核素结合中药治疗距骨骨软骨损伤的临床观察

发布时间：2018-06-29 03:11

本文选题：中药 + 锝亚甲基二磷酸盐　；参考：《河南中医学院》2015年硕士论文

【摘要】：目的:观察锝亚甲基二磷酸盐配合中药对距骨骨软骨损伤患者治疗前后疼痛度变化、AOFAS评分变化、应用SPECT/CT图像融合技术进行疗效评价,验证锝亚甲基二磷酸盐配合中药对距骨骨软骨损伤疾病的治疗意义。方法:选取符合纳入标准的距骨骨软骨损伤患者75例。按随机对照的原则分成三组,各25例。中药组:采用活血通络法治疗,每日口服中药,分别于早、晚各冲服1剂,饭后温开水送服。连续用药30天。云克组:单纯给予锝亚甲基二磷酸盐配静脉滴注治疗,每日一次,每次22mg,连续治疗30天。联合组:采用活血通络法结合锝亚甲基二磷酸盐治疗,连续治疗30天。疗程结束半年后观察三组患者疼痛评分,AOFAS评分等方面的变化,并行SPECT/CT检查,测量患者病变范围变化,最后在三组的结果之间作统计学分析,得出结论。结果:治疗前三组在年龄、性别、病程、疼痛程度值方面无显著性差异。疗程结束半年后,三组在疼痛疗效比较方面有显著差异(P0.05),中药组有效率为80%,云克组有效率84%,联合组有效率92%;在AOFAS评分比较方面有显著差异(P0.05),中药组有效率为76%,云克组有效率80%,联合组有效率92%;在SPECT/CT范围比较方面有显著差异(P0.05),中药组有效率为73.68%,云克组有效率80.93%,联合组有效率88.89%。结论:1、锝亚甲基二磷酸盐联合中药治疗距骨骨软骨损伤,能够有效的缓解患者疼痛,提高AOFAS评分,促进软骨的修复。2、采用SPECT/CT检查方法能及早、直接反应病变区域组织代谢变化及解剖学变化,客观评价疗效。
[Abstract]:Objective: To observe the changes of the pain degree before and after the treatment of talus osteochondral damage by technetium methylene two phosphate and the change of AOFAS score, and evaluate the curative effect by using SPECT/CT image fusion technique, and verify the significance of the treatment of technetium methylene two phosphate and traditional Chinese medicine on the injury of the talus osteochondral injury. 75 cases of osteochondral injury of the talus were divided into three groups according to the principle of random control, each 25 cases. The Chinese traditional medicine group was treated with the method of activating blood circulation and collaterals, taking oral Chinese medicine every day in the morning and evening, taking 1 doses in each day, after meals and feeding for 30 days. In Yun Ke group, intravenous drip of technetium methylene two phosphate and intravenous drip, once a day, 22mg, Continuous treatment for 30 days. The combined group was treated with the method of activating blood circulation and collaterals combined with technetium methylene two phosphate for 30 days. After the end of the course, the pain scores, AOFAS scores and other changes in the three groups were observed, and the changes in the range of the patients' lesions were measured in parallel, and the results were statistically analyzed between the results of the three groups and the conclusion was concluded. Results: there was no significant difference in age, sex, course of disease and pain degree between the three groups before the treatment. After half a year, the three groups had significant differences in the pain effect (P0.05), the effective rate of the Chinese medicine group was 80%, the effective rate of Yun Ke group was 84%, the effective rate of the combined group was 92%, and there was significant difference in the AOFAS score (P0.05), and the effective Chinese medicine group was effective. The rate was 76%, the effective rate of the Yun Ke group was 80%, the effective rate of the combined group was 92%, the comparison of the SPECT/CT range was significant (P0.05), the effective rate of the Chinese medicine group was 73.68%, the effective rate of Yun Ke group was 80.93%, the effective rate of the combined group was 88.89%. conclusion: 1, technetium methylene two phosphate combined with traditional Chinese medicine in the treatment of the talar osteochondral injury, which could effectively relieve the pain and improve the AO of the patients. FAS score can promote cartilage repair.2, SPECT/CT examination can be used as early as possible to directly reflect the metabolic changes and anatomical changes in the lesion area, and objectively evaluate the curative effect.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684

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