小针刀联合关节腔注射药物治疗膝骨性关节炎的临床对照研究

发布时间：2018-10-29 18:23

【摘要】：目的:本研究的目的是通过对小针刀联合关节腔注射药物治疗膝骨性关节炎的可行性及疗效的临床对照研究,为膝骨性关节炎的治疗提供一种有效的临床方案。方法:将2015年3月至2016年12月期间,通过新疆黄河路中医医院门诊确诊为膝骨性关节炎90例,通过软件产生的随机数字表法将门诊符合纳入标准的患者随机分为两组,试验组45例和对照组45例。以症状重的一侧为观察对象。两组均予基础治疗(复方倍他米松+维生素B12+利多卡因注射液混合配成5ml注射液,将其中2.5ml注射入膝关节周围痛点,剩余2.5ml注射入关节腔,留置针头,将玻璃酸钠注射液注入关节腔),试验组在基础治疗同时予以小针刀对膝关节周围痛点行松解治疗,每周进行1次,3次为1个疗程。治疗结束后观察患者临床疗效、VAS评分、Lysholm评分情况。并在治疗结束后第4周、治疗结束后第8周进行随访,同时进行疗效评估。结果:治疗结束后小针刀组临床疗效97.78%,对照组临床疗效95.56%,两组没有统计学意义(X~2=1.200,P0.05)。治疗结束后第四周小针刀组总有效率97.5%,对照组总有效率92.1%,两组数据有明显差异(X~2=8.044,P0.05),治疗结束后第八周小针刀组总有效率97.4%,对照组89.2%(X~2=8.682,P0.05)。治疗结束后两组VAS评分统计学差异不明显(t=0.848,P0.05),治疗结束后第四周、第八周评分有统计学差异(t=3.029,P0.05;t=2.814,P0.05)。治疗结束后两组Lysholm评分无明显差异(t=0.836,P0.05),治疗结束后第四周、第八周评分有统计学差异(t=2.598,P0.05;t=2.408,P0.05)。结论:小针刀临床治疗能够明显减轻膝关节的疼痛,极大的缩减患者的恢复时间,加快膝关节功能的恢复,作用持续久,远期疗效较佳。
[Abstract]:Objective: to study the feasibility and efficacy of small needle knife combined with intraarticular injection in the treatment of knee osteoarthritis, and to provide an effective clinical scheme for the treatment of knee osteoarthritis. Methods: from March 2015 to December 2016, 90 cases of knee osteoarthritis were diagnosed in the outpatient clinic of Huanghe Road Hospital of Xinjiang, Xinjiang. The patients who met the inclusion criteria were randomly divided into two groups by the random digital table method produced by software. There were 45 cases in the test group and 45 cases in the control group. The severe side of the symptom was used as the observation object. Both groups were treated with basic therapy (compound betamethasone vitamin B12 lidocaine injection was mixed with 5ml injection, in which 2.5ml was injected into the pain point around the knee joint, the remaining 2.5ml was injected into the articular cavity, and the needle was retained. Sodium hyaluronate injection was injected into the articular cavity). In the experimental group, the pain points around the knee joint were treated with small needle knife at the same time, once a week, 3 times as a course of treatment. The clinical efficacy, VAS score and Lysholm score were observed after treatment. The patients were followed up 4 weeks after treatment and 8 weeks after treatment. Results: after the treatment, the clinical effect of small needle knife group was 97.78 and that of control group was 95.56. There was no statistical significance between the two groups (P 0.05). The total effective rate of the small needle knife group was 97.55.The total effective rate of the control group was 92.1.There was a significant difference between the two groups in the data of the two groups (P 0.05). The total effective rate of the small needle knife group was 97.4% at the eighth week after treatment. The control group was 89.2% (P 0.05). There was no significant difference in VAS scores between the two groups after treatment (t0. 848, P 0.05), but there was a significant difference in the scores at the fourth week and the eighth week after treatment (t0. 029, P 0. 05, P < 0. 05). There was no significant difference in Lysholm score between the two groups after treatment (t = 0.836 P 0.05), but there was a significant difference in the score of the eighth week after the end of treatment (P 0.05). Conclusion: the clinical treatment with small needle knife can significantly reduce the pain of knee joint, greatly reduce the recovery time of patients, accelerate the recovery of knee joint function, the effect lasts for a long time, and the long-term effect is better.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R684.3

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