大防風(fēng)湯加減治療氣血并肝腎不足型髕骨軟化癥的臨床療效觀察
發(fā)布時(shí)間：2019-04-30 09:47
【摘要】：目的:探討“大防風(fēng)湯加減”治療氣血并肝腎不足型髕骨軟化癥的療效;探討“治未病”思想對(duì)髕骨軟化癥的指導(dǎo)作用。方法:本課題采用簡(jiǎn)單隨機(jī)化的方法,將符合納入標(biāo)準(zhǔn)的患者分為治療組和對(duì)照組平行對(duì)照,同時(shí)進(jìn)行兩組觀察指標(biāo)自身治療前后對(duì)照的臨床研究設(shè)計(jì)。治療組予服用中藥治療,對(duì)照組服用鹽酸氨基葡萄糖膠囊(香港澳美制藥廠生產(chǎn)0.75g/粒)。治療組和對(duì)照組均進(jìn)行常規(guī)治療股四頭肌鍛煉。根據(jù)病例納入標(biāo)準(zhǔn)納入髕骨軟化癥的患者,根據(jù)入組順序?qū)⑵浞种林委熃M和對(duì)照組,同時(shí)完成膝功能評(píng)價(jià)表(WOMAC評(píng)分),對(duì)不良反應(yīng)、不良事件及脫落情況進(jìn)行記錄�；颊咧委熃Y(jié)束后完成出組檢查(與入組時(shí)檢查項(xiàng)目相同)后出組,完成數(shù)據(jù)統(tǒng)計(jì)分析(臨床計(jì)數(shù)資料采用卡方檢驗(yàn);計(jì)量資料以均數(shù)土標(biāo)準(zhǔn)差((x|-)±s)表示,并采用獨(dú)立樣本t檢驗(yàn)或配對(duì)樣本t檢驗(yàn)分析;臨床療效分析采用秩和檢驗(yàn)分析),根據(jù)設(shè)計(jì)時(shí)的療效評(píng)價(jià)標(biāo)準(zhǔn),最后明確大防風(fēng)湯加減治療氣血并肝腎不足型髕骨軟化癥的臨床療效。結(jié)果:1、本課題按設(shè)計(jì)要求共納入80髕骨軟化癥患者,歷時(shí)2年,其中有5例患者因合并用藥,中途被剔除出課題組,有7例患者脫落失訪,兩組均無(wú)不良反應(yīng)及不良事件發(fā)生,共計(jì)68例患者完成本次研究,療程為6周�；�分析示治療組和對(duì)照組在患者性別、年齡、病程等方面無(wú)明顯差異(p0.05),入組時(shí)兩組的WOMAC評(píng)分值無(wú)明顯差異(p0.05)。兩組具有可比性,符合隨機(jī)設(shè)計(jì)。2、根據(jù)課題設(shè)定的臨床有效標(biāo)準(zhǔn),35例治療組患者中32例為臨床有效,有效率91.4%;33例對(duì)照組患者中28例為臨床有效,有效率84.8%;治療組和對(duì)照組臨床有效率之間差異無(wú)顯著性(p=0.359)。3、次要結(jié)局指標(biāo)分析發(fā)現(xiàn),治療結(jié)束后,兩組觀察指標(biāo)(膝關(guān)節(jié)WOMAC評(píng)分)都有所改善;治療前后觀察指標(biāo)的變化在治療組和對(duì)照組組之間無(wú)明顯差異(p值均大于0.05)。結(jié)論:主要結(jié)局指標(biāo)分析發(fā)現(xiàn),應(yīng)用大防風(fēng)湯加減治療氣血并肝腎不足型髕骨軟化癥,在臨床上是有效的,而和口服鹽酸氨基葡萄糖膠囊治療氣血并肝腎不足型髕骨軟化癥的臨床有效率無(wú)顯著差別。次要結(jié)局指標(biāo)分析發(fā)現(xiàn),應(yīng)用大防風(fēng)湯加減和鹽酸氨基葡萄糖膠囊均可改善膝關(guān)節(jié)的功能;觀察指標(biāo)的改善程度在治療組和對(duì)照組之間無(wú)明顯差異�！爸挝床 彼枷朐隗x骨軟化癥的治療中具有積極的指導(dǎo)意義。
[Abstract]:Aim: to explore the curative effect of "Dafangfeng decoction" in treating patellar chondromalacia due to qi-blood and liver-kidney deficiency, and to explore the guiding effect of "treating no disease" on patellar chondromalacia. Methods: a simple randomized method was used to divide the patients who met the inclusion criteria into two groups: treatment group and control group. The clinical study design of two groups of observation indexes before and after treatment was carried out at the same time. The treatment group was treated with traditional Chinese medicine, and the control group was treated with glucosamine hydrochloride capsule (0.75g/ granules produced by Hong Kong Australia and the United States Pharmaceutical Factory). Both the treatment group and the control group were treated with routine treatment of quadriceps femoris exercise. The patients with patellar chondromalacia were divided into the treatment group and the control group according to the inclusion criteria, and the knee function evaluation (WOMAC score) was completed to record the adverse reactions, adverse events and shedding of the patellae. The patients were divided into the treatment group and the control group according to the order of the treatment group and the control group. After the treatment, the patients completed the group examination (the same as the items at the time of admission) and completed the statistical analysis of the data (clinical counting data were tested by chi-square test). The measured data were expressed in the mean soil standard deviation (x | -) equation (s) and analyzed by independent sample t test or paired sample t test. The clinical curative effect was analyzed by rank sum test (Rank sum test). According to the evaluation criteria of therapeutic effect at the time of design, the clinical efficacy of Dafangfeng decoction in the treatment of patellar chondromalacia with qi-blood and deficiency of liver and kidney was confirmed at the end of the paper. Results: 1. According to the design requirements, 80 patella chondromalacia patients were included in this project for two years. Among them, 5 patients were dropped out of the research group in the middle of the course due to combined medication, and 7 patients were dropped out of the study group, and 7 patients lost follow-up. There were no adverse reactions and adverse events in both groups. 68 patients completed the study for 6 weeks. Baseline analysis showed that there was no significant difference in sex, age and course of disease between the treatment group and the control group (p0.05), and there was no significant difference in the WOMAC score between the two groups at the time of entering the group (p0.05). 2. According to the standard of clinical efficacy, 32 of the 35 patients in the treatment group were clinically effective, and the effective rate was 91.4%. In 33 cases of control group, 28 cases were clinically effective, and the effective rate was 84.8%. There was no significant difference between the treatment group and the control group in the clinical effective rate (p = 0.359). 3. The secondary outcome analysis showed that after the treatment, the observation index (knee joint WOMAC score) was improved in both groups. There was no significant difference between the treatment group and the control group before and after treatment (p > 0.05). Conclusion: the analysis of main outcome indexes showed that Dafangfeng decoction was effective in treating patellar chondromalacia due to deficiency of liver and kidney with Qi-blood and liver-kidney deficiency. However, there was no significant difference in the clinical efficacy of Glucosamine Hydrochloride capsule in the treatment of patellar chondromalacia due to deficiency of liver and kidney. The secondary outcome analysis showed that both Dafangfeng decoction and Glucosamine Hydrochloride capsule could improve the function of knee joint, but there was no significant difference between the treatment group and the control group in the improvement degree of the observed indexes. The thought of "treating no disease" has positive guiding significance in the treatment of patellar chondromalacia.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R274.9
本文編號(hào)：2468685
[Abstract]:Aim: to explore the curative effect of "Dafangfeng decoction" in treating patellar chondromalacia due to qi-blood and liver-kidney deficiency, and to explore the guiding effect of "treating no disease" on patellar chondromalacia. Methods: a simple randomized method was used to divide the patients who met the inclusion criteria into two groups: treatment group and control group. The clinical study design of two groups of observation indexes before and after treatment was carried out at the same time. The treatment group was treated with traditional Chinese medicine, and the control group was treated with glucosamine hydrochloride capsule (0.75g/ granules produced by Hong Kong Australia and the United States Pharmaceutical Factory). Both the treatment group and the control group were treated with routine treatment of quadriceps femoris exercise. The patients with patellar chondromalacia were divided into the treatment group and the control group according to the inclusion criteria, and the knee function evaluation (WOMAC score) was completed to record the adverse reactions, adverse events and shedding of the patellae. The patients were divided into the treatment group and the control group according to the order of the treatment group and the control group. After the treatment, the patients completed the group examination (the same as the items at the time of admission) and completed the statistical analysis of the data (clinical counting data were tested by chi-square test). The measured data were expressed in the mean soil standard deviation (x | -) equation (s) and analyzed by independent sample t test or paired sample t test. The clinical curative effect was analyzed by rank sum test (Rank sum test). According to the evaluation criteria of therapeutic effect at the time of design, the clinical efficacy of Dafangfeng decoction in the treatment of patellar chondromalacia with qi-blood and deficiency of liver and kidney was confirmed at the end of the paper. Results: 1. According to the design requirements, 80 patella chondromalacia patients were included in this project for two years. Among them, 5 patients were dropped out of the research group in the middle of the course due to combined medication, and 7 patients were dropped out of the study group, and 7 patients lost follow-up. There were no adverse reactions and adverse events in both groups. 68 patients completed the study for 6 weeks. Baseline analysis showed that there was no significant difference in sex, age and course of disease between the treatment group and the control group (p0.05), and there was no significant difference in the WOMAC score between the two groups at the time of entering the group (p0.05). 2. According to the standard of clinical efficacy, 32 of the 35 patients in the treatment group were clinically effective, and the effective rate was 91.4%. In 33 cases of control group, 28 cases were clinically effective, and the effective rate was 84.8%. There was no significant difference between the treatment group and the control group in the clinical effective rate (p = 0.359). 3. The secondary outcome analysis showed that after the treatment, the observation index (knee joint WOMAC score) was improved in both groups. There was no significant difference between the treatment group and the control group before and after treatment (p > 0.05). Conclusion: the analysis of main outcome indexes showed that Dafangfeng decoction was effective in treating patellar chondromalacia due to deficiency of liver and kidney with Qi-blood and liver-kidney deficiency. However, there was no significant difference in the clinical efficacy of Glucosamine Hydrochloride capsule in the treatment of patellar chondromalacia due to deficiency of liver and kidney. The secondary outcome analysis showed that both Dafangfeng decoction and Glucosamine Hydrochloride capsule could improve the function of knee joint, but there was no significant difference between the treatment group and the control group in the improvement degree of the observed indexes. The thought of "treating no disease" has positive guiding significance in the treatment of patellar chondromalacia.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R274.9
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 董晶晶;閆國(guó)強(qiáng);陳淑蘭;李寶芬;;堅(jiān)骨湯治療氣虛血瘀型髕骨軟化癥的療效及對(duì)血液流變學(xué)的影響分析[J];四川中醫(yī);2016年12期
2 邢麗陽(yáng);屈留新;李明舉;郭毅;高嵩;李平;;脊柱手法治療髕骨軟化癥90例臨床研究[J];江蘇中醫(yī)藥;2016年05期
3 魏子耿;李麗肖;劉永強(qiáng);高佳麗;曹永亮;路少華;徐曉磊;;《靈樞·經(jīng)筋》“十二經(jīng)筋”組織解剖結(jié)構(gòu)淺析[J];河北中醫(yī);2016年02期
4 歐曉波;黃淦波;林昌松;;《金匱翼》論痹思想探要[J];風(fēng)濕病與關(guān)節(jié)炎;2016年01期
5 成魯杰;徐輝;;薄氏腹針療法治療髕骨軟化癥的臨床研究[J];中醫(yī)臨床研究;2015年32期
6 李忻;文玉敏;嚴(yán)美花;李平;;淺談肝腎同源理論的科學(xué)內(nèi)涵[J];中華中醫(yī)藥雜志;2015年11期
7 馮小波;朱思剛;;獨(dú)活寄生湯對(duì)髕骨軟化癥髕骨軟骨及膝關(guān)節(jié)液中IL-1,MMP-1,GAG的影響[J];中國(guó)實(shí)驗(yàn)方劑學(xué)雜志;2015年17期
8 周兆德;鐘慧;張麗秀;李春才;李明英;李捷;;治未病思想在骨關(guān)節(jié)炎治療中體現(xiàn)[J];光明中醫(yī);2015年02期
9 曹玉風(fēng);張u&穎;;扁鵲“治未病”學(xué)術(shù)思想對(duì)《金匱要略》的影響[J];河南中醫(yī);2015年02期
10 劉世榮;;《內(nèi)經(jīng)》五痹證病因病機(jī)及臨床辨治初探[J];湖南中醫(yī)雜志;2015年01期
，本文編號(hào)：2468685
本文鏈接：http://sikaile.net/zhongyixuelunwen/2468685.html
最近更新
教材專(zhuān)著
