定点手法联合功能锻炼治疗早期膝骨性关节炎的疗效观察

发布时间：2017-12-27 23:24

本文关键词：定点手法联合功能锻炼治疗早期膝骨性关节炎的疗效观察　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:评价定点手法联合功能锻炼治疗早期膝骨性关节炎的临床疗效。方法:根据纳入标准,选择自2015年12月至2016年12月期间,厦门市中医院骨三科住院的符合早期KOA诊断标准且为原发性KOA患者,随机分为对照组、试验组,分配比例为1:1。若有部分病例脱落,在随访时间允许下适当增补,最终完成对照组30人,试验组30人。一般治疗为护架烤灯+理疗+玻璃酸钠关节腔内注射,功能锻炼为多角度屈膝位下行下肢静力收缩+屈髋屈膝位下多角度伸膝锻炼+俯卧位小角度屈膝锻炼,定点手法为膝关节周围定点弹拨+分筋法+活动关节法。在两组均有一般治疗的前提下,予对照组功能锻炼,予试验组定点手法+功能锻炼。疗程两周,分别在治疗前、治疗2周后、第4周、第8周收集患者一般资料及WOMAC评分(疼痛评分、关节僵硬程度评分、日常活动功能评分、总分)、尼莫地平疗效指数、关节活动度等数据,运用SPSS 19.0对所得数据进行分析,对两治疗方法的效果做出评价。结果:(1)共收集63例,对照组31例,脱落1例,试验组32例,剔除和脱落各1例;(2)基线比较:两组患者的性别、年龄、病程、侧别影像学等级资料的比较,差异无无统计学意义,具有可比性;(3)治疗2周后两组组间比较,疼痛、关节僵硬程度、日常活动功能评分、尼莫地平疗效指数、关节活动度等的比较,差异均有统计学意义(P0.05),说明试验组优于对照组;(4)第4周两组组间比较,疼痛、日常活动功能评分、尼莫地平疗效指数关节活动度等的比较,差异无统计学意义(P0.05),说明试验组优于对照组;(5)第8周两组组间比较,疼痛、关节僵硬程度、日常活动功能评分、总分、尼莫地平疗效指数、关节活动度的比较,差异均无统计学意义(P0.05)。结论:治疗2周后,两种治疗方法均能改善患者疼痛、关节僵硬程度、日常活动功能及关节活动度,但定点手法联合功能锻炼组在短期即可达到缓解患者疼痛、关节僵硬,改善关节活动度的目的,优于单纯功能锻炼组。
[Abstract]:Objective: To evaluate the clinical efficacy of fixed-point manipulation combined with functional exercise in the treatment of early osteoarthritis of the knee. Methods: according to the inclusion criteria, select from December 2015 to December 2016, Xiamen City Hospital of orthopedics hospital to meet the criteria for the diagnosis of early KOA and primary KOA patients were randomly divided into control group and test group, the distribution ratio of 1:1. If some cases were lost, 30 people in the control group and 30 in the experimental group were completed at the time of follow-up. The general treatment for a light roast physiotherapy + + intra-articular injection of sodium hyaluronate, functional exercise for lower limb flexion angles of static contraction + hip flexion bending under multi angle knee extensor exercise + prone small flexion exercise for fixed-point manual knee tendons method + + plucked fixed-point movable joint method. On the premise of general treatment in the two groups, the control group was given functional exercise, and the experimental group was given fixed-point manipulation + functional exercise. For two weeks, respectively, before treatment, after 2 weeks, fourth weeks and eighth weeks were collected general information and WOMAC score (pain score, the degree of joint ankylosis score, daily function score, total score), nimodipine efficacy index, joint activity data were analyzed by SPSS 19 of the data, make evaluation of the treatment effect of two. Results: (1) a total of 63 cases, 31 cases in the control group, 1 cases were lost and 32 cases of the test group, 1 cases in each removal and falling; (2) baseline: gender, age, course of disease, side imaging were compared between the two groups of rank data, no difference has no statistical significance ratio; (3) after 2 weeks of treatment between the two groups, compare the pain degree, joint stiffness, ADL score, index, efficacy of nimodipine ROM, the differences were statistically significant (P0.05), the experimental group was better than the control group; (4) fourth weeks between the two groups comparison, pain, ADL score, nimodipine therapeutic index ROM, the difference was not statistically significant (P0.05), the experimental group was better than the control group; (5) eighth weeks between the two groups, degree of pain, joint stiffness, daily activity function score, total score, curative effect index, nimodipine joint There was no significant difference in the difference of activity degree (P0.05). Conclusion: after 2 weeks of treatment, the two treatment methods can improve the degree of pain, joint stiffness, daily function and joint activity, but the point of manipulation combined with functional exercise group in the short term can relieve pain, improve joint stiffness, joint activity, better than pure functional exercise group.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

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