经外奇穴与经穴配合温针灸治疗膝骨关节炎临床观察
发布时间：2018-11-01 20:50
【摘要】：目的:膝骨关节炎是老年常见病之一,伴随着中国人口老龄化、饮食结构、肥胖比例的变化,其发病率日益升高,使老年人生活质量降低,加重社会经济负担。因此如何使用中医治疗方法提高患者生活水平成为热点。本课题通过随机对照的科研方法,旨在探讨经外奇穴温针灸疗法治疗因膝关节出现的疼痛、僵硬、肿胀临床疗效,进一步完善经外奇穴临床使用内容,为临床治疗该种疾病提供全新的理论依据,同时丰富了对膝骨关节炎的中医治疗方法,也为温针灸经外奇穴治疗的疗效提供临床证据。方法:本研究的患者均来自于广东省第二中医院针灸门诊及康复科病房,均符合膝骨关节炎的纳入标准,收集病人时间:2016年6月-2017年2月。现对60例患者,给予随机分配成两组,治疗组(30例)为经外奇穴温针灸、对照组(30例)为经穴温针灸。治疗时间:1次/日,6次/周为1疗程,休息1天,总共治疗3个疗程。治疗前后对患者的WOMAC指数各种指标、Lequesne MG量表及VAS量表进行打分,对病患者治疗前后的各项数据收集整理,运用SPSS 22.0统计软件对所收集的数据分析统计。结果:治疗前经外奇穴温针灸组、经穴温针灸组的性别、年龄、病程、X线分级等资料经统计学分析,P0.05,说明无显著差异,两组患者治疗前的一般资料具有可比性。治疗前,两组比较,Lequesne-Mery评分、VAS量表、WOMAC骨关节炎指数积分,显示P0.05,表明两组患者有在一起的可比性;治疗后,对Lequesne-Mery评分、VAS量表、WOMAC量表各项指标进行评定,显示两组患者各项指标有明显改善(P0.05);组间比较:经外奇穴温针灸组的积分较经穴温针灸组明显减少(P0.05),说明两种疗法都可以有效改善患者临床症状,其中经外奇穴温针灸组在改善临床症状方面优于经穴组。两组患者疗效经秩和检验比较(P0.05),其中治疗组经外奇穴温针灸达到有效以上的有29人,总有效率为96.7%;对照组经穴温针灸有效以上的有26人,总有效率为86.7%。两组总有效率经统计学分析具有意义(P0.05),综上说明:对于膝骨关节炎的治疗,经外奇穴温针灸疗效优于经穴温针灸。结论:经外奇穴温针灸及经穴温针灸均能在一定程度上改善膝骨关节炎临床症状,但前者的临床疗效优于后者。经外奇穴温针对膝骨关节炎的治疗,不仅有针刺、灸法的作用,更突出经外奇穴具有功效显著、作用相对专一的特性,而且本次研究的治疗方法操作相对简单、取效迅速、具有较高的临床疗效,有应用于临床的价值。
[Abstract]:Objective: knee osteoarthritis is one of the common diseases in the elderly. With the changes of aging population, diet structure and obesity ratio, the incidence of knee osteoarthritis is increasing, which reduces the quality of life of the elderly and increases the social and economic burden. Therefore, how to use traditional Chinese medicine to improve the living standards of patients has become a hot spot. The purpose of this study was to explore the clinical effect of acupuncture and moxibustion therapy on pain, stiffness and swelling of knee joint, and to further improve the clinical use of Meridian Qi point. It provides a new theoretical basis for clinical treatment of this disease, enriches the traditional Chinese medicine treatment method for knee osteoarthritis, and provides clinical evidence for the therapeutic effect of warming acupuncture and moxibustion at Waiqi point. Methods: all the patients in this study were from acupuncture outpatient department and rehabilitation ward of Guangdong Provincial second Hospital of traditional Chinese Medicine. The patients met the inclusion criteria of knee osteoarthritis and collected the patient time from June 2016 to February 2017. 60 patients were randomly divided into two groups. The treatment group (30 cases) was treated with meridian Qi point warming acupuncture and moxibustion, and the control group (30 cases) with meridian point warming acupuncture. Treatment time: once a day, 6 times a week as a course of treatment, rest 1 day, a total of 3 courses of treatment. The WOMAC index, Lequesne MG scale and VAS scale were scored before and after treatment, and the data before and after treatment were collected and sorted, and the collected data were analyzed by SPSS 22.0 software. Results: before treatment, there was no significant difference in sex, age, course of disease and X-ray grading between the two groups. The general data of the two groups before treatment were comparable. Before treatment, Lequesne-Mery score, VAS scale and WOMAC osteoarthritis index score were compared between the two groups, indicating that the two groups were comparable. After treatment, the Lequesne-Mery score, VAS scale, WOMAC scale were evaluated, showing that the two groups of patients with significant improvement in each index (P0.05); Comparison between the two groups: the integral of the acupoint warming group was significantly lower than that of the warm acupuncture group (P0.05), indicating that both treatments could effectively improve the clinical symptoms of the patients. The Meridian Qi-point warming acupuncture group was superior to the Meridian acupoint group in improving clinical symptoms. The curative effect of the two groups was compared by rank sum test (P0.05), among which 29 patients in the treatment group achieved more than effective acupuncture and moxibustion at Waiqi point, the total effective rate was 96.7g. In the control group, 26 patients were above the effective point of warming acupuncture and moxibustion, and the total effective rate was 86.7. The total effective rate of the two groups was statistically significant (P0.05), which showed that: for the treatment of knee osteoarthritis, the acupuncture and moxibustion effect of Waiqi point warming was better than that of acupoint warming acupuncture. Conclusion: both meridian Qi point warming acupuncture and meridian point warming acupuncture can improve the clinical symptoms of knee osteoarthritis to some extent, but the clinical effect of the former is better than that of the latter. The treatment of knee osteoarthritis by Waiqi acupoint temperature not only has the effect of acupuncture and moxibustion, but also highlights the characteristic that Meridian Qi points have remarkable efficacy and relatively specific effect. Moreover, the treatment method in this study is relatively simple and effective. It has high clinical effect and has the value of clinical application.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9
本文编号：2305066
[Abstract]:Objective: knee osteoarthritis is one of the common diseases in the elderly. With the changes of aging population, diet structure and obesity ratio, the incidence of knee osteoarthritis is increasing, which reduces the quality of life of the elderly and increases the social and economic burden. Therefore, how to use traditional Chinese medicine to improve the living standards of patients has become a hot spot. The purpose of this study was to explore the clinical effect of acupuncture and moxibustion therapy on pain, stiffness and swelling of knee joint, and to further improve the clinical use of Meridian Qi point. It provides a new theoretical basis for clinical treatment of this disease, enriches the traditional Chinese medicine treatment method for knee osteoarthritis, and provides clinical evidence for the therapeutic effect of warming acupuncture and moxibustion at Waiqi point. Methods: all the patients in this study were from acupuncture outpatient department and rehabilitation ward of Guangdong Provincial second Hospital of traditional Chinese Medicine. The patients met the inclusion criteria of knee osteoarthritis and collected the patient time from June 2016 to February 2017. 60 patients were randomly divided into two groups. The treatment group (30 cases) was treated with meridian Qi point warming acupuncture and moxibustion, and the control group (30 cases) with meridian point warming acupuncture. Treatment time: once a day, 6 times a week as a course of treatment, rest 1 day, a total of 3 courses of treatment. The WOMAC index, Lequesne MG scale and VAS scale were scored before and after treatment, and the data before and after treatment were collected and sorted, and the collected data were analyzed by SPSS 22.0 software. Results: before treatment, there was no significant difference in sex, age, course of disease and X-ray grading between the two groups. The general data of the two groups before treatment were comparable. Before treatment, Lequesne-Mery score, VAS scale and WOMAC osteoarthritis index score were compared between the two groups, indicating that the two groups were comparable. After treatment, the Lequesne-Mery score, VAS scale, WOMAC scale were evaluated, showing that the two groups of patients with significant improvement in each index (P0.05); Comparison between the two groups: the integral of the acupoint warming group was significantly lower than that of the warm acupuncture group (P0.05), indicating that both treatments could effectively improve the clinical symptoms of the patients. The Meridian Qi-point warming acupuncture group was superior to the Meridian acupoint group in improving clinical symptoms. The curative effect of the two groups was compared by rank sum test (P0.05), among which 29 patients in the treatment group achieved more than effective acupuncture and moxibustion at Waiqi point, the total effective rate was 96.7g. In the control group, 26 patients were above the effective point of warming acupuncture and moxibustion, and the total effective rate was 86.7. The total effective rate of the two groups was statistically significant (P0.05), which showed that: for the treatment of knee osteoarthritis, the acupuncture and moxibustion effect of Waiqi point warming was better than that of acupoint warming acupuncture. Conclusion: both meridian Qi point warming acupuncture and meridian point warming acupuncture can improve the clinical symptoms of knee osteoarthritis to some extent, but the clinical effect of the former is better than that of the latter. The treatment of knee osteoarthritis by Waiqi acupoint temperature not only has the effect of acupuncture and moxibustion, but also highlights the characteristic that Meridian Qi points have remarkable efficacy and relatively specific effect. Moreover, the treatment method in this study is relatively simple and effective. It has high clinical effect and has the value of clinical application.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9
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