本文選題：膝骨關(guān)節(jié)炎 + 針刺�。� 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探究針刺治療膝骨關(guān)節(jié)炎(KOA)的臨床療效。方法:提取檢索關(guān)鍵詞,設(shè)計科學(xué)有效的文獻檢索策略,利用計算機檢索中國知網(wǎng)數(shù)據(jù)庫(CNKI)、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫(CBM)、萬方數(shù)據(jù)庫(WF)、維普數(shù)據(jù)庫(VIP),各數(shù)據(jù)庫檢索時間均截止到2016年12月。共納入40個隨機對照試驗,包括4031例受試者,其中試驗組2012例,對照組2019例。采用Rev Man 5.3軟件進行數(shù)據(jù)分析。文獻質(zhì)量采用Cochrane協(xié)作網(wǎng)提供的質(zhì)量評價工具進行評價。主要評價指標(biāo)包括臨床有效率、疼痛效果、僵硬效果、日�；顒佣刃Ч�。所得出的計數(shù)資料采用比值比(OR),計量資料采用標(biāo)準(zhǔn)化均數(shù)差(SMD)及它們的95%置信區(qū)間(CI)表示。結(jié)果:1.針刺治療KOA總臨床有效率試驗組高于對照組[OR=3.20,95%CI(2.63,3.90)];總疼痛效果試驗組低于對照組[SMD=-0.52,95%CI(-0.90,-0.15)];總僵硬效果兩組間無顯著性差異[SMD=-0.22,95%CI(-0.52,0.08)];總?cè)粘；顒佣刃Ч麅山M間無顯著性差異[SMD=-0.14,95%CI(-0.29,0.01)];漏斗圖均左右基本對稱。2.三種不同針刺方法治療KOA臨床有效率:OR(溫針灸)OR(普通針刺)OR(電針);疼痛效果:SMD(溫針灸)SMD(電針)SMD(普通針刺);僵硬效果:SMD(電針)SMD(溫針灸)SMD(普通針刺);日�；顒佣刃Ч�:SMD(溫針灸)SMD(電針)SMD(普通針刺)。3.針刺對比中藥、推拿和西藥治療KOA臨床有效率:OR(對比西藥組)OR(對比中藥組)OR(對比推拿組);疼痛效果:SMD(對比西藥組)SMD(對比中藥組)SMD(對比推拿組);僵硬效果:SMD(對比西藥組)SMD(對比中藥組)SMD(對比推拿組);日�；顒佣刃Ч�:SMD(對比西藥組)SMD(對比中藥組)SMD(對比推拿組)。4.不同結(jié)局時間針刺治療KOA臨床有效率:OR(30d以上)OR(22d~30d)OR(1d~21d);疼痛效果:SMD(30d以上)SMD(1d~21d)SMD(22d~30d);僵硬效果:SMD(30d以上)SMD(22d~30d)SMD(1d~21d);日�；顒佣刃Ч�:SMD(30d以上)SMD(1d~21d)SMD(22d~30d)。5.針刺配合理療對比單獨理療治療KOA臨床有效率:試驗組高于對照組[OR=2.50,95%CI(1.28,4.88)];配合推拿對比單獨推拿治療KOA臨床有效率:試驗組高于對照組[OR=4.77,95%CI(2.85,7.98)];配合中藥對比單獨中藥治療KOA臨床有效率:試驗組高于對照組[OR=5.05,95%CI(2.55,9.98)]。結(jié)論:1.針刺治療KOA臨床有效率高于其它療法,止痛效果優(yōu)于其它療法。2.三種不同針刺方法治療KOA,溫針灸療法臨床有效率最高,溫針灸療法止痛效果最優(yōu),電針療法改善僵硬效果最優(yōu),溫針灸療法改善日�；顒佣刃Ч顑�(yōu)。3.針刺對比中藥、推拿和西藥治療KOA,臨床有效率對比西藥組最高,止痛效果、改善僵硬效果、改善日常活動度效果均對比西藥組最優(yōu)。4.不同結(jié)局時間針刺治療KOA,臨床有效率療程30天以上最高,止痛效果、改善僵硬效果、改善日�；顒佣刃Ч煶�30天以上最優(yōu)。5.治療KOA臨床有效率,針刺配合理療高于單獨理療,配合推拿高于單獨推拿,配合中藥高于單獨中藥治療。
[Abstract]:Objective: to explore the clinical effect of acupuncture on knee osteoarthritis. Methods: the key words were extracted, and scientific and effective literature retrieval strategies were designed. Using computer to search CNKI, CBM, WFN, VIPB, all the databases were searched as of December, 2016. The retrieval time of each database is as of December 2016, and the search time of each database is as of December 2016. The search time of each database is as follows: (1) the Chinese biomedical literature database (CBM); A total of 40 randomized controlled trials were conducted, including 4031 subjects, including 2012 in the trial group and 2019 in the control group. The data were analyzed by Rev Man 5.3 software. The literature quality is evaluated by the quality evaluation tool provided by Cochrane Cooperative Network. The main evaluation measures include clinical efficacy, pain effect, stiffness effect and daily activity effect. The calculated data are expressed by the ratio ratio and the standard mean difference (SMD) and their 95% confidence interval (CI). The result is 1: 1. The total clinical effective rate of acupuncture treatment for KOA was higher in the experimental group than in the control group [OR3.20995 CI 2.633.90]; the total pain effect in the experimental group was lower than that in the control group [SMD-0.5295CI-0.90 CI-0.15]; there was no significant difference in the total stiffness effect between the two groups [SMD-0.2295CI-0.520.08]; there was no significant difference in the total daily activity between the two groups [SMD-0.1495CI-0.290.01]; and the funnel graph showed no significant difference between the two groups (SMD-0.2295CI-0.520.08); the total daily activity effect had no significant difference between the two groups [SMD-0.1495CI-0.290.01]. Average left and right basic symmetry. 2. Effective rate of three different Acupuncture methods for KOA Clinical effectiveness: (warm Acupuncture or Orr; pain effect: SMD); effect of warming Acupuncture and moxibustion on SMD (General Acupuncture); rigid effect of SMD (warm Acupuncture SMD; effect of Daily activity) SMD (Acupuncture and moxibustion SMD). Acupuncture contrast traditional Chinese medicine, The effective rate of massage and western medicine in treating KOA is: (1) the clinical effective rate of KOA is compared with that of traditional Chinese medicine group (control group); the effect of pain is compared with that of western medicine group (SMD group); the effect of pain is compared with that of traditional Chinese medicine group (SMD group); the effect of inflexibility is compared with that of traditional Chinese medicine group (SMD group). The effect of daily activity was as follows: 1. The effective rate of acupuncture in the treatment of KOA at different outcome times was more than 22 days, 30 days and more than 22 days and 21 days, the pain effect was more than 30 days, the pain effect was more than 22 days, the stiffness effect was more than 30 days, and the stiffness effect was more than 22 days and 30 days, and the effect of daily activity was more than 30 days, and the effect of daily activity was more than one day, thirty days, and five days, the effect of stiffness was more than 30 days and more than 30 days, and the effect of daily activity was more than 30 days and more than one day, and the effect of daily activity was more than one day, one day and thirty days. The clinical effective rate of acupuncture combined with physiotherapy alone in the treatment of KOA was higher in the experimental group than in the control group [ORA 2.50 ~ 95 ~ 1.28 ~ 4.88]; in the experimental group, the clinical effective rate of massage alone was higher than that in the control group [ORF 4.775 ~ 95CII 2.85 ~ 7.98]; and in comparison with traditional Chinese medicine alone, the clinical effective rate was higher in the experimental group than in the control group. The clinical effective rate of KOA in the trial group was higher than that in the control group. Conclusion 1. The clinical effective rate of acupuncture for KOA is higher than that of other therapies, and the analgesic effect is better than that of other therapies. Among the three different acupuncture methods, the clinical effective rate of warming acupuncture therapy is the highest, the effect of warming acupuncture therapy is the best, the effect of electroacupuncture therapy is the best, and the effect of warming acupuncture therapy is the best. 3. Acupuncture compared with traditional Chinese medicine, massage and western medicine treatment of KOA. the clinical effective rate of western medicine group is the highest, analgesic effect, improve stiffness effect, improve the effect of daily activities compared with the western medicine group is the best. 4. 4. In the treatment of KOAat with different outcome time, the clinical effective rate was the highest in more than 30 days, the analgesic effect was the highest, the stiffness effect was improved, and the average course of treatment was more than 30 days. 5. The effective rate of acupuncture combined with physiotherapy was higher than that of physical therapy alone, and that of combined massage was higher than that of massage alone, and that of traditional Chinese medicine was higher than that of traditional Chinese medicine alone.
【學(xué)位授予單位】：遼寧中醫(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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