本文選題：慢性肩袖損傷 + 針刀�。� 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的隨著人們生活方式及工作環(huán)境的變化,肩袖損傷患者逐年增多,并有逐漸年輕化趨勢(shì),肩袖損傷是十分常見的一類肩關(guān)節(jié)退行性病變,臨床主要表現(xiàn)為肩周疼痛、活動(dòng)受限、上肢無力、肌肉萎縮。本課題主要通過探討針刀松解術(shù)結(jié)合內(nèi)熱針治療慢性肩袖損傷的臨床療效,并與常規(guī)針刺療法進(jìn)行對(duì)照研究,驗(yàn)證其治療慢性肩袖損傷可行性,評(píng)價(jià)其療效、治療周期,找出并建立一種療效突出,治療周期短,安全可靠,患者易于接受,并且能在臨床上應(yīng)用與推廣的治療方式。研究方法本課題研究對(duì)象60例患者,均選自2015年05月至2016年10月于十堰市太和醫(yī)院康復(fù)中心住院治療患者,均符合本課題納入標(biāo)準(zhǔn),按照隨機(jī)、對(duì)照、單盲原則進(jìn)行分類,分為治療組(針刀結(jié)合內(nèi)熱針療法)及對(duì)照組(針刺+電針綜合療法),每組各30例患者。參照“中華人民共和國(guó)中醫(yī)藥行業(yè)標(biāo)準(zhǔn)《中醫(yī)病癥診斷療效標(biāo)準(zhǔn)》,治療組采用針刀松解結(jié)合內(nèi)熱針療法,先予患者行針刀松解術(shù)治療,術(shù)后第3、第5天行內(nèi)熱針治療,治療后囑患者行功能鍛煉,7天為1療程;對(duì)照組行常規(guī)針刺得氣后接用電針治療,治療后囑患者行肩關(guān)節(jié)功能鍛煉,每日1次,治療6天后休息一天,7天為一療程。兩組均連續(xù)治療兩個(gè)療程。療程結(jié)束后,采用美國(guó)加州大學(xué)(UCLA)肩關(guān)節(jié)功能評(píng)分及視覺模擬評(píng)分法(VAS)評(píng)分表,作為觀察及療效指標(biāo),并對(duì)其進(jìn)行統(tǒng)計(jì)學(xué)分析。研究結(jié)果治療后觀察數(shù)據(jù)采用SPSS19.0統(tǒng)計(jì)軟件進(jìn)行分析。結(jié)果:1.實(shí)驗(yàn)組痊愈9例,有效19例,無效2例,總有效率93.33%,針刺綜合療法組治療后痊愈5例,有效19例,無效6例,總有效率80.00%。針刀結(jié)合內(nèi)熱針治療組療效明顯高于綜合針刺治療組,差異具有顯著性(P0.05)2.視覺模擬評(píng)分(VAS):治療前兩組的VAS評(píng)分比較無明顯差異(P0.05),具有可比性。治療后兩組VAS評(píng)分均下降,與治療前相比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),且針刀結(jié)合內(nèi)熱針組優(yōu)于針刺加電針組(P0.05)。3.肩關(guān)節(jié)功能評(píng)分(UCLA):兩組患者治療后,疼痛、功能、向前側(cè)屈曲活動(dòng)、前屈曲力量、病人滿意度評(píng)分均較治療前升高,且治療前后組內(nèi)比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05),兩種治療方式均可治療慢性肩袖損傷。治療后,兩組間疼痛評(píng)分比較(P0.05),提示兩組在改善疼痛時(shí),效果相當(dāng);兩組其余各項(xiàng)評(píng)分組間比較(P0.05),差異明顯,針刀結(jié)合內(nèi)熱針治療慢性肩袖損傷效果更優(yōu),患者滿意度更高。結(jié)論實(shí)驗(yàn)組及對(duì)照組均能緩解慢性肩袖損傷患者疼痛癥狀、增加關(guān)節(jié)活動(dòng)度及肌力,提高患者滿意度,但針刀結(jié)合內(nèi)熱針療法優(yōu)于針刺加電針療法,是一種療效確切,操作簡(jiǎn)單可行性高的治療手段,且無明顯不良反應(yīng),值得臨床推廣。
[Abstract]:Objective with the change of people's life style and working environment, the number of patients with rotator cuff injury increases year by year and tends to be younger. Rotator cuff injury is a kind of common degenerative disease of shoulder joint. Limited movement, upper limb weakness, muscular atrophy. This paper mainly discusses the clinical effect of needle knife loosening combined with internal heat acupuncture in the treatment of chronic rotator cuff injury, and carries out a comparative study with conventional acupuncture therapy to verify the feasibility of treatment of chronic rotator cuff injury, to evaluate its curative effect, and to evaluate the treatment period. To find out and establish a treatment that is effective, short, safe and reliable, easily accepted by patients, and can be applied and popularized in clinic. Methods 60 patients were selected from May 2015 to October 2016 in the rehabilitation center of Taihe Hospital, Shiyan City. The patients were divided into treatment group (acupuncture knife combined with internal heat acupuncture therapy) and control group (acupuncture electroacupuncture combined therapy) with 30 patients in each group. Referring to the Standard of traditional Chinese Medicine (TCM) Industry Standard of the people's Republic of China for the diagnosis of TCM Diseases, the treatment group was treated with needle knife release combined with internal heat acupuncture therapy, the patients were treated with needle knife release first, and the patients were treated with internal heat acupuncture on the 3rd and 5th day after operation. The patients in the control group were treated with electroacupuncture after routine acupuncture. After the treatment, the patients were told to exercise the shoulder joint once a day. After 6 days of treatment, the patients were given a day off for 7 days as a course of treatment. The two groups were treated continuously for two courses. After the course of treatment, the shoulder function score and visual analogue score of UCLA-VAS-scale were used as the observation and curative effect index, and the statistical analysis was carried out. Results the observation data were analyzed by SPSS 19.0 statistical software. The result is 1: 1. In the experimental group, 9 cases were cured, 19 cases were effective, 2 cases were ineffective, the total effective rate was 93.33%. In the combined acupuncture therapy group, 5 cases were cured, 19 cases were effective, 6 cases were ineffective, and the total effective rate was 80.003%. The curative effect of acupuncture knife combined with internal heat acupuncture treatment group was significantly higher than that of comprehensive acupuncture group, and the difference was significant (P 0.05). Visual analogue score (VAS): there was no significant difference in VAS score between the two groups before treatment (P 0.05), which was comparable. The VAS scores of the two groups decreased after treatment, and the difference was statistically significant compared with that before treatment, and the combination of needle knife and internal hot acupuncture group was better than that of acupuncture plus electroacupuncture group. Shoulder function score: after treatment, pain, function, anterior flexion activity, anterior flexion strength, patient satisfaction were increased in both groups. The difference before and after treatment was statistically significant (P 0.05). Both methods could treat chronic rotator cuff injury. After treatment, the pain scores of the two groups were compared with that of the two groups, indicating that the two groups had the same effect in improving the pain, and the other scores of the two groups were significantly different. The effect of needle knife combined with internal heat acupuncture on treating chronic rotator cuff injury was better and the patient satisfaction was higher. Conclusion both the experimental group and the control group can relieve the pain symptoms of the patients with chronic rotator cuff injury, increase the joint motion and muscle strength, and improve the satisfaction of the patients. But the acupuncture knife combined with internal heat acupuncture therapy is better than acupuncture plus electroacupuncture therapy, which is an effective method. Simple operation, high feasibility and no obvious adverse reaction, it is worth popularizing in clinic.
【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)】：R246.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張?zhí)烀?張強(qiáng);曾垂秀;劉建民;;針刀刀具及其作用原理[J];中國(guó)醫(yī)藥導(dǎo)報(bào);2016年27期

2 王麗彬;劉銳鋒;;超聲引導(dǎo)下小針刀治療肩袖鈣化性肌腱炎的臨床觀察[J];內(nèi)蒙古中醫(yī)藥;2016年08期

3 鄭建平;鄭琦;劉飛;;小針刀配合手法松解治療慢性肩袖損傷97例[J];浙江中西醫(yī)結(jié)合雜志;2016年06期

4 鄭榮宗;樓超;童勇駿;黃淑明;吳泉州;;IL-1β、IL-6和TNF-α在肩袖損傷大鼠肩峰下滑囊中的表達(dá)及作用[J];浙江醫(yī)學(xué);2016年11期

5 宮恩強(qiáng);;肩袖損傷的診斷與治療[J];臨床醫(yī)學(xué)研究與實(shí)踐;2016年06期

6 毛玲娣;劉克峰;;鈹針療法配合推拿手法治療肩袖損傷76例[J];實(shí)用中醫(yī)藥雜志;2016年03期

7 楊曉勇;;“肩三針”針刺治療肩袖損傷30例[J];江西中醫(yī)藥;2016年03期

8 廖成靜;廖章渝;曾憲輝;游先菊;;肩袖損傷病因的研究概況[J];哈爾濱醫(yī)藥;2016年01期

9 李方;劉晉閩;;關(guān)節(jié)腔注射玻璃酸鈉配合三號(hào)傷膏外敷治療肩峰下撞擊綜合征臨床觀察[J];陜西中醫(yī)藥大學(xué)學(xué)報(bào);2016年01期

10 楊兵;;磁共振平掃與磁共振關(guān)節(jié)造影在肩袖撕裂診斷中的應(yīng)用價(jià)值[J];當(dāng)代醫(yī)學(xué);2016年01期

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