易筋经锻炼改善退行性膝关节炎肝肾亏虚证的机理研究

发布时间：2018-05-20 05:53

本文选题：易筋经 + 退行性膝关节炎　；参考：《湖南中医药大学》2015年硕士论文

【摘要】：目的：通过观察易筋经锻炼对退行性膝关节炎肝肾亏虚证患者中医证候积分、临床综合疗效、膝关节屈曲度、疼痛程度以及C反应蛋白(CRP)、白细胞介素-1(IL-1)的影响,探讨易筋经锻炼对退行性膝关节炎肝肾亏虚证的临床疗效及作用机理,从而为易筋经的临床推广和应用提供一定的临床及理论基础。方法：将符合纳入标准的90例退行性膝关节炎肝肾亏虚证患者按照随机数字表法,随机分为易筋经加艾灸组(A组)、艾灸组(B组)和易筋经组(C组),每组各30例,A组给予易筋经锻炼加艾灸疗法,B组给予艾灸疗法,C组给予易筋经锻炼疗法,观察三组治疗前、1个月后、2个月后退行性膝关节炎肝肾亏虚证患者中医证候积分、临床综合疗效、膝关节屈曲度、疼痛程度以及应用免疫比浊法检测90例退行性膝关节炎肝肾亏虚证患者CRP水平,用ELISA法检测其IL-1水平的变化,将三组治疗前后的观察指标加以对比。结果： 1.三组治疗后中医证候积分、临床综合疗效都得到改善(P0.05),其中A组疗效显著(P0.01),A组临床疗效优于B、C组(P0.05)。B组与C组之间比较无差异性(P0.05)。 2.三组治疗后膝关节屈曲度,都得到改善(P0.05),其中A组作用显著(P0.01),B、C两组作用次之。在治疗1个月后,B、C两组作用相当(P0.05),治疗2个月后,C组较B组效果好(P0.05)。 3.三组治疗后膝关节疼痛程度,都得到改善(P0.05),其中A组作用显著(P0.01),B、C两组作用次之。在治疗1个月后,B、C两组作用相当(P0.05),治疗2个月后,B组较C组效果好(P0.05)。 4.三组治疗后CRP、IL-1水平都得到改善(P0.05)。A组作用显著(P0.01),B、C两组作用次之。在治疗后1个月后,B、C两组作用相当(P0.05),治疗2个月后,B组较C组效果好(P0.05)。结论： 1.易筋经锻炼能改善退行性膝关节炎肝肾亏虚证患者膝关节功能,提高生活质量,尤其是改善膝关节屈伸不利症状。 2.CRP、IL-1水平与退行性膝关节炎病情活动性呈正相关性。易筋经锻炼能降低退行性膝关节炎肝肾亏虚证患者CRP、IL-1水平。 3.易筋经锻炼对退行性膝关节炎肝肾亏虚证患者无明显不良反应。 4.易筋经锻炼和艾灸改善退行性膝关节炎作用具有协同性,可以在临床上联合应用于治疗退行性膝关节炎肝肾亏虚证。 5.长期坚持每天一次易筋经锻炼,对于维持和改善退行性膝关节炎肝肾亏虚证疗效有重要意义。
[Abstract]:Objective: to observe the effects of training on the syndromes of traditional Chinese medicine (TCM), clinical comprehensive curative effect, knee flexion, pain degree and C-reactive protein (CRP), interleukin-1 (IL-1) in degenerative knee arthritis patients with deficiency of liver and kidney. To explore the clinical curative effect and mechanism of degenerative knee arthritis with deficiency of liver and kidney by the exercise of Yi jin meridian, so as to provide a certain clinical and theoretical basis for the clinical popularization and application of Yi Jin Jing. Methods: 90 cases of degenerative knee arthritis with deficiency of liver and kidney were divided into two groups according to random digital table method. They were randomly divided into two groups: group A (group A), group B (moxibustion group) and group C (group C). Each group (30 cases) was treated with moxibustion therapy and moxibustion therapy (group B). Three groups of patients with degenerative arthritis of liver and kidney deficiency syndrome were observed before, 1 month, 2 months after the treatment of TCM syndromes integral, clinical comprehensive efficacy, knee flexion, The degree of pain and the level of CRP in 90 cases of degenerative knee arthritis with deficiency of liver and kidney were detected by using immune turbidimetry. The changes of IL-1 level were detected by ELISA method. The observed indexes before and after treatment were compared among the three groups. Results: 1. After treatment, the integral of TCM syndromes and the comprehensive curative effect of the three groups were all improved (P 0.05). The clinical efficacy of group A was significantly better than that of group B (P 0.05). There was no difference between group B and group C (P 0.05). 2. After treatment, the flexion degree of knee joint was improved in all three groups, and group A was the second group. After 1 month of treatment, the effect of the two groups was equivalent to P0.05A, and after 2 months of treatment, the effect of group C was better than that of group B (P 0.05). 3. The degree of knee joint pain in the three groups was improved after treatment. After 1 month of treatment, the effect of group B was equal to that of group B, and the effect of group B was better than that of group C 2 months after treatment. 4. After treatment, the levels of IL-1 in CRPnI were improved significantly in group A and group A, and the effect of group A was significantly higher than that of group C (P 0.01). After 1 month of treatment, the effect of group B was equal to that of group B, and the effect of group B was better than that of group C 2 months after treatment. Conclusion: 1. It can improve the function of knee joint, improve the quality of life, especially improve the adverse symptoms of knee joint flexion and extension in degenerative knee arthritis patients with deficiency of liver and kidney. 2. There was a positive correlation between the level of IL 1 and the activity of degenerative knee arthritis. Easy tendon exercise can reduce the level of CRPN IL 1 in degenerative knee arthritis patients with deficiency of liver and kidney. 3. There was no obvious adverse reaction in degenerative knee arthritis with deficiency of liver and kidney. 4. The treatment of degenerative knee arthritis by training and moxibustion is synergistic and can be used in clinical treatment of degenerative knee arthritis due to deficiency of liver and kidney. 5. It is important to maintain and improve the effect of deficiency of liver and kidney in degenerative knee arthritis.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684.3

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