“髋四刀”疗法干预髋关节骨性关节炎的疗效观察

发布时间：2018-01-10 14:00

本文关键词：“髋四刀”疗法干预髋关节骨性关节炎的疗效观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:骨关节炎(OA)是一种常见的骨关节病,因其具有较高的致残率而对患者生活有重要的影响。随着我国社会人群的老龄化,骨关节炎的患病率更是逐年提升。临床上髋关节是骨性关节炎的好发部位。髋关节骨性关节炎是由多个因素综合作用引起的慢性、退行性的关节疾病,其发展过程具有一定的不可逆性,临床表现主要为关节疼痛及功能受限,在疾病早期及发展的过程中有效的保守治疗手段较为局限。本研究旨在探讨“髋四刀”这一针刀疗法对改善髋关节骨性关节病的患者髋关节功能及疼痛程度的临床疗效。方法:回顾性研究2014年5月至2016年1月于武汉市中医医院门诊就诊的符合纳入标准的髋关节骨性关节炎患者48例共60髋,其中男9例,女39例;单侧髋36例,双侧髋12例;平均年龄41.98±11.42岁;病程12.08±9.89月。运用“髋四刀”,髋关节囊壁的四个部分的针刀松解针刀疗法,对患侧髋进行四个特定部位的松解治疗,治疗后对病人进行随访。分别收集治疗前及治疗后第二周、第三个月的临床相关资料,以视觉模拟评分法(Visual Analogue Scale)、Harris评分为疗效评估评分,用SPSS19.0软件进行统计学分析,数据处理采用配对样本t检验,所有计量资料以均数±标准差(x±s)表示,所有计数资料用卡方检验,根据P值判断其是否存在统计学差异,从而判断其临床疗效。结果:采用“髋四刀”疗法干预后,患者髋关节VAS评分及Harris评分均优于治疗前。治疗前VAS评分6.82±1.14,治疗后二周及三月随访VAS评分为3.62±1.33、3.80±1.35,均显著低于治疗前,P值均小于0.01(△P0.01,△△P0.01)。治疗前Harris评分63.17±5.64,治疗后二周及三个月随访的Harris评分分别为75.65±4.76、76.46±4.87,均显著高于治疗前,P值均小于0.01(*P0.01,**P0.01)。结论:针刀干预髋关节骨性关节炎具有其独特优势,运用“髋四刀”干预髋关节骨性关节炎可有效改善患者髋关节功能及疼痛程度,本方法操作简单,具有一定临床疗效,有临床运用的价值,为髋关节骨性关节炎的治疗提供了新思路。熟悉髋关节解剖,找准正确的入路,熟练掌握针刀操作是此治疗方法的关键。
[Abstract]:Objective: osteoarthritis (OAA) is a common osteoarthropathy, which has an important effect on patients' life because of its high rate of disability. The prevalence of osteoarthritis is increasing year by year. Hip joint is the common site of osteoarthritis clinically. Hip osteoarthritis is a chronic degenerative joint disease caused by multiple factors. Its development process has certain irreversibility, the clinical manifestation mainly is the joint pain and the function limitation. The effective conservative treatment in the early stage and development of the disease is limited. The clinical effect of this needle knife therapy on the improvement of hip joint function and pain in patients with hip osteoarthropathy. Methods:. A retrospective study of 48 hip osteoarthritis patients who met the inclusion criteria from May 2014 to January 2016 in the outpatient clinic of Wuhan traditional Chinese Medicine Hospital was conducted. There were 9 males and 39 females; 36 cases of unilateral hip and 12 cases of bilateral hip; The average age was 41.98 卤11.42 years old; The course of the disease was 12.08 卤9.89 months. The four parts of the hip capsule wall were treated with four special parts of the hip. The patients were followed up after treatment. The clinical data were collected before and after treatment, and visual Analogue scale was evaluated by visual analogue score (VAS). The Harris score was used to evaluate the curative effect, and the statistical analysis was carried out by SPSS19.0 software. The data were processed by paired sample t test. All the measured data were expressed as mean 卤standard deviation (x 卤s). All the counting data were checked by chi-square test, according to P value to judge whether there was statistical difference, so as to judge the clinical efficacy. Results: after the intervention of "Hip Si-Dao" therapy. The VAS score and Harris score of hip joint of the patients were better than those before treatment. The VAS score before treatment was 6.82 卤1.14, and the VAS score was 3.62 卤1.33 after 2 weeks and March follow-up. 3.80 卤1.35, which was significantly lower than that before treatment (P < 0.01, P 0.01, P 0.01). The Harris score before treatment was 63.17 卤5.64. The Harris scores of two weeks and three months after treatment were 75.65 卤4.76 卤76.46 卤4.87, respectively, which were significantly higher than those before treatment. P values were less than 0.01P 0.01P 0.01. Conclusion: needle knife intervention in hip osteoarthritis has its unique advantages. The use of "hip four knife" intervention hip osteoarthritis can effectively improve the hip joint function and pain degree, this method is simple, has a certain clinical efficacy, clinical application value. It provides a new idea for the treatment of hip osteoarthritis. The key to this treatment is to be familiar with the anatomy of the hip joint, to find the correct approach and to master the operation of needle-knife skillfully.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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