針刀治療股骨頭缺血性壞死筋脈瘀滯型的臨床研究
發(fā)布時(shí)間：2019-01-08 08:42
【摘要】：目的:本研究主要通過觀察針刀松解髖關(guān)節(jié)周圍的腧穴、髖關(guān)節(jié)腔減壓以及髖關(guān)節(jié)相應(yīng)攣縮肌肉松解的治療方法,對股骨頭缺血性壞死筋脈瘀滯型患者疼痛程度的緩解及髖關(guān)節(jié)功能的影響,與毫針針刺髖三針的治療效果進(jìn)行比較,驗(yàn)證針刀治療的效果,并試圖對針刀松解髖周腧穴、髖關(guān)節(jié)腔減壓以及髖關(guān)節(jié)相應(yīng)攣縮肌肉松解治療早期股骨頭缺血性壞死的作用機(jī)制進(jìn)行探討,并為臨床治療股骨頭壞死筋脈瘀滯型提供有效的理論依據(jù)。方法:將64例股骨頭缺血性壞死筋脈瘀滯型患者隨機(jī)分為2組,其中治療組32例,其中雙髖21例,單髖11例,共53個(gè)髖關(guān)節(jié);對照組32例,包括雙髖15例,單髖17例,共47個(gè)髖關(guān)節(jié)。治療組每7天治療1次,3次為1個(gè)療程,雙側(cè)同時(shí)患病者兩髖治療間隔為3天;對照組每天治療1次,每周治療6天,休息1天,治療21次為1個(gè)療程。每組均治療1個(gè)療程。療程結(jié)束1周后評定療效,在3個(gè)月時(shí)進(jìn)行隨訪。觀察治療前、治療后及治療3個(gè)月后患者疼痛視覺模擬評分(VAS)、髖關(guān)節(jié)功能評分(Harris),比較差異,進(jìn)行統(tǒng)計(jì)分析。結(jié)果:本研究共納入64例股骨頭缺血性壞死筋脈瘀滯型患者共100個(gè)髖關(guān)節(jié)。在VAS評分及髖關(guān)節(jié)功能評分方面,通過統(tǒng)計(jì)分析發(fā)現(xiàn)兩組治療后與治療前都能緩解疼痛,且差異具有統(tǒng)計(jì)學(xué)意義(P0.05),提示針刀松解髖關(guān)節(jié)周圍的腧穴、髖關(guān)節(jié)腔減壓以及髖關(guān)節(jié)相應(yīng)攣縮肌肉松解能更好地緩解疼痛。治療療程結(jié)束后,治療組臨床治愈9例(雙髖2例),顯效19例(雙髖15例),有效3例(雙髖),無效1例(雙髖),總有效率為96.22%;對照組臨床治愈4例,顯效17例(雙髖4例),有效9例(雙髖9例),無效2例(雙髖2例),總有效率為91.49%。兩組經(jīng)統(tǒng)計(jì)學(xué)分析,在疼痛和髖關(guān)節(jié)功能恢復(fù)方面,差異有顯著性意義(P0.05);治療組能更好的緩解患者的疼痛,能更好的維持髖關(guān)節(jié)功能的恢復(fù)。結(jié)論:針刀松解髖關(guān)節(jié)周圍的腧穴、髖關(guān)節(jié)腔減壓以及髖關(guān)節(jié)相應(yīng)攣縮肌肉松解能更快、更好的緩解股骨頭缺血性壞死筋脈瘀滯引起的髖關(guān)節(jié)疼痛,能更好的維持髖關(guān)節(jié)功能的恢復(fù)。
[Abstract]:Objective: to observe the treatment of acupoints around hip joint, decompression of hip joint cavity and muscle release of corresponding contracture of hip joint by acupuncture knife. The degree of pain relief and the effect of hip joint function on the patients with avascular necrosis of femoral head and vein stasis were compared with that of three needle acupuncture in the hip, and the effect of acupuncture was verified, and the acupoints around the hip were loosened by acupuncture. The mechanism of hip joint decompression and muscle release of hip contracture in the treatment of early avascular necrosis of femoral head was discussed, and the effective theoretical basis for clinical treatment of femoral head necrotic vein stasis type was provided. Methods: Sixty-four patients with avascular necrosis of femoral head were randomly divided into two groups: treatment group (n = 32), double hip (n = 21) and single hip (n = 11). 32 cases in the control group, including 15 cases of double hip, 17 cases of single hip, 47 hips. The treatment group was treated once every 7 days, 3 times as a course of treatment, the interval between two hips of bilateral patients was 3 days, while the control group was treated once a day, 6 days a week, rest for 1 day, and 21 times as a course of treatment. Each group was treated with one course of treatment. The curative effect was evaluated 1 week after the course of treatment and followed up at 3 months. The visual analogue score (VAS),) and hip function score (Harris),) of patients with pain before treatment, after treatment and 3 months after treatment were observed and analyzed statistically. Results: a total of 100 hips were included in 64 patients with avascular necrosis of femoral head. In terms of VAS score and hip function score, the two groups were found to be able to relieve pain after treatment and before treatment, and the difference was statistically significant (P0.05), suggesting that the needle knife releases the acupoints around the hip joint. Decompression of hip cavity and muscle release of contracture of hip joint can relieve pain better. After the course of treatment, 9 cases were cured (2 cases of double hip), 19 cases (15 cases of double hip) were cured, 3 cases (double hip) were effective, 1 case (double hip) was ineffective in the treatment group, the total effective rate was 96.22%. In the control group, 4 cases were cured, 17 cases were markedly effective (4 cases of double hips), 9 cases were effective (9 cases of double hips), 2 cases were ineffective (2 cases of double hips), the total effective rate was 91.49%. Through statistical analysis, the two groups in pain and hip function recovery, there was a significant difference (P0.05); treatment group can better alleviate the pain of patients, can better maintain the hip function recovery. Conclusion: acupuncture knife can release acupoints around hip joint, decompression of hip joint cavity and muscle release of corresponding contracture of hip joint, which can relieve hip joint pain caused by avascular necrosis of femoral head and vein stasis of femoral head. Can better maintain the recovery of hip function.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.9
本文編號：2404369
[Abstract]:Objective: to observe the treatment of acupoints around hip joint, decompression of hip joint cavity and muscle release of corresponding contracture of hip joint by acupuncture knife. The degree of pain relief and the effect of hip joint function on the patients with avascular necrosis of femoral head and vein stasis were compared with that of three needle acupuncture in the hip, and the effect of acupuncture was verified, and the acupoints around the hip were loosened by acupuncture. The mechanism of hip joint decompression and muscle release of hip contracture in the treatment of early avascular necrosis of femoral head was discussed, and the effective theoretical basis for clinical treatment of femoral head necrotic vein stasis type was provided. Methods: Sixty-four patients with avascular necrosis of femoral head were randomly divided into two groups: treatment group (n = 32), double hip (n = 21) and single hip (n = 11). 32 cases in the control group, including 15 cases of double hip, 17 cases of single hip, 47 hips. The treatment group was treated once every 7 days, 3 times as a course of treatment, the interval between two hips of bilateral patients was 3 days, while the control group was treated once a day, 6 days a week, rest for 1 day, and 21 times as a course of treatment. Each group was treated with one course of treatment. The curative effect was evaluated 1 week after the course of treatment and followed up at 3 months. The visual analogue score (VAS),) and hip function score (Harris),) of patients with pain before treatment, after treatment and 3 months after treatment were observed and analyzed statistically. Results: a total of 100 hips were included in 64 patients with avascular necrosis of femoral head. In terms of VAS score and hip function score, the two groups were found to be able to relieve pain after treatment and before treatment, and the difference was statistically significant (P0.05), suggesting that the needle knife releases the acupoints around the hip joint. Decompression of hip cavity and muscle release of contracture of hip joint can relieve pain better. After the course of treatment, 9 cases were cured (2 cases of double hip), 19 cases (15 cases of double hip) were cured, 3 cases (double hip) were effective, 1 case (double hip) was ineffective in the treatment group, the total effective rate was 96.22%. In the control group, 4 cases were cured, 17 cases were markedly effective (4 cases of double hips), 9 cases were effective (9 cases of double hips), 2 cases were ineffective (2 cases of double hips), the total effective rate was 91.49%. Through statistical analysis, the two groups in pain and hip function recovery, there was a significant difference (P0.05); treatment group can better alleviate the pain of patients, can better maintain the hip function recovery. Conclusion: acupuncture knife can release acupoints around hip joint, decompression of hip joint cavity and muscle release of corresponding contracture of hip joint, which can relieve hip joint pain caused by avascular necrosis of femoral head and vein stasis of femoral head. Can better maintain the recovery of hip function.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.9
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