拇指揉法对强直性脊柱炎髋部病变髋屈伸肌群等速肌力影响的临床研究

发布时间：2018-01-10 15:33

本文关键词：拇指揉法对强直性脊柱炎髋部病变髋屈伸肌群等速肌力影响的临床研究　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过等速肌力测定数值变化来研究推拿手法对强直性脊柱炎引起的早期髋关节病变周围肌群的影响,探讨拇指揉法对强直性脊柱炎引起的髋关节病变的防治效果及作用机制,为该治疗的临床应用提供科学依据。方法:实验采用强直性脊柱炎髋部病变髋屈伸肌群功能障碍病人40例,正常成人20例,共60例作为研究对象。将强直性脊柱炎髋部病变髋屈伸肌群功能障碍病人40例,随机分为二组:推拿组(治疗组—A组,20例)、常规治疗组(对照组—B组,20例)。正常成人20例,为正常成人组(空白组—C组,20例)。共三组。三组均分别在第1天治疗开始前、第21天治疗开始前,均进行ESR、CRP检测,并采用德国Isomed 2000等速肌力测试系统,进行等速肌力测定并记录(C组未治疗,正常参与日常生活活动):在角速度为60(°/s、120(°/s情况下,观察髋屈伸肌群的峰力矩(peak torque,PT)、相对峰力矩(peak torque to body weight,PT/BW)、总功(total work,TW)、相对总功(average power,AP)。双髋均有症状者,均记录右侧数据进行分析。计量资料采用均数±标准差((?)±s)表示,将所有数据输入计算机,用SPSS 13.0 For Windows软件进行统计学分析。采用方差分析的检验方法。定性资料采用百分比表示。所有检验均以P0.05表示有统计学意义,具有显著性差异;差异无统计学意义以P0.05表示。结果:(1)治疗前患者髋部屈伸肌群等速肌力测试观察结果:患者组(推拿组、常规治疗组)治疗前较正常组髋部屈伸肌群等速肌力降低,差异有统计学意义(P0.05),具有显著性差异。(2)治疗20天后髋部屈伸肌群等速肌力观察:推拿组、常规组患者髋屈伸肌群等速肌力均能改善,包括:髋屈伸肌群的峰力矩(peak torque,PT)、相对峰力矩(peak torque to body weight,PT/BW)、总功(total work,TW)、相对总功(average power,AP),进行组内对比,与治疗前差异有统计学意义(P0.05),具有显著性差异。(3)在角速度60°/s情况下髋部屈伸肌群等速肌力观察进行组间对比:推拿组(A组)峰力矩、相对峰力矩、总功、相对总功各项测试结果均优于常规治疗组(B组),差异具有有统计学意义(P0.05),在角速度120°/s情况下,其屈肌、伸肌总功和屈肌、伸肌相对总功测试结果,均与常规治疗组(B组)相当,差异无统计学意义(P0.05)。(4)ESR,CRP实验结果显示:A,B两组阴性率治疗后大于治疗前。治疗后阴性率改善程度AB,CRP变异率大于ESR变异率。结论:拇指揉法治疗可有效提高患者等速肌力指标:峰力矩、相对峰力矩、总功、相对总功,降低ESR、CRP等炎性指标数值,提高阴性率,达到治疗强直性脊柱炎引起的髋周疾病髋部肌群功能目的;等速肌力可作为介于日常生活活动评定和血清生化指标间的一种测定指标。
[Abstract]:Objective: to study the effect of massage manipulation on the peripheral muscles of ankylosing spondylitis (ankylosing spondylitis). To explore the effect and mechanism of thumb rubbing on the prevention and treatment of hip joint lesions caused by ankylosing spondylitis (ankylosing spondylitis). Methods: 40 patients with ankylosing spondylitis hip lesions and 20 normal adults were treated with hip flexion and extensor dysfunction. A total of 60 patients with ankylosing spondylitis (ankylosing spondylitis) were randomly divided into two groups: massage group (group A, n = 20). The routine treatment group (control group, group B, n = 20) and normal adults group (n = 20, n = 20) were divided into three groups: group C (n = 20) and group C (n = 20). All three groups were treated before the beginning of treatment on the first day. Before the 21st day of treatment, all patients were tested with ESR-CRP, and the isokinetic muscle strength test system of Isomed 2000 in Germany was used to measure the isokinetic muscle strength and recorded that group C was not treated. Normal participation in daily life activities: at an angular velocity of 60 掳/ s ~ 120 (掳/ s), the peak torque of hip flexion and extensor muscle group was observed. Relative peak torque peak torque to body weight PTR / BW, total work total. The patients with symptoms of both hips recorded the right side data for analysis. The measurement data were measured with mean 卤standard deviation. ) means that all data is entered into the computer. Using SPSS 13.0 For. Windows software for statistical analysis. Analysis of variance using the test method. Qualitative data are expressed in percentage. All tests are P0.05 to show statistical significance. There was significant difference; Results before treatment, the hip flexion and extensor muscle group of patients with isokinetic muscle strength test results: patients group (massage group). Compared with the normal group, the isokinetic muscle strength of flexion and extensor muscle group in the routine treatment group was lower than that in the normal group, the difference was statistically significant (P0.05). Observation of isokinetic muscle strength of hip flexion and extensor muscle group after 20 days treatment: the isokinetic muscle strength of hip flexion and extensor muscle group in massage group and routine group could be improved. The peak torque of hip flexion and extensor muscle group was peak torque to body weight PTP / BW). Total work was compared with that before treatment (P 0.05). At 60 掳/ s angular velocity, the isokinetic muscle strength of flexion and extensor group of hip was observed and compared between groups: group A (massage group) peak moment, relative peak moment, total work. The results of relative total work were better than that of group B, and the difference was statistically significant (P 0.05). At the angular velocity of 120 掳/ s, the total work of flexor, extensor and flexor were measured. The results of relative total work of extensor muscle were similar to those of group B (P 0.05, P 0.05, P < 0.05), and the results of ESR-CRP test showed that there was no significant difference between two groups (P 0.05, P < 0.05). The negative rate of group B after treatment was higher than that before treatment. The degree of improvement of negative rate after treatment was higher than that of ESR. Conclusion: thumb rubbing can effectively improve the isokinetic muscle strength index: peak torque. Relative peak torque, total work, relative total work, reduced ESR-CRP and other inflammatory index values, increased the negative rate, and achieved the purpose of treating hip muscle group caused by ankylosing spondylitis. Isokinetic muscle strength can be used as an index between daily life evaluation and serum biochemical index.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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