熱敏灸聯(lián)合中藥熏洗治療髕骨軟化癥（氣滯血淤型）的臨床療效研究
發(fā)布時間：2018-07-17 01:53
【摘要】：目的：應(yīng)用Lysholm膝關(guān)節(jié)評分量表和視覺模擬評分法,評價熱敏灸聯(lián)合中藥熏洗對髕骨軟化癥(氣滯血瘀型)的臨床療效,目的在于探索出一種能為臨床治療髕骨軟化癥提供更多參考的有效的、綜合的且安全的治療方案。方法：將96名患者按照1：1：1隨機分為熱敏灸組、中藥熏洗組和熱敏灸聯(lián)合中藥熏洗組。熱敏灸組女18例,男14例,平均病程6.69±3.24月,平均年齡29.72±5.33歲；中藥熏洗組女15例,男17例,平均病程6.78±3.14月,平均年齡30.38±5.07歲；聯(lián)合組男15例,女17例,平均年齡30.03±5.58歲,平均病程6.84±3.12月。熱敏灸組的操作方法如下：選取阿是穴、犢鼻、足三里、太溪、懸鐘、梁丘、內(nèi)外膝眼、陽陵泉、血海,同時以選取的穴位為中心,并在以3cm為半徑的范圍內(nèi),保持與皮膚距離在3-4cm處,施以回旋灸和溫和灸。在施灸過程中,如若出現(xiàn)患者對遠離施灸部位或者施灸部位感受到以下情況即可確定熱敏點,如：痛、麻、重、冷、腫、壓、酸等。并選取最敏感點3-4個予以灸療。每次1劑,每日1次,10次為1個療程,療程間隙2天,治療2個療程。中藥熏洗組的具體操如下：用煎煮好后的中藥蒸汽熏膝關(guān)節(jié),隨后在以外洗。具體組方為：獨活、紅花、沒藥、防風(fēng)各15g,地龍5g,草烏、川烏、威靈仙20g,伸筋草、雞血藤、透骨草各30g組方。每次1劑,每日1次,10次為1個療程,療程間隙2天,治療2個療程。熱敏灸聯(lián)合中藥熏洗組的操作方法是同時采用前面兩組的治療方案,每次1劑,每日1次,10次為1個療程,療程間隙2天,治療2個療程。于患者治療的開始前與結(jié)束后,運用Lysholm膝關(guān)節(jié)評分量表、視覺模擬評分法對患者進行評分,并比較臨床療效。結(jié)果：治療前,三組Lysholm評分差別無統(tǒng)計學(xué)意義(P0.05)；治療后,分別與治療前比較,三組Lysholm評分均有顯著性升高(均有P0.05)；與中藥熏洗組比較,熱敏灸組和聯(lián)合組Lysholm評分均有顯著性升高(P0.05)；與熱敏灸組比較,聯(lián)合組Lysholm評分有顯著性升高(P0.05)。治療前,三組VAS評分差別無統(tǒng)計學(xué)意義(P＞0.05)；治療后,分別與與治療前比較,三組VAS評分均有顯著性降低(均有P0.05)；與中藥熏洗組比較,熱敏灸組和聯(lián)合組VAS評分均有顯著性降低(P0.05)；與熱敏灸組比較,聯(lián)合組VAS評分有顯著性降低(P0.05)。治療后,熱敏灸組和聯(lián)合組總有效率分別為75.00%、84.37%和93.74%；與中藥熏洗組比較,熱敏灸組合聯(lián)合組總有效率有顯著性提高(均有P0.05);與熱敏灸組比較,聯(lián)合組總有效率有顯著性提高(P0.05)。結(jié)論：中藥熏洗和熱敏灸都能有效改善髕骨軟化癥患者的癥狀體征(顯著提高Lysholm膝關(guān)節(jié)評分量表評分),但中藥熏洗聯(lián)合熱敏灸的治療方案效果更優(yōu)；中藥熏洗和熱敏灸都能有效改善髕骨軟化癥患者的自覺疼痛情況(顯著降低VAS評分),但中藥熏洗聯(lián)合熱敏灸的治療方案效果更優(yōu)；中藥熏洗和熱敏灸對髕骨軟化癥均有較好的療效,但中藥熏洗聯(lián)合熱敏灸的治療方案效果更優(yōu),中藥熏洗聯(lián)合熱敏灸值得在髕骨軟化癥(氣滯血瘀型)臨床治療中進一步推廣。
[Abstract]:Objective: To evaluate the clinical effect of thermosensitive moxibustion combined with traditional Chinese medicine fumigation on patellar softening (qi stagnation and blood stasis type) by using the Lysholm knee score scale and the visual analogue scale, and to explore an effective, comprehensive and safe treatment for the clinical treatment of patellar softening. Methods: 96 patients were treated. According to 1:1:1 randomly divided into hot sensitive moxibustion group, traditional Chinese medicine fumigation group and heat sensitive moxibustion combined with traditional Chinese medicine fumigation group, 18 women in hot moxibustion group and 14 males, with an average course of 6.69 + 3.24 months, with an average age of 29.72 + 5.33 years, 15 women and 17 men, average course 6.78 + 3.14 months, average age of 30.38 + 5.07 years, combined group of male 15 cases, female 17 cases, average Age 30.03 + 5.58 years old, the average course of disease was 6.84 + 3.12 months. The methods of operation of hot moxibustion group were as follows: select the acupoints, calf nose, Zusanli, Tai Xi, hang clocks, beam colliculus, internal and external knee eyes, Yang Ling spring, blood sea, and take the selected acupoints as the center, and keep the distance from the skin with the skin in the range of 3cm, and apply the moxibustion and mild moxibustion at the distance from the skin. During the process of moxibustion, if the patient felt the following conditions, such as pain, hemp, weight, cold, swelling, pressure and acid, 3-4 of the most sensitive points were selected. 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The specific exercises of the Chinese medicine fumigating and washing group Below: fumigate knee joint with decocted Chinese medicine steam, and then wash out the knee joint. Specific groups are: single live, safflower, myrrh, 15g, 5g, Radix Aconiti, kubun, 20g, extensor grass, chicken blood, 1 times a day, 10 times for 2 days, 2 courses of treatment. Thermosensitive moxibustion combined with traditional Chinese medicine. The operation method of the group was used at the same time with the treatment plan of the first two groups, 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The Lysholm knee score scale, the visual analogue score method was used to score the patients and the clinical effect was compared. The results were before treatment, The difference between the three groups of Lysholm scores was not statistically significant (P0.05). After the treatment, the scores of the three groups were significantly higher than before the treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the Lysholm scores of the thermal moxibustion group and the combined group were significantly higher (P0.05). Compared with the thermal moxibustion group, the Lysholm score of the combined group was significantly higher. (P0.05) before treatment, there was no significant difference between the three groups of VAS scores (P > 0.05). After treatment, the three groups of VAS scores were significantly lower than before and before treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the VAS scores of the thermal moxibustion group and the combined group were significantly lower (P0.05). Compared with the thermal moxibustion group, the VAS score of the combined group was significant. After treatment, the total effective rate of the heat sensitive moxibustion group and the combined group was 75%, 84.37% and 93.74%, respectively. Compared with the traditional Chinese medicine fumigation group, the total effective rate of the combined group was significantly improved (P0.05). Compared with the thermal moxibustion group, the total effective rate of the combined group was significantly improved (P0.05). Conclusion: both Chinese medicine fumigating and thermosensitive moxibustion can all be improved (P0.05). The symptoms and signs of patellar softening patients were improved (significantly improved Lysholm knee score scale), but the effect of traditional Chinese medicine fumigation and thermosensitive moxibustion was better. Traditional Chinese medicine fumigation and thermosensitive moxibustion could effectively improve the conscious pain of patellar softening patients (significantly lower VAS score), but Chinese herbal fumigation and washing combined heat sensitive moxibustion The effect of the treatment scheme is better. The Chinese herbal fumigation and thermosensitive moxibustion has a good effect on the softening of the patella, but the effect of the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is better, and the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is worth further promoting in the clinical treatment of the patellar softening syndrome (qi stagnation and blood stasis type).
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9
本文編號：2128505
[Abstract]:Objective: To evaluate the clinical effect of thermosensitive moxibustion combined with traditional Chinese medicine fumigation on patellar softening (qi stagnation and blood stasis type) by using the Lysholm knee score scale and the visual analogue scale, and to explore an effective, comprehensive and safe treatment for the clinical treatment of patellar softening. Methods: 96 patients were treated. According to 1:1:1 randomly divided into hot sensitive moxibustion group, traditional Chinese medicine fumigation group and heat sensitive moxibustion combined with traditional Chinese medicine fumigation group, 18 women in hot moxibustion group and 14 males, with an average course of 6.69 + 3.24 months, with an average age of 29.72 + 5.33 years, 15 women and 17 men, average course 6.78 + 3.14 months, average age of 30.38 + 5.07 years, combined group of male 15 cases, female 17 cases, average Age 30.03 + 5.58 years old, the average course of disease was 6.84 + 3.12 months. The methods of operation of hot moxibustion group were as follows: select the acupoints, calf nose, Zusanli, Tai Xi, hang clocks, beam colliculus, internal and external knee eyes, Yang Ling spring, blood sea, and take the selected acupoints as the center, and keep the distance from the skin with the skin in the range of 3cm, and apply the moxibustion and mild moxibustion at the distance from the skin. During the process of moxibustion, if the patient felt the following conditions, such as pain, hemp, weight, cold, swelling, pressure and acid, 3-4 of the most sensitive points were selected. 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The specific exercises of the Chinese medicine fumigating and washing group Below: fumigate knee joint with decocted Chinese medicine steam, and then wash out the knee joint. Specific groups are: single live, safflower, myrrh, 15g, 5g, Radix Aconiti, kubun, 20g, extensor grass, chicken blood, 1 times a day, 10 times for 2 days, 2 courses of treatment. Thermosensitive moxibustion combined with traditional Chinese medicine. The operation method of the group was used at the same time with the treatment plan of the first two groups, 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The Lysholm knee score scale, the visual analogue score method was used to score the patients and the clinical effect was compared. The results were before treatment, The difference between the three groups of Lysholm scores was not statistically significant (P0.05). After the treatment, the scores of the three groups were significantly higher than before the treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the Lysholm scores of the thermal moxibustion group and the combined group were significantly higher (P0.05). Compared with the thermal moxibustion group, the Lysholm score of the combined group was significantly higher. (P0.05) before treatment, there was no significant difference between the three groups of VAS scores (P > 0.05). After treatment, the three groups of VAS scores were significantly lower than before and before treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the VAS scores of the thermal moxibustion group and the combined group were significantly lower (P0.05). Compared with the thermal moxibustion group, the VAS score of the combined group was significant. After treatment, the total effective rate of the heat sensitive moxibustion group and the combined group was 75%, 84.37% and 93.74%, respectively. Compared with the traditional Chinese medicine fumigation group, the total effective rate of the combined group was significantly improved (P0.05). Compared with the thermal moxibustion group, the total effective rate of the combined group was significantly improved (P0.05). Conclusion: both Chinese medicine fumigating and thermosensitive moxibustion can all be improved (P0.05). The symptoms and signs of patellar softening patients were improved (significantly improved Lysholm knee score scale), but the effect of traditional Chinese medicine fumigation and thermosensitive moxibustion was better. Traditional Chinese medicine fumigation and thermosensitive moxibustion could effectively improve the conscious pain of patellar softening patients (significantly lower VAS score), but Chinese herbal fumigation and washing combined heat sensitive moxibustion The effect of the treatment scheme is better. The Chinese herbal fumigation and thermosensitive moxibustion has a good effect on the softening of the patella, but the effect of the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is better, and the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is worth further promoting in the clinical treatment of the patellar softening syndrome (qi stagnation and blood stasis type).
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9
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