斜刺经筋法治疗膝骨性关节炎的临床观察

发布时间：2017-12-28 17:19

本文关键词：斜刺经筋法治疗膝骨性关节炎的临床观察　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:以常规针刺穴位为对照,探讨从经筋角度治疗膝骨性关节炎的临床有效性及优越性,提高本病治愈率及降低复发率。方法:采用随机对照试验的研究方法,将符合研究标准的60例膝骨性关节炎患者随机分为试验组和对照组两组,各30例。试验组根据膝关节及其周围疼痛部位,在病变经筋路线上寻找阳性反应点进行针刺;对照组采用传统穴位治疗。两组疗程相同,隔日1次,每周3次,1周为1个疗程,疗程间休息2天,共4个疗程,疗程结束后进行第一次疗效评估,疗程结束1月后随访进行第二次疗效评估。采用目测类比定级法评分(VAS)、膝关节骨性关节量表指数(WOMAC)在治疗前、后及随访时记录患者各项评分情况,从而评价其临床疗效。成果:1.患者基本资料方面:治疗前两组的性别、年龄、病程及各项评分等基线情况组间比较,差异无统计学意义(P0.05),具有可比性。2.总体疗效组间比较:(1)治疗后:试验组总有效率96.67%,对照组总有效率86.67%,总体疗效组间比较差异有统计学意义(P0.01)。(2)随访时:试验组总有效率90.00%,对照组总有效率80.00%,总体疗效组间比较差异有统计学意义(P0.01)。3.治疗前后各项评分组内比较差异有统计学意义(P0.05)。4.治疗后各项评分组间比较差异有统计学意义(P0.05)。5.随访时与治疗后各项评分组内比较:试验组:疼痛评分、日常活动难度评分、WOMAC总分组内比较差异有统计学意义(P0.05),僵硬评分组内比较无统计学意义(P0.05)。对照组:疼痛评分组内比较差异有统计学意义(P0.05),僵硬评分、日常活动难度评分、WOMAC总分组内比较无统计学意义(P0.05)。6.随访时与治疗后疼痛评分、日常活动难度评分、WOMAC总分组间比较差异有统计学意义(P0.05),僵硬评分组间比较差异无统计学意义(P0.05)。结论:1.两种疗法治疗膝骨性关节炎都有很好的临床疗效,但试验组的总体疗效优于对照组。2.试验组对疼痛、僵硬、日常活动难度及整体症状的改善均优于对照组,且在疼痛、日常活动难度及整体症状的改善方面持续效应优于对照组,在僵硬改善方面两组均无明显持续效应。
[Abstract]:Objective: To investigate the clinical efficacy and superiority of the treatment of knee osteoarthritis from the perspective of meridian tendons, and to improve the cure rate and reduce the recurrence rate. Methods: 60 patients with knee osteoarthritis who met the research criteria were randomly divided into two groups: the experimental group and the control group, with two cases in each group, 30 cases in each group. In the experimental group, the positive reaction points were found on the tendons of the knee and the pain sites around the knee, and the control group was treated with traditional acupoint therapy. The two groups had the same course of treatment, 1 times every other day, 3 times a week, 1 weeks for 1 courses, and 2 days of treatment between them, a total of 4 courses. After the end of the treatment, the first efficacy was evaluated. After the end of the course of treatment, second patients were followed up for curative effect evaluation after January. Visual analogue scale (VAS) and knee osteoarthrosis index (WOMAC) were used to record patients' scores before and after treatment, so as to evaluate their clinical efficacy. Results: 1. patients' basic data: before treatment, there was no statistically significant difference in gender, age, course of disease and score between the two groups in the baseline situation (P0.05). 2., the overall efficacy group comparison: (1) after treatment: the total effective rate of the experimental group was 96.67%, and the total effective rate of the control group was 86.67%, the difference between the overall efficacy group was statistically significant (P0.01). (2) in the follow-up period, the total effective rate of the experimental group was 90%, the total effective rate of the control group was 80%, and the difference between the total therapeutic groups was statistically significant (P0.01). There was a significant difference between the scores of each group before and after treatment (P0.05). (P0.05). 4. after treatment, there were significant differences between the scores of each group (P0.05). 5. there was a difference between the follow-up group and the score group after treatment: the pain score, daily activity difficulty score and WOMAC total score of the experimental group were statistically different (P0.05), and there was no statistically significant difference between the rigid score group (P0.05). Control group: pain score group had statistically significant difference (P0.05), stiffness score, daily activity difficulty score and WOMAC total group had no statistical significance (P0.05). 6. there was a statistically significant difference in the pain score, daily activity difficulty score and WOMAC total score between the follow-up group and the control group (P0.05). There was no significant difference in stiffness score between the two groups (P0.05). Conclusion: 1. two kinds of therapy have good clinical effect on knee osteoarthritis, but the overall effect of the test group is better than that of the control group. 2., the improvement of pain, stiffness, daily activity difficulty and overall symptoms in the experimental group was better than that in the control group, and the continuous effect in pain, daily activity difficulty and overall symptom improvement was better than that in the control group. There was no significant sustained effect in the improvement of stiffness in the two groups.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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