàn)有的中藥療法效果并不明確,常常良莠不齊;西醫(yī)手術治療則損傷較大,麻醉風險也高,因此尋求一種簡、驗、廉、便的膝骨性關節(jié)炎治療方法是一個亟待解決的問題。本課題根據(jù)臨床病例觀察微針刀解結法對膝骨性關節(jié)炎的治療結果,從患者的膝關節(jié)疼痛、僵硬和關節(jié)生理功能幾個方面,分析該療法對本病的具體療效,從而證實其有效性和安全性并指導實踐治療。研究結果對于改善中老年患者們的生活質(zhì)量有重大的醫(yī)學和社會意義。方法:本課題的受試者均來自2016年06月至2017年01月于廣東省第二中醫(yī)院針康科門診和住院部的病人,均切合所設定的診斷標準和納入標準。本課題采用的是隨機對照、單盲的前瞻性研究方法來進行試驗。將收集到的患者按就診順序隨機分為微針刀組(采用微針刀解結法治療)和針刺組(采用普通針刺法治療)。觀察經(jīng)微針刀組和針刺組治療后患者膝關節(jié)疼痛、僵硬、生理功能的改善程度。所有患者每周進行3次操作,連續(xù)4周。在治療前、后分別采用國際視覺模擬評分量表(VAS)、骨關節(jié)炎指數(shù)評分(W0MAC)量表對患者進行評估。先對兩組的一般資料、X線分級情況和每個量表評分進行基線比較,在發(fā)現(xiàn)兩組之間無差異,具有可比性后,接著分別比較兩組治療前后的量表數(shù)據(jù)改變,以及兩組組間在改善膝關節(jié)疼痛、僵硬、生理功能之間的差別,最終根據(jù)療效評定標準比較兩組的總體療效。結果:療程結束,二組的VAS評分、WOMAC各指標評分及其總積分都比治療之前明顯降低,且兩者具有顯著統(tǒng)計學差異(P0.01),說明微針刀解結法和普通針刺法都可以明顯影響患者的膝關節(jié)疼痛、僵硬以及生理功能。治療后,微針刀組和針刺組在減輕患者的膝關節(jié)僵硬癥狀方面效果相當,兩組治療后評分沒有明顯的差異(P0.05),兩組治療前后的積分差值比較亦沒有顯著性差異(P0.05);而在疼痛癥狀的減輕以及生理功能的改善方面,微針刀組的治療效果比針刺組更佳,兩組治療后評分有顯著差異(P0.05),各組治療前后評分的差值比較也有統(tǒng)計學差異(P0.05)。并且它們治療后的總體臨床療效相比,二者具有統(tǒng)計學差異(P0.05),微針刀組治療效果明顯比針刺組更好。結論:使用微針刀解結法和普通針刺法治療膝骨性關節(jié)炎,二者治療前后都具有顯著性差異,效果明顯,且微針刀組各量表指標的結果大多優(yōu)于針刺組,說明微針刀組的治療效果較針刺組更明顯�？傊�,微針刀解結法是一種療效佳、操作易、無不良反應的療法,可以從很大程度上改善患者膝關節(jié)疼痛、僵硬及活動受限的情況,值得推廣使用。
[Abstract]:Objective: the modernization of the social development rapidly, resulting in the demand for quality and health status of their own life gradually increased, so there are many nutritional excess eating habits, and the progress of science and technology make people's physical labor decreased year by year, the number of overweight is not broken up, beyond the normal range of the weight of the load of double knee joint more and more, resulting in knee osteoarthritis prevalence rate increased, age decreased, significantly affect the quality of life of patients. The current commonly used drugs for the treatment of the disease is left non oral medicine anti-inflammatory analgesic, its curative effect is obvious, but can cause adverse reactions in the digestive system; while the existing Chinese medicine therapy effect is not clear often, western medicine treatment is uneven in quality; the larger damage, the risk of anesthesia is also high, so seeking a simple, low-cost, and knee osteoarthritis of the treatment is an urgent To solve the problem. According to the clinical observation of micro needle therapy results untie the knot of knee osteoarthritis of the knee pain from patients, several stiffness and joint physiological function, analysis of the specific effect of the treatment of this disease, so as to confirm the effectiveness and safety of the treatment. The results of the study and practice is of great significance for improving the medical and social elderly patients' quality of life. Methods: the subjects of this research were from 2016 06 to 2017 01 months in the second hospital of Guangdong Province Department of outpatient and inpatient rehabilitation patients were cut by setting the diagnostic criteria and inclusion criteria in this paper. Using the randomized, prospective study of single blind method to test. The collected patients were randomly divided into treatment group (using micro micro needle knife solution method and node treatment) acupuncture group (the ordinary acupuncture law ). Observe the micro needle therapy group and acupuncture group after treatment of patients with knee joint pain, stiffness, improve the degree of physiological function. All of the patients was 3 times a week, for 4 weeks. Before treatment, after using the international visual analogue scale (VAS), index of osteoarthritis score (W0MAC) amount the table for the evaluation of patients. The general data of the two groups, and each X-ray grading score were compared in the baseline, found no differences between the two groups are comparable, then the two groups were compared before and after treatment, the scale of data change, and between the two groups in the improvement of knee joint pain. Stiff, the physiological function of the difference between the final according to the overall curative effect evaluation standard of two groups were compared. Results: the end of treatment, two groups of VAS score, WOMAC score and the total score of each index than before treatment significantly decreased, and both have significant difference (P0.01) That shows the micro needle knife solution node method and ordinary acupuncture can significantly affect patients with knee joint pain, stiffness and physiological function. After treatment, the micro needle group and acupuncture group in reducing patients' symptoms of knee joint stiffness effect is equivalent to that of the two groups after treatment were not significantly difference (P0.05), integral difference before and after two groups of treatment as compared with no significant difference (P0.05); while the pain reduction of symptoms and physiological function improvement, micro needle knife group treatment effect better than the acupuncture group, the two groups after treatment were significantly different (P0.05), the difference between the groups before and after treatment were compared with significant differences (P0.05) the overall clinical efficacy. And compared them after treatment, two showed a significant difference (P0.05), micro needle knife treatment effect is obviously better than the acupuncture group. Conclusion: the use of micro needle knife solution method and ordinary acupuncture treatment of knee osteoarthritis Inflammation, before and after the two treatment has significant difference, the effect is obvious, and the micro scale index of the Acupotomy group results are better than the acupuncture group, indicating that the micro needle knife group than in the acupuncture group treatment effect is more obvious. In short, micro needle knot solving method is a good curative effect, easy operation, no adverse reaction in the therapy from, can greatly improve the knee joint pain, stiffness and limitation of activity situation, which is worthy of promotion.

【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.9

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本文編號：1565538