詹氏正骨手法配合中藥薰藥治療陳舊性踝關(guān)節(jié)扭傷的臨床研究
發(fā)布時間：2018-09-12 13:03
【摘要】：目的：通過詹氏正骨手法配合中藥薰藥治療與單純中藥薰藥治療陳舊性踝關(guān)節(jié)扭傷的對比研究,綜合比較詹氏正骨手法配合中藥熏藥治療與單純中藥熏藥治療陳舊性踝關(guān)節(jié)扭傷之間的療效差異,從療效指標,多角度、多環(huán)節(jié)的評價詹氏正骨手法配合中藥熏藥的療效。通過臨床實踐的研究、總結(jié),研究手法治療機理,建立詹氏正骨手法治療陳舊性踝關(guān)節(jié)扭傷的診療規(guī)范,制定詹氏正骨手法治療陳舊性踝關(guān)節(jié)扭傷的操作流程。以期為臨床治療提供參考依據(jù)。方法：根據(jù)納入標準及排除標準,借助SPSS19.0統(tǒng)計分析系統(tǒng)對60例來源于詹氏醫(yī)院門診的陳舊性踝關(guān)節(jié)扭傷(筋脈失養(yǎng)型)患者隨機分為2組,每組各30例。其中治療組采用詹氏正骨手法配合中藥薰藥治療,對照組單純采用中藥薰藥治療,對照組：中藥薰藥治療方劑為來源于《中醫(yī)傷科講義》經(jīng)驗方“四肢損傷洗方”,使用XZQ-III型中藥熏蒸器治療,熏藥時間為20分鐘,每日一次。7次為一療程,共治療兩個療程。治療組30例同樣使用四肢損傷洗方中藥熏藥后,再采用詹氏正骨手法治療。每天一次,每次15分鐘,每7天為1個療程,共治療兩個療程。然后進行治療前后VAS疼痛評分和Kofoed關(guān)節(jié)功能評分及根據(jù)《中醫(yī)病證診斷療效標準》對療效進行評價,進行數(shù)據(jù)統(tǒng)計分析,來制定手法治療的診療規(guī)范,形成詹氏正骨手法治療陳舊性踝關(guān)節(jié)扭傷的標準操作流程。結(jié)果：(1)總體療效：治療組(詹氏正骨手法配合中藥薰藥治療)30例,治愈13例,好轉(zhuǎn)16例,未愈1例。對照組(單純中藥薰藥治療)30例,治愈5例,好轉(zhuǎn)20例,無效5例。經(jīng)卡方檢驗,兩組差異有統(tǒng)計學意義(P0.05),表明兩種方法治療陳舊性踝關(guān)節(jié)扭傷均有效,但詹氏正骨手法配合中藥薰藥治療療效優(yōu)于單純中藥薰藥治療。(2)VAS：兩組受試者治療前后局部壓痛分值比較,治療前兩組局部壓痛積分P0.05,差異無統(tǒng)計學意義,具有可比性。治療組與對照組治療前后局部壓痛分值相比,治療后一周開始往后所有P值均0.05,差異有統(tǒng)計學意義�？梢姀闹委熀笠恢芷鹬委熃M疼痛減輕方面就優(yōu)于對照組。(3)癥狀積分：治療前兩組癥狀積分P0.05,差異無統(tǒng)計學意義,具有可比性。治療組與對照組評分相比,治療后一周開始往后所有P值均0.05,差異有統(tǒng)計學意義�？梢姀闹委熀笠恢芷鹬委熃M癥狀減輕方面就優(yōu)于對照組。(4)疼痛、功能活動度積分：兩組患者治療前疼痛積分與功能活動積分比較P0.05,差異無統(tǒng)計學意義,具有可比性。治療組與對照組疼痛積分比較,兩組治療一周后組間疼痛評分比較(P0.05)差異無統(tǒng)計學意義；治療兩周及三個月后隨訪兩組間比較差異有統(tǒng)計學意義(P0.05),說明治療組與對照組在治療一周后疼痛評分改善差異不明顯,治療兩周及三個月后治療組疼痛評分改善方面優(yōu)于對照組。治療組與對照組功能活動積分相比,治療后一周開始往后所有P值均0.05,差異有統(tǒng)計學意義�？梢姀闹委熀笠恢芷鹬委熃M功能活動度改善方面就優(yōu)于對照組。結(jié)論：本研究治療組采用詹氏正骨手法配合中藥薰藥治療陳舊性踝關(guān)節(jié)扭傷,對照組單純使用中藥薰藥治療陳舊性踝關(guān)節(jié)扭傷。受試者經(jīng)治療后在癥狀、體征改善上均比較明顯,兩種治療方案對陳舊性踝關(guān)節(jié)扭傷均有顯著療效。治療組的疼痛、功能和活動度的改善好于對照組；在關(guān)節(jié)功能上面治療組明顯優(yōu)于對照組。而且在總體療效上治療組明顯好于對照組�？梢娬彩险鞘址ㄅ浜现兴庌顾幣c單純中藥薰藥治療陳舊性踝關(guān)節(jié)扭傷相比在療效的改善方面更具優(yōu)勢,對于陳舊性踝關(guān)節(jié)扭傷患者的總體療效更佳,值得推廣使用。
[Abstract]:Objective: To compare the curative effect of Zhan's Bone-setting manipulation combined with traditional Chinese medicine fumigation and traditional Chinese medicine fumigation on old ankle sprain, and to evaluate Zhan's Bone-setting manipulation combined with traditional Chinese medicine fumigation and traditional Chinese medicine fumigation on old ankle sprain. Through the study of clinical practice, summarize, study the mechanism of manipulation therapy, establish the diagnostic and therapeutic criteria of Zhan's manipulation for the treatment of old ankle sprain, and formulate the operation procedure of Zhan's manipulation for the treatment of old ankle sprain. Sixty patients with old ankle sprain (tendon and vein dystrophy) were randomly divided into two groups with the help of SPSS19.0 statistical analysis system, 30 cases in each group. The fumigating agent was "Limb Damage Washing Prescription" from "Handbook of Traumatology of TCM" and "Experience Prescription of Limb Damage". The fumigating time was 20 minutes, once a day. 7 times a course of treatment for two courses. Once, every 15 minutes, every 7 days for a course of treatment, a total of two courses of treatment. Then before and after treatment, VAS pain score and Kofoed joint function score and according to the < Chinese medicine syndrome diagnosis and curative effect standard > to evaluate the efficacy of statistical analysis of data, to formulate the diagnosis and treatment criteria of manipulation therapy, the formation of Jane's Bone-setting manipulation treatment of obsolete ankle. Results: (1) Total curative effect: 30 cases were cured, 13 cases were cured, 16 cases were improved and 1 case was not cured in the treatment group (Zhan's Bone-setting manipulation combined with Chinese herbal fumigation). 30 cases were cured, 5 cases were cured, 20 cases were improved and 5 cases were ineffective in the control group (Chinese herbal fumigation alone). The treatment of old ankle sprain was effective, but the effect of Zhan's Bone-setting manipulation combined with traditional Chinese medicine fumigation was better than that of traditional Chinese medicine fumigation alone. (2) VAS: The score of local tenderness before and after treatment was compared between the two groups, and the score of local tenderness before and after treatment was P 0.05, with no statistical significance. Compared with local tenderness score, all P values were 0.05 after one week of treatment, and the difference was statistically significant. It was obvious that the pain relief of the treatment group was better than that of the control group from one week after treatment. (3) Symptom score: The symptom score of the two groups before treatment was P 0.05, with no significant difference and comparability. After one week of treatment, all P values were 0.05, the difference was statistically significant. It can be seen that the treatment group was better than the control group in relieving symptoms from one week after treatment. (4) Pain, functional activity score: two groups of patients before treatment pain score and functional activity score compared P 0.05, there was no significant difference, with comparability. There was no significant difference in pain score between the two groups after one week of treatment (P 0.05); there was significant difference between the two groups after two weeks of treatment and three months of follow-up (P 0.05), indicating that there was no significant difference in the improvement of pain score between the treatment group and the control group after one week of treatment. The pain score of the treatment group was better than that of the control group. Compared with the functional activity score of the control group, all P values of the treatment group were 0.05 from the beginning of the week after treatment, and the difference was statistically significant. After treatment, the symptoms and signs of the subjects were improved obviously. Both of the two treatments had significant effects on the old ankle sprain. The pain, function and activity of the treatment group were better than those of the control group. The treatment group is obviously better than the control group in terms of joint function, and the overall effect of the treatment group is obviously better than the control group. It should be popularized.
【學位授予單位】：浙江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R274.3
本文編號：2239084
[Abstract]:Objective: To compare the curative effect of Zhan's Bone-setting manipulation combined with traditional Chinese medicine fumigation and traditional Chinese medicine fumigation on old ankle sprain, and to evaluate Zhan's Bone-setting manipulation combined with traditional Chinese medicine fumigation and traditional Chinese medicine fumigation on old ankle sprain. Through the study of clinical practice, summarize, study the mechanism of manipulation therapy, establish the diagnostic and therapeutic criteria of Zhan's manipulation for the treatment of old ankle sprain, and formulate the operation procedure of Zhan's manipulation for the treatment of old ankle sprain. Sixty patients with old ankle sprain (tendon and vein dystrophy) were randomly divided into two groups with the help of SPSS19.0 statistical analysis system, 30 cases in each group. The fumigating agent was "Limb Damage Washing Prescription" from "Handbook of Traumatology of TCM" and "Experience Prescription of Limb Damage". The fumigating time was 20 minutes, once a day. 7 times a course of treatment for two courses. Once, every 15 minutes, every 7 days for a course of treatment, a total of two courses of treatment. Then before and after treatment, VAS pain score and Kofoed joint function score and according to the < Chinese medicine syndrome diagnosis and curative effect standard > to evaluate the efficacy of statistical analysis of data, to formulate the diagnosis and treatment criteria of manipulation therapy, the formation of Jane's Bone-setting manipulation treatment of obsolete ankle. Results: (1) Total curative effect: 30 cases were cured, 13 cases were cured, 16 cases were improved and 1 case was not cured in the treatment group (Zhan's Bone-setting manipulation combined with Chinese herbal fumigation). 30 cases were cured, 5 cases were cured, 20 cases were improved and 5 cases were ineffective in the control group (Chinese herbal fumigation alone). The treatment of old ankle sprain was effective, but the effect of Zhan's Bone-setting manipulation combined with traditional Chinese medicine fumigation was better than that of traditional Chinese medicine fumigation alone. (2) VAS: The score of local tenderness before and after treatment was compared between the two groups, and the score of local tenderness before and after treatment was P 0.05, with no statistical significance. Compared with local tenderness score, all P values were 0.05 after one week of treatment, and the difference was statistically significant. It was obvious that the pain relief of the treatment group was better than that of the control group from one week after treatment. (3) Symptom score: The symptom score of the two groups before treatment was P 0.05, with no significant difference and comparability. After one week of treatment, all P values were 0.05, the difference was statistically significant. It can be seen that the treatment group was better than the control group in relieving symptoms from one week after treatment. (4) Pain, functional activity score: two groups of patients before treatment pain score and functional activity score compared P 0.05, there was no significant difference, with comparability. There was no significant difference in pain score between the two groups after one week of treatment (P 0.05); there was significant difference between the two groups after two weeks of treatment and three months of follow-up (P 0.05), indicating that there was no significant difference in the improvement of pain score between the treatment group and the control group after one week of treatment. The pain score of the treatment group was better than that of the control group. Compared with the functional activity score of the control group, all P values of the treatment group were 0.05 from the beginning of the week after treatment, and the difference was statistically significant. After treatment, the symptoms and signs of the subjects were improved obviously. Both of the two treatments had significant effects on the old ankle sprain. The pain, function and activity of the treatment group were better than those of the control group. The treatment group is obviously better than the control group in terms of joint function, and the overall effect of the treatment group is obviously better than the control group. It should be popularized.
【學位授予單位】：浙江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R274.3
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