本文選題：針刀 + 肩周炎��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：肩周炎是一種以肩痛、肩關(guān)節(jié)活動障礙為主要特征的筋傷,因該病多發(fā)生于50歲左右的患者,該年齡段處于工作的中間力量,目前肩周炎的早期診斷,早期治療的研究己取得了巨大的進(jìn)展,但診療標(biāo)準(zhǔn)尚有爭議,我國人口眾多,發(fā)病患者占骨科病人的1%,需要尋找一種簡便廉效、易于推廣的診斷治療方法極為重要。針刀微創(chuàng)治療肩周炎是一種理想的技術(shù),需要把相關(guān)針刀入路進(jìn)行分析,從理論和臨床上進(jìn)行合理的論證,以便更好的在接診中運用。研究目的:全面綜述肩周炎的中西醫(yī)理論觀點,以及當(dāng)今各種治療方案,分析針刀微創(chuàng)治療的機(jī)理與臨床應(yīng)用。通過對人體標(biāo)本進(jìn)行針刀治療的方案,并對相關(guān)標(biāo)本部位的尺寸進(jìn)行測量和研究,把相關(guān)的數(shù)據(jù)用來指導(dǎo)篩選確定針刀入路的臨床應(yīng)用,觀察針刀微創(chuàng)治療技術(shù)在肩周炎的臨床癥狀包括VAS疼痛,活動角度及L‘Insalata評定的影響,通過規(guī)范標(biāo)準(zhǔn)化針刀治療方案。評價針刀治療技術(shù)對肩周炎治療的安全入路風(fēng)險與療效,探討針刀微創(chuàng)治療的機(jī)理及臨床規(guī)范。研究方法:實驗研究以成人尸體上肢標(biāo)本例進(jìn)行局部解剖,觀察肌肉、血管、神經(jīng)分布走行以成人15具標(biāo)本測量骨性標(biāo)志,指導(dǎo)整理針刀治療肩周炎的安全有效的入路。并結(jié)合臨床60例患者分成兩組,針灸組30人,針刀組30人,進(jìn)行針刀治療臨床應(yīng)用研究對比。臨床采用隨機(jī)方法分兩組,即針刀組與針灸組,針刀組采用解剖數(shù)據(jù)確定安全的針刀松解療法,每周治療1次,4次為療程,療程結(jié)束后觀察治療結(jié)果。針灸組取穴,每日一次,5次一個療程,間隔2日,進(jìn)行4個療程。對L‘Insalata肩關(guān)節(jié)功能評價量表、肩關(guān)節(jié)VAS疼痛分?jǐn)?shù)、肩關(guān)節(jié)功能活動3個方面進(jìn)行分析評價。結(jié)果:15具成人尸體標(biāo)本提供了大量的圖像和數(shù)據(jù),并直觀的展示了針刀進(jìn)入人體后松解相關(guān)的神經(jīng)與肌肉組織對肩部的影響,在此基礎(chǔ)上,研究人員結(jié)合針刀理論整理出13個治療肩周炎相對安全的針刀入路,在臨床治療運用,對60例患者進(jìn)行針刀松解法與針灸治療的對比,針刀組與針灸組的VAS評分組間比較在治療1個月,3個月后的隨訪、6個月的隨訪,P指分別為0.019、0.036與0.001,針刀組明顯優(yōu)于針灸組;針刀組與針灸組的外展角度組間比較在治療1個月,3個月后的隨訪、6個月的隨訪,P指分別為0.000、0.036與0.032,針刀組明顯優(yōu)于針灸組;針刀組與針灸組的前屈角度組間比較在治療1個月,3個月后的隨訪、6個月的隨訪,P指分別為0.000,0.000與0.014,針刀組明顯優(yōu)于針灸組;針刀組與針灸組的內(nèi)旋角度組間比較在治療1個月,3個月后的隨訪、6個月的隨訪,P指分別為0.010,0.002與0.000,針刀組明顯優(yōu)于針灸組;針刀組與針灸組的外旋角度組間比較在治療1個月,3個月后的隨訪、6個月的隨訪,P指分別為0.000,0.000與0.001,針刀組明顯優(yōu)于針灸組;針刀組與針灸組的L‘Insalata評價表評分組間比較在治療1個月,3個月后的隨訪、6個月的隨訪,P指分別為0.002,0.003與0.030,針刀組明顯優(yōu)于針灸組。針刀組與針灸組治療前后沒有出現(xiàn)患者受傷的報道.針刀組治療肩周在VAS評分,肩關(guān)節(jié)功能活動、L‘Insalata評價表各個方面均優(yōu)于針灸組。
[Abstract]:Scapulohumeral periarthritis (scapulohumeral periarthritis) is a kind of muscle injury with the main characteristics of shoulder pain and shoulder joint activity disorder. Because the disease is mostly born in the patients about 50 years old, the age section is in the middle of the work, the early diagnosis of the periarthritis of shoulder, the early treatment research has made great progress, but the medical treatment standard is still controversial, our population is large and the patients are occupied. 1% of the patients in the Department of orthopedics need to find a simple and inexpensive and easy to spread diagnosis and treatment method. The needle knife minimally invasive treatment of scapulohumeral periarthritis is an ideal technique. It is necessary to analyze the related Acupotomy approach and make a reasonable argument in theory and clinic, so as to better use it in the reception. The theory of traditional Chinese and Western medicine, as well as the various treatment schemes today, analysis the mechanism and clinical application of the needle knife minimally invasive treatment. Through the needle knife treatment of the human specimens, and the measurement and study of the size of the related specimen, the related data are used to guide the clinical application of the needle knife approach and to observe the needle knife minimally invasive. The clinical symptoms of scapulohumeral periarthritis include VAS pain, activity angle and the influence of L 'Insalata assessment, standardized needle knife treatment plan. Evaluate the safe approach to the treatment of periarthritis of scapulohumeral periarthritis by needle knife treatment technology, explore the mechanism and clinical standard of needle knife minimally invasive treatment. Research method: Experimental Study on adult cadavers The body upper limb specimens were dissected to observe the muscle, blood vessel, and nerve distribution to measure bone markers in 15 adult specimens and guide the safe and effective approach of treating periarthritis of shoulder by needle knife. Combined with 60 clinical cases, 30 people and 30 needle knife groups were divided into two groups, and the clinical application of acupotomy was compared. The machine method was divided into two groups, namely needle knife group and acupuncture group, needle knife group using anatomical data to determine safe needle knife loosening therapy, 1 times a week, 4 times as a course of treatment, after the end of the course observation treatment results. Acupuncture group taking acupoint, 5 times a day, 2 days, 4 courses of treatment. L 'Insalata shoulder joint function evaluation scale, shoulder joint VAS Analysis and evaluation of 3 aspects of pain score and functional activity of shoulder joint. Results: 15 adult cadavers provided a large number of images and data, and intuitively demonstrated the influence of the Acupotomy into the human body and the influence of the related nerve and muscle tissue on the shoulder. On this basis, the researchers collate 13 scapulohumeral periarthritis in combination with the needle knife theory. Relatively safe needle knife approach, in clinical treatment, 60 patients were compared with acupuncture and acupuncture treatment. The comparison between the needle knife group and the VAS score group in the acupuncture group and the acupuncture group was 1 months, 3 months follow-up, 6 months follow-up, the P finger was 0.019,0.036 and 0.001, the needle knife group was obviously superior to the acupuncture group; the needle knife group and the acupuncture group were obviously better than the acupuncture group. The abduction angle group comparison between 1 months, 3 months follow-up, 6 months follow-up, P finger 0.000,0.036 and 0.032, needle knife group is obviously better than the acupuncture group, acupuncture group and acupuncture group of the anterior flexion angle group compared in the treatment 1 months, 3 months after the follow-up, 6 months with the visit, P finger respectively 0.000,0.000 and 0.014, needle knife group is obviously better than the group. Acupuncture group, acupuncture group and acupuncture group in the group of internal rotation angle comparison between 1 months, 3 months after follow-up, 6 months follow-up, P 0.010,0.002 and 0, needle knife group is obviously better than acupuncture group, needle knife group and acupuncture group of external rotation angle group comparison between 1 months, 3 months after the follow-up, 6 months follow-up, P finger is 0.000,0., respectively. 000 and 0.001, the needle knife group was obviously better than the acupuncture group; the L 'Insalata evaluation table between the needle knife group and the acupuncture group was compared in the treatment 1 months, 3 months follow-up, 6 months follow-up, the P finger was 0.002,0.003 and 0.030, the needle knife group was obviously superior to the acupuncture group. The shoulder circumference of the group was better than that of the acupuncture group in terms of VAS score, shoulder function activity and L 'Insalata evaluation table.

【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.9

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