補(bǔ)腎祛瘀針刺法治療膝骨性關(guān)節(jié)炎的臨床研究
發(fā)布時(shí)間：2018-07-18 21:48
【摘要】：目的:補(bǔ)腎祛瘀法是全國(guó)名老中醫(yī)李家康教授四十余年針灸臨床經(jīng)驗(yàn)的學(xué)術(shù)總結(jié)。本研究采用補(bǔ)腎祛瘀法治療膝骨性關(guān)節(jié)炎并與普通針刺對(duì)照,通過針刺前后各項(xiàng)指標(biāo)的對(duì)比,評(píng)價(jià)其療效,以進(jìn)一步總結(jié)李家康教授的臨床經(jīng)驗(yàn)和學(xué)術(shù)思想,以期在針灸臨床中推廣。方法:選取2014.12-2016.9月就診于湖北省中醫(yī)院針灸科門診與針灸科住院部(花園山病區(qū))的膝骨性關(guān)節(jié)炎的患者64例,采用隨機(jī)分組法,將納入的研究對(duì)象隨機(jī)分為補(bǔ)腎祛瘀針刺組和常規(guī)局部針刺組,每組32例。補(bǔ)腎祛瘀針刺組取穴為懸鐘、大杼、腎俞、太溪、陰谷、膈俞、足三里、血海、內(nèi)膝眼、犢鼻和陽陵泉。操作方法:先采用點(diǎn)刺不留針的方法點(diǎn)刺大杼、腎俞及膈俞,大杼與腎俞行捻轉(zhuǎn)補(bǔ)法每穴行手法3次,膈俞斜刺0.8寸行捻轉(zhuǎn)瀉法3次。再囑患者取坐位,針刺其余穴位。太溪、陰谷、足三里、陽陵泉、血海、內(nèi)膝眼、犢鼻行平補(bǔ)平瀉法。出針時(shí)直接取出。常規(guī)局部針刺組取穴為:內(nèi)膝眼、犢鼻、血海、梁丘、陽陵泉、膝陽關(guān)、足三里、陰陵泉和鶴頂。留針時(shí)采用平補(bǔ)平瀉針刺方法,出針時(shí)直接取出。兩組所有患者留針時(shí)間為30分鐘,每10分鐘行手法1次。每周治療3次,隔日一次,2周為1個(gè)療程,總共治療2個(gè)療程。治療結(jié)束后第3個(gè)月進(jìn)行隨訪。記錄兩組治療前與治療后的VAS疼痛視覺評(píng)分、WOMAC骨關(guān)節(jié)炎評(píng)分、下肢功能LEFS功能評(píng)分,觀察對(duì)比兩種治療方案的臨床療效。記錄治療結(jié)束后3個(gè)月末隨訪的WOMAC骨關(guān)節(jié)炎評(píng)分。結(jié)果:1.治療前,補(bǔ)腎祛瘀針刺組和常規(guī)局部針刺組在性別、年齡、病程、中醫(yī)辨證分型、BMI體質(zhì)指數(shù)、KL-X線關(guān)節(jié)指數(shù)、VAS評(píng)分、WOMAC評(píng)分、下肢功能LEFS評(píng)分方面,經(jīng)統(tǒng)計(jì)均無統(tǒng)計(jì)學(xué)意義,說明兩組組間的臨床基線資料具有可比性。2.VAS評(píng)分的比較VAS評(píng)分結(jié)果顯示,補(bǔ)腎祛瘀針刺組治療后與治療前兩兩比較,有顯著性差異(P0.05);常規(guī)局部針刺組治療后與治療前兩兩比較,有顯著性差異(P0.05);治療后,補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組兩兩比較,有顯著性差異(P0.05)。3.WOMAC評(píng)分的比較WOMAC評(píng)分結(jié)果顯示,補(bǔ)腎祛瘀針刺組治療后與治療前兩兩比較,有顯著性差異(P0.05);常規(guī)局部針刺組治療后與治療前兩兩比較,有顯著性差異(P0.05);治療后,補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組兩兩比較,有顯著性差異(P0.05)。4.下肢功能LEFS評(píng)分的比較LEFS評(píng)分結(jié)果顯示,補(bǔ)腎祛瘀針刺組治療后與治療前兩兩比較,有顯著性差異(P0.05);常規(guī)局部針刺組治療后與治療前兩兩比較,有顯著性差異(P0.05);治療后,補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組兩兩比較,有顯著性差異(P0.05)。5.療效比較補(bǔ)腎祛瘀針刺組有效率為86.67%,局部常規(guī)針刺組有效率為80.00%。經(jīng)秩和檢驗(yàn),P值為0.044,P0.05。兩組之間的療效具有可比性。6.隨訪在治療結(jié)束3個(gè)月后進(jìn)行隨訪。補(bǔ)腎祛瘀組與常規(guī)局部針刺組在WOMAC評(píng)分量表的評(píng)分上存在差異(P0.05)。結(jié)論:(1)補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組相比,在改善疼痛癥狀方面,補(bǔ)腎祛瘀針刺組療效更好。(2)補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組相比,在改善僵硬癥狀方面,補(bǔ)腎祛瘀針刺組療效更佳。(3)補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組相比,在改善下肢功能方面,補(bǔ)腎祛瘀針刺組效果更佳。(4)補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組相比,在總有效率方面,補(bǔ)腎祛瘀針刺組效果更明顯。(5)補(bǔ)腎祛瘀針刺組與常規(guī)局部針刺組相比,補(bǔ)腎祛瘀針刺組遠(yuǎn)期療效優(yōu)于常規(guī)局部針刺組。
[Abstract]:Objective: the method of invigorating kidney and removing stasis is an academic summary of Professor Li Jiakang's clinical experience for more than forty years. This study uses the method of Tonifying the kidney and removing stasis to treat osteoarthritis of the knee and compared with the common acupuncture. Through the comparison of various indexes before and after acupuncture, the curative effect is evaluated in order to sum up professor Li Jiakang's clinical experience and academic thought. Methods: 64 patients with osteoarthritis of the knee in the Department of acupuncture and moxibustion Department of Hubei Provincial Traditional Chinese Medical Hospital and the Department of acupuncture and moxibustion Department (Huayuan sick area) were selected for 2014.12-2016.9 months. The subjects were randomly divided into two groups, 32 cases in each group. The operation method: first use the method of punctate needling, the method of punctating the needling, the Shenshu and the phrenic Shu, the 3 times of the twisting and twisting of the Shu and Shenshu 0.8 inches, and the 3 times of the twisting and transpoing method. Position, acupuncture at the rest of the acupoints: Tai Xi, Yin Valley, Zusanli, Yang Mausoleum, blood sea, inner knee, and calf nose, take out the flat purging method. The acupuncture points of the conventional local acupuncture group are taken as: the inner knee, the calf nose, the blood sea, the beam hillock, the Yang mausu spring, the knee Yang Guan, the Zusanli, the Yin mausoleum and the crane. Two The needle retention time of all the patients was 30 minutes, 1 times every 10 minutes. 3 times a week, one day and 2 weeks for 1 courses, and 2 courses were treated in a total. The VAS pain visual score of the two groups before and after treatment, the WOMAC osteoarthritis score, the functional LEFS function score of the lower extremity, and two were observed and two. The results of WOMAC osteoarthritis score were recorded at the end of 3 months after the end of treatment. Results: before 1., the sex, age, course of disease, TCM syndrome differentiation, BMI body mass index, KL- X - ray joint index, VAS score, WOMAC score, and lower extremity function LEFS score before treatment were statistically analyzed. There was no statistical significance. The comparison of the clinical baseline data between the two groups showed that the comparison of the.2.VAS score of the clinical baseline showed that there was a significant difference (P0.05) between the treatment and the 22 before the treatment (P0.05). The routine local acupuncture group had a significant difference (P0.05) after treatment and 22 before treatment. After treatment, the kidney was treated with kidney tonifying. Compared with the conventional local acupuncture group 22, there was significant difference (P0.05).3.WOMAC score compared with the WOMAC score results showed that after treatment and 22 before treatment, there was significant difference (P0.05); the routine local acupuncture group was compared with 22 before treatment (P0.05); after treatment, supplementation Compared with the conventional local acupuncture group 22, there were significant differences (P0.05).4. lower limb function LEFS score compared with the result of LEFS score, there was significant difference (P0.05) compared with the 22 before treatment (P0.05); there were significant differences between the routine local acupuncture group and the 22 before treatment (P0.05). After treatment, there was significant difference (P0.05).5. effect compared with conventional local acupuncture group (22), the effective rate of the acupuncture group was 86.67%, the effective rate of the local conventional acupuncture group was 80.00%. through the rank sum test, the P value was 0.044, the therapeutic effect between the P0.05. two groups was comparable with.6. after 3 months of treatment after the end of the treatment. The score of the WOMAC score was different (P0.05). Conclusion: (1) the effect of Tonifying the kidney and removing blood stasis acupuncture group is better than the conventional local acupuncture group. (2) the group of Tonifying the kidney and removing stasis acupuncture group and the routine local acupuncture group are compared with the conventional local acupuncture group, and improve the stiffness symptoms. The effect of invigorating kidney and removing stasis acupuncture group was better. (3) compared with conventional local acupuncture group, the effect of tonifying kidney and removing blood stasis in acupuncture group was better than that of conventional local acupuncture group. (4) the effect of tonifying kidney and removing blood stasis acupuncture group with conventional local acupuncture group was more obvious in total effective efficiency. (5) the group of tonifying kidney and removing blood stasis acupuncture group and Compared with routine local acupuncture group, the long-term effect of Bushen Qu Yu acupuncture group was better than that of routine local acupuncture group.
【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
本文編號(hào)：2132877
[Abstract]:Objective: the method of invigorating kidney and removing stasis is an academic summary of Professor Li Jiakang's clinical experience for more than forty years. This study uses the method of Tonifying the kidney and removing stasis to treat osteoarthritis of the knee and compared with the common acupuncture. Through the comparison of various indexes before and after acupuncture, the curative effect is evaluated in order to sum up professor Li Jiakang's clinical experience and academic thought. Methods: 64 patients with osteoarthritis of the knee in the Department of acupuncture and moxibustion Department of Hubei Provincial Traditional Chinese Medical Hospital and the Department of acupuncture and moxibustion Department (Huayuan sick area) were selected for 2014.12-2016.9 months. The subjects were randomly divided into two groups, 32 cases in each group. The operation method: first use the method of punctate needling, the method of punctating the needling, the Shenshu and the phrenic Shu, the 3 times of the twisting and twisting of the Shu and Shenshu 0.8 inches, and the 3 times of the twisting and transpoing method. Position, acupuncture at the rest of the acupoints: Tai Xi, Yin Valley, Zusanli, Yang Mausoleum, blood sea, inner knee, and calf nose, take out the flat purging method. The acupuncture points of the conventional local acupuncture group are taken as: the inner knee, the calf nose, the blood sea, the beam hillock, the Yang mausu spring, the knee Yang Guan, the Zusanli, the Yin mausoleum and the crane. Two The needle retention time of all the patients was 30 minutes, 1 times every 10 minutes. 3 times a week, one day and 2 weeks for 1 courses, and 2 courses were treated in a total. The VAS pain visual score of the two groups before and after treatment, the WOMAC osteoarthritis score, the functional LEFS function score of the lower extremity, and two were observed and two. The results of WOMAC osteoarthritis score were recorded at the end of 3 months after the end of treatment. Results: before 1., the sex, age, course of disease, TCM syndrome differentiation, BMI body mass index, KL- X - ray joint index, VAS score, WOMAC score, and lower extremity function LEFS score before treatment were statistically analyzed. There was no statistical significance. The comparison of the clinical baseline data between the two groups showed that the comparison of the.2.VAS score of the clinical baseline showed that there was a significant difference (P0.05) between the treatment and the 22 before the treatment (P0.05). The routine local acupuncture group had a significant difference (P0.05) after treatment and 22 before treatment. After treatment, the kidney was treated with kidney tonifying. Compared with the conventional local acupuncture group 22, there was significant difference (P0.05).3.WOMAC score compared with the WOMAC score results showed that after treatment and 22 before treatment, there was significant difference (P0.05); the routine local acupuncture group was compared with 22 before treatment (P0.05); after treatment, supplementation Compared with the conventional local acupuncture group 22, there were significant differences (P0.05).4. lower limb function LEFS score compared with the result of LEFS score, there was significant difference (P0.05) compared with the 22 before treatment (P0.05); there were significant differences between the routine local acupuncture group and the 22 before treatment (P0.05). After treatment, there was significant difference (P0.05).5. effect compared with conventional local acupuncture group (22), the effective rate of the acupuncture group was 86.67%, the effective rate of the local conventional acupuncture group was 80.00%. through the rank sum test, the P value was 0.044, the therapeutic effect between the P0.05. two groups was comparable with.6. after 3 months of treatment after the end of the treatment. The score of the WOMAC score was different (P0.05). Conclusion: (1) the effect of Tonifying the kidney and removing blood stasis acupuncture group is better than the conventional local acupuncture group. (2) the group of Tonifying the kidney and removing stasis acupuncture group and the routine local acupuncture group are compared with the conventional local acupuncture group, and improve the stiffness symptoms. The effect of invigorating kidney and removing stasis acupuncture group was better. (3) compared with conventional local acupuncture group, the effect of tonifying kidney and removing blood stasis in acupuncture group was better than that of conventional local acupuncture group. (4) the effect of tonifying kidney and removing blood stasis acupuncture group with conventional local acupuncture group was more obvious in total effective efficiency. (5) the group of tonifying kidney and removing blood stasis acupuncture group and Compared with routine local acupuncture group, the long-term effect of Bushen Qu Yu acupuncture group was better than that of routine local acupuncture group.
【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 霍綺雯;譚峰;張昕;劉曉林;;針灸治療對(duì)腦梗死患者血小板活化因子表達(dá)的影響[J];中國(guó)實(shí)用醫(yī)藥;2016年22期
2 田昕;楊曉梅;郭豐;張玉蓮;馮亞茹;黃亞川;;老年膝關(guān)節(jié)骨性關(guān)節(jié)炎患者心理護(hù)理與抑郁的相關(guān)性研究[J];國(guó)際精神病學(xué)雜志;2016年03期
3 涂雪松;劉曉安;胡利霞;;溫針灸治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床隨機(jī)對(duì)照研究[J];針灸臨床雜志;2016年06期
4 李翠娟;劉子tD;孫理軍;鞏振東;;“正常體質(zhì)-腎虛體質(zhì)-腎虛證候”唾液生化指標(biāo)變化研究[J];中國(guó)中醫(yī)藥信息雜志;2016年06期
5 田強(qiáng);趙家友;郭汝松;范志勇;吳山;;腰部脊柱推拿治療膝關(guān)節(jié)骨性關(guān)節(jié)炎30例[J];實(shí)用醫(yī)學(xué)雜志;2016年06期
6 任偉亮;朱艷風(fēng);韓昆;于健;胡志勇;劉士誠(chéng);王金榜;田雅峰;齊立卿;;骨氏葆方治療腎虛血瘀型膝重度骨關(guān)節(jié)炎的臨床研究[J];南京中醫(yī)藥大學(xué)學(xué)報(bào);2016年02期
7 楊渠平;范寧;何仁建;;膝關(guān)節(jié)骨性關(guān)節(jié)炎的性別差異及相關(guān)因素[J];中國(guó)老年學(xué)雜志;2016年01期
8 劉搏宇;李宏宇;;骨性關(guān)節(jié)炎治療方法的研究進(jìn)展[J];醫(yī)學(xué)綜述;2015年24期
9 周建林;方洪松;彭昊;鄧爽;翁金清;劉豐;陳森;周觀金;;自體、異體骨軟骨移植及組織工程材料修復(fù)的關(guān)節(jié)軟骨損傷[J];中國(guó)組織工程研究;2015年34期
10 史志萍;劉霄霞;陸君;李英;盧麗;王靜馥;李煥麗;薛有萍;;補(bǔ)腎健脾中藥對(duì)圍絕經(jīng)期及絕經(jīng)期肥胖婦女體重指數(shù)與生殖激素水平影響的研究[J];四川中醫(yī);2015年01期
相關(guān)碩士學(xué)位論文 前4條
1 陸南南;下肢功能評(píng)價(jià)量表（LEFS）在膝關(guān)節(jié)骨性關(guān)節(jié)炎患者中應(yīng)用的信度和效度[D];首都體育學(xué)院;2015年
2 王金;髓會(huì)、骨會(huì)配穴結(jié)合針刺治療膝骨性關(guān)節(jié)炎臨床療效的研究[D];安徽中醫(yī)藥大學(xué);2014年
3 譚三春;補(bǔ)腎祛瘀針刺法治療類風(fēng)濕性關(guān)節(jié)炎的臨床觀察[D];湖北中醫(yī)藥大學(xué);2013年
4 王燕;益腎祛瘀方治療膝骨性關(guān)節(jié)炎的臨床及實(shí)驗(yàn)研究[D];山東中醫(yī)藥大學(xué);2006年
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