不同疗法干预瘀血阻滞型膝骨关节炎的临床疗效观察

发布时间：2018-01-02 08:28

本文关键词：不同疗法干预瘀血阻滞型膝骨关节炎的临床疗效观察　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:探讨针刀、膝关节炎治疗仪、针灸干预瘀血阻滞型膝骨关节炎的临床疗效差异性,为探寻一种疗效稳定、可靠的瘀血阻滞型膝骨关节炎治疗方法提供临床依据。方法:将120例患者随机分为针刀组30例、膝关节炎治疗仪组30例、针灸组30例及对照组30例。针刀组取血海、梁丘、阴陵泉、阳陵泉、鹤顶穴及髌周压痛点、内外侧副韧带、髌韧带起止点进行针刀松解剥离粘连挛缩,每周1次,5次为1个疗程;膝关节炎治疗仪组将治疗仪电极片贴于膝关节内外膝眼处,根据病情和病人耐受情况,调节输出脉冲合适的强度,每天1次,每次30分钟,连续治疗30天为一个疗程;针灸组针刺血海穴、梁丘穴、阴陵泉、阳陵泉、犊鼻穴、鹤顶穴,每天1次,每次30分钟,连续治疗30天为一个疗程;对照组行关节腔内注射玻璃酸钠注射液治疗,每周1次,5次为1个疗程。四组治疗前后VAS评分、膝关节运动功能、临床症状积分进行对比,对临床总体疗效、控显率及总有效率评估,并行统计学分析。结果:在入组的120例患者中,最后完成研究114例,针刀组29例、膝关节炎治疗仪组29例、针灸组28例及对照组28例。1.VAS评分比较:疗程完成后,针刀组、膝关节炎治疗仪组、针灸组及对照组治疗后VAS评分均较治疗前显著降低(P0.01),四组组间治疗后有统计学差异(P0.01)。VAS评分降低程度比较:四组组间差异有统计学意义(P0.05),其中针刀组明显高于对照组(P0.01),并高于针灸组(P0.05)均有统计学意义;其余两两比较无明显统计学差异(P0.05)。2.膝关节运动功能比较:疗程结束后,四组患者治疗后膝关节运动功能评分均明显高于治疗前(P0.01);针刀组膝关节运动功能评分增加程度明显高于其余三组(P0.01),膝关节炎治疗仪组高于对照组(P0.05),膝关节炎治疗仪组虽高于针灸组,针灸组也要高于对照组,但差异均无统计学意义(P0.05)。3.临床症状比较:疗程结束后,治疗后四组膝关节临床症状积分均明显低于治疗前(P0.01)。降低程度组间比较:针刀组、膝关节炎治疗仪组膝关节临床症状积分降低程度均明显高于对照组(P0.01),有显著差异;针刀组高于针灸组(P0.05),有统计学意义;针刀组高于膝关节炎治疗仪组、针灸组虽高于对照组,但差异无统计学意义(P0.05)4.临床疗效比较:疗程结束后,四组临床疗效分级比较经Kruskal-WallisH秩和检验显示差异有统计学意义(P0.05)。四组控显率显著差别,经卡方检验显示有差别(P0.05);四组总有效率比较经卡方检验分析显示差异无统计学意义(P0.05)。临床疗效分级及控显率比较均有差异,针刀疗法明显优于其他三组疗效,膝关节炎治疗仪组较针灸组、对照组疗效好,针灸组较对照组效佳。结论:1.针刀、膝关节炎治疗仪、针灸、关节腔注射玻璃酸钠治疗膝骨关节炎均有效。2.针刀疗法治疗瘀血阻滞型膝骨关节炎在改善疼痛、关节运动功能及临床症状等方面优于膝关节炎治疗仪、针灸、关节腔注射玻璃酸钠。3.针刀疗法治疗瘀血阻滞型膝骨关节炎临床疗效较好,值得临床推广。
[Abstract]:Objective: To investigate the knife, knee osteoarthritis treatment, clinical curative effect of blood stasis type of knee osteoarthritis of the acupuncture intervention, to explore a stable curative effect, to provide reliable clinical evidence of blood stasis type of knee osteoarthritis treatment. Methods: 120 patients were randomly divided into treatment group of 30 cases of knee joint in treatment group 30 cases, 30 cases of acupuncture group and 30 cases in the control group. Treatment group take Xuehai, Liangqiu, yinlingquan, Yanglingquan, heding acupoints and patellar aroundtender points, medial and lateral collateral ligament, patellar ligament of acupotomy stripping adhesion contracture, 1 times a week for 5 times the 1 course of treatment; knee osteoarthritis treatment group will therapeutic instrument electrode is attached to the knee joint and knee eye, according to the disease and patient tolerance, adjust the output pulse of appropriate strength, 1 times a day, every 30 minutes, for 30 days as a course of treatment; acupuncture group acupuncture Xuehai, Liangqiu, Yin Ling Quan, Yang Ling Stephen, Dubi acupoint, heding acupoints, 1 times a day, every 30 minutes, for 30 days as a course of treatment; the control group underwent intra-articular injection of Sodium Hyaluronate Injection treatment, 1 times a week, 5 times for 1 course. VAS scores of the four groups before and after treatment, the knee joint motion function, clinical symptoms integral comparison, on the general clinical curative effect, the control rate and the total efficiency evaluation, the results were statistically analyzed. Results: in 120 patients, finally completed the study in 114 cases, 29 cases of treatment group, knee osteoarthritis treatment group 29 cases, acupuncture group 28 cases and control group 28 cases.1.VAS score: treatment after the completion of the treatment of knee osteoarthritis Acupotomy group, instrument group, acupuncture group and control group after treatment VAS scores were significantly lower than before treatment (P0.01), between the four groups after treatment, there were significant differences in.VAS score (P0.01) reduce the degree of comparison: the difference between the four groups had statistical significance (P0.05), which the needle knife group was significantly higher In the control group (P0.01), and higher than the acupuncture group (P0.05) had statistical significance; the remaining 22 is no significant difference between.2. (P0.05) knee joint motion function: after the end of treatment, four groups of patients after treatment of knee joint function score were significantly higher than those before treatment (P0.01); Acupotomy group of knee joint motion function the score increase was significantly higher than the other three groups (P0.01), knee arthritis treatment group than in control group (P0.05), knee osteoarthritis treatment group was higher than the acupuncture group, acupuncture group was higher than that of the control group, but the differences were not statistically significant (P0.05) compared with.3. clinical symptoms: after treatment, after treatment four groups of knee joint clinical symptom scores were significantly lower than that before treatment (P0.01). To reduce the degree of comparison between groups: Acupotomy group, knee osteoarthritis treatment instrument group knee clinical symptom score decreased significantly than the control group (P0.01), there was significant difference; Acupotomy group Higher than the acupuncture group (P0.05), there was statistical significance; Acupotomy group was higher than that of knee osteoarthritis treatment group, acupuncture group was higher than control group, but the difference was not statistically significant (P0.05) comparison of 4. clinical efficacy: after treatment, the clinical efficacy of the four groups were compared by Kruskal-WallisH test showed that there was a statistically significant difference (P0.05) four. The control rate was significant difference by chi square test showed difference (P0.05); the total efficiency of four groups by chi square test analysis showed no significant difference (P0.05). Clinical classification and control rate were difference, acupuncture therapy was significantly better than the other three groups, osteoarthritis of the knee treatment group compared with the acupuncture group, the control group has good curative effect, good effect of acupuncture and moxibustion group than in the control group. Conclusion: 1. acupuncture, knee osteoarthritis treatment, acupuncture, needle knife.2. were effective therapy in the treatment of blood stasis type of knee joint cavity injection of sodium hyaluronate for treatment of knee osteoarthritis Arthritis is superior to the treatment of knee osteoarthritis in improving pain, joint movement function and clinical symptoms. Acupuncture, intraarticular injection of sodium hyaluronate,.3. needle knife therapy has better clinical efficacy in treating blood stasis type knee osteoarthritis, and is worthy of clinical promotion.

【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】：R246.9

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