关节镜清理术联合“洗按补”疗法治疗膝关节骨关节炎的临床疗效研究

发布时间：2018-03-15 20:20

本文选题：膝骨性关节炎　切入点：关节镜清理术　出处：《云南中医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的:对比研究关节镜清理术分别联合常规疗法与“洗按补”疗法治疗膝骨关节炎的临床疗效。方法:将2013年10月-2015年10月共收集47例纳入本研究,运用随机数字表分组法。其中观察组23例,对照组24例。观察过程中因资料不全、医嘱性差、病例脱落等原因,最终观察组20例,对照组20例。最终数据统计分析按40病例进行研究,来评价关节镜清理术联合常规治疗与“洗按补”疗法治疗膝关节骨关节炎的临床疗效。结果:1观察组和对照组治疗KOA的疗效分析观察组和对照组经过治疗后的总疗效分析(表6)得知:HSS评分系统两组总疗效结果,观察组有效率95%,对照组有效率90%;经秩和检验分析(Z=-2.031,P=0.0420.05),说明观察组关节镜清理术联合“洗按补”疗法与对照组关节镜清理术联合常规疗法有差异性,且前者总疗效率高于后者。2观察组治疗组前后主要症状对比分析观察组经过治疗前后的主要症状分析(表7)得知:观察组患者在HSS评分系统主要症状的治疗前与治疗后用配对t检验表明:观察组在改善患膝疼痛、功能、活动度、肌力、屈曲挛缩上(P0.01)有极显著差异性;在膝关节稳定性上(P=0.3200.05)无统计学意义,无差异性。说明患者通过关节镜清理术联合“洗按补”疗法治疗KOA,在改善患膝疼痛、功能、活动度、肌力、屈曲挛缩等临床疗效上有着极显著的临床改善。但对改善患者膝关节稳定性上没有明显效果。3对照组治疗组前后主要症状对比分析对照组经过治疗前后的主要症状分析(表8)得知:对照组患者在HSS评分系统主要症状的治疗前与治疗后用配对t检验表明:对照组在改善患膝疼痛、功能、屈曲挛缩上(P0.01)有极显著差异性;在活动度、肌力上(P0.05)有统计学意义,有差异性;在膝关节稳定性上(P0.05),无统计学意义,无差异性。说明关节镜清理术联合常规疗法治疗KOA,仅在患膝疼痛、功能、屈曲挛缩的临床效果上有着极显著的临床改善,在活动度和肌力的临床效果上有着显著的临床改善,而在膝关节稳定性上无明显改善。4治疗后观察组与对照组主要症状对比分析治疗后观察组与对照组主要症状对比分析(表9)得知:治疗后患者在HSS评分系统主要症状的观察组与对照度用独立样本t检验表明:观察组和对照组治疗后在改善患膝活动度上(P0.01)有极显著差异性;在疼痛、屈曲挛缩上(P0.05)有统计学意义,有差异性;在功能、稳定性、肌力上(P0.05),无统计学意义,无差异性。结论:1 HSS系统评分数据分析知观察组有效率95%,对照组有效率90%;经秩和验分析(Z=-2.031,P=0.0420.05),观察组关节镜清理术联合“洗按补”疗法对照组关节镜清理术联合常规疗法二者具有差异性,且前者总疗效高于后者。2两组治疗后疗效数据对比分析知,HSS系统评分数据分析中说明关节镜清理术联合“洗按补”疗法治疗KOA患者,在改善患者膝关节活动度的临床效果上极明显优于关节镜清理术联合常规疗法(P0.01);在疼痛、屈曲挛缩的临床效果明显优于关节镜清理术联合常规疗法(P0.05);在功能、稳定性、肌力的临床效果上,二者治疗效果无明显差异(P0.05)。3综上研究,关节镜清理术联合“洗按补”疗法治疗KOA在改善患者患膝疼痛、活动度、屈曲挛缩、僵硬等主要临床症状上有着很好的临床效果,值得临床运用。
[Abstract]:Objective: To compare the effects of arthroscopic debridement combined with conventional therapy and wash separately according to the clinical curative effect of complement therapy in the treatment of knee osteoarthritis. Methods: the October 2013 -2015 year in October 47 cases were collected in this study, using a random number table grouping method. 23 cases in the observation group, 24 cases in the control group. The observation process for incomplete information, order difference, cause cases, the final 20 cases in the observation group, 20 cases in the control group. The final data were analyzed according to the study of 40 cases, to evaluate the arthroscopic debridement combined with routine treatment and wash according to the clinical curative effect of complement therapy in the treatment of knee osteoarthritis. Results: the observation group 1 and the control group curative effect in the treatment of KOA of the observation group and the control group after the total curative effect after the treatment analysis (Table 6) show that the HSS scoring system, the total effect of the two groups, the observation group the effective rate was 95%, the effective rate of control group 90%; the rank and inspection analysis (Z=-2.031, P =0.0420.05), the observation group of arthroscopic debridement combined with "wash to fill" therapy and the control group of arthroscopic debridement combined with conventional therapy has the difference, and the total treatment efficiency is higher than that of the latter analysis.2 observation group treatment group the main symptoms before and after comparison of the observation group after analysis the main symptoms before and after treatment (Table 7) that: observation and treatment the main symptoms of patients in the HSS score system before and after treatment by paired t test showed that the observation group in improving knee pain, function, activity, muscle strength, flexion contracture on (P0.01) had significant differences in knee stability; (P=0.3200.05) had no statistical significance, there was no difference in patients. Through arthroscopic debridement combined with "wash to fill" therapy in the treatment of KOA, in the improvement of knee pain, function, activity, muscle strength, flexion contracture of clinical curative effect has significant clinical improvement. But the improvement of patients with knee joint instability There is no obvious effect on the qualitative analysis group.3 control group before and after treatment of symptoms compared with the control group after the main symptoms before and after treatment and analysis (Table 8) that the control group in the HSS score system the main symptoms before and after treatment by paired t test showed that the control group in improving knee function, pain, flexion contracture on (P0.01) had significant differences; in activity, strength (P0.05) was statistically significant difference in knee stability; (P0.05), no statistical significance, no difference. Arthroscopic debridement combined with conventional therapy in the treatment of KOA, only in the function of knee pain, clinical. The effect of flexion contracture has significant clinical improvement, significant clinical improvements in clinical activity and muscle strength, and no significant improvement after.4 treatment, the observation group and the control group in the treatment of main symptoms of comparative analysis of the stability of the knee. After the observation group and the control group comparison analysis of main symptoms (Table 9) that: after treatment of patients with the main symptoms scoring system in HSS observation group and contrast with the independent sample t test showed that the observation group and the control group after treatment in improving knee motion (P0.01) has a significant difference in pain; flexion contracture (P0.05) on a statistically significant differences; in function, stability, strength (P0.05), no statistical significance, no difference. Conclusion: analysis of 1 known HSS system score data the effective rate of observation group was 95%, the effective rate of control group 90%; the rank and inspection analysis (Z=-2.031, P=0.0420.05) the observation group, arthroscopic debridement combined with "wash to fill" therapy in the control group of arthroscopic debridement combined with conventional treatment two has the difference, and the total effect of.2 was higher than that of the latter two groups after treatment efficacy data comparison analysis, analysis of HSS data shows that arthroscopic score system Combined with "wash according to supplement therapy in KOA patients, to improve clinical outcome in patients with knee joint activity was significantly better than the arthroscopic debridement combined with conventional therapy (P0.01); in pain, flexion contracture of the clinical effect is obviously better than that of arthroscopic debridement combined with conventional therapy (P0.05); in the function, stability and clinical effect of muscle strength no significant difference on the treatment effect of two (P0.05).3 in conclusion, arthroscopic debridement combined with" wash to fill "therapy in the treatment of KOA patients in improving knee pain, activity, flexion contracture, stiffness of the main clinical symptoms has a good clinical effect, worthy of clinical application.

【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4

【相似文献】