关节镜下滑膜辨证治疗气滞血瘀型慢性膝关节滑膜炎

发布时间：2018-01-30 05:59

本文关键词： 慢性膝关节滑膜炎关节镜清理术辨证论治中药膝关节功能锻炼　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本文通过回顾性分析研究关节清理联合镜下滑膜辨证治疗气滞血瘀型慢性膝关节滑膜炎,探讨辨证论治治疗滑膜炎的作用机理,寻求一种治疗慢性膝关节滑膜炎更加有效、经济实用的方法。方法:收集湖北省中医院骨伤科(花园山院区)从2015年03月到2016年03月住院治疗的符合研究纳入标准的气滞血瘀型慢性膝关节滑膜炎患者,总共48例,分为治疗组24例,对照组24例。其中治疗组为关节清理联合辨证方身痛逐瘀汤加减治疗,术后第二天口服身痛逐瘀汤加减,水煎服,日一剂,分早晚两次口服,连续服用21天;对照组为关节清理联合滑膜炎颗粒治疗法,术后口服滑膜炎颗粒,每日3次,每次1袋,亦连续用药21天。两组患者均在术后第二天开始行膝关节功能锻炼。治疗21天后,运用Bristol膝关节功能评分,观察患者治疗前后膝关节疼痛、屈伸功能及肿胀程度的改善情况,各治疗小组之间行对比分析,所得数据用SPSS19.0软件进行统计学分析。结果:两组患者在入院时Bristol膝关节评分经过分析,P㧐0.05,无明显统计学意义,具有可比性。手术患者术后未见切口感染、延迟愈合等不良反应。各组患者治疗前后的Bristol膝关节评分比较,P㩳0.05,表明两种治疗方法治疗膝关节滑膜炎都有效;两组患者治疗后Bristol膝关节评分比较,P0.05,表明治疗组的疗效优于对照组;治疗组与对照组的远期疗效比较,得出P0.05,表明两组的远期疗效无明显差异。结论:上述治疗方法都能够治疗慢性膝关节滑膜炎,但治疗组的近期疗效较好,恢复快,经过一年修养锻炼,两组远期疗效无明显差别。关节清理术能够直接清除关节内病变滑膜,相较于传统开放性手术,具有创伤小、恢复快、易于患者接受等优势,配合辨证方药口服巩固治疗,促进血液、淋巴循环,改善关节内生理环境,辨证后对症用药相较于直接予以常规药物治疗,疗效更加显著。通过关节清理联合辨证方给药,清理与调养相结合,标本兼治,是一种值得在临床上推广的治疗慢性膝关节滑膜炎的治疗方法。
[Abstract]:Objective: to study the mechanism of joint debridement combined with synovium differentiation in treating chronic knee joint synovitis with qi stagnation and blood stasis. To seek a more effective treatment for chronic synovitis of the knee. Economic and practical methods. Methods: collection of orthopedics and trauma department of Hubei traditional Chinese medicine hospital (garden mountain hospital district). Patients with chronic knee joint synovitis with Qi stagnation and Blood stasis type who were hospitalized from March 2015 to March 2016 were included in the study. A total of 48 cases were divided into treatment group (n = 24) and control group (n = 24). Take orally twice in morning and evening for 21 days; The control group was treated with joint debridement combined with synovitis granules. Postoperative oral synovitis granules were given 3 times a day with 1 bag each time. After 21 days of treatment, Bristol score was used to observe the pain of knee joint before and after treatment. The improvement of flexion and extension function and swelling degree were compared among the treatment groups. The data were statistically analyzed by SPSS19.0 software. Results: the Bristol knee joint score of the two groups was analyzed at admission. 0. 05, no statistical significance, comparable. No postoperative incision infection, delayed healing and other adverse reactions. Comparison of Bristol knee score before and after treatment in each group. 0.05, indicating that both methods are effective in the treatment of synovitis of knee joint. The comparison of Bristol knee joint score between the two groups showed that the curative effect of the treatment group was better than that of the control group. Compared with the control group, the long-term curative effect of the treatment group and the control group, P0.05, indicating that there is no significant difference in the long-term efficacy between the two groups. Conclusion: the above treatment methods can treat chronic synovitis of knee joint. But the short-term curative effect of the treatment group is better and the recovery is fast. After one year training, there is no significant difference between the two groups. Joint debridement can directly clear the synovial membrane of the joint, compared with the traditional open surgery. With the advantages of small trauma, quick recovery and easy to be accepted by patients, combined with oral consolidation therapy of dialectical prescription, it can promote blood, lymphatic circulation and improve the physiological environment of joints. After syndrome differentiation, the therapeutic effect is more significant than that of direct routine medicine. Through joint cleaning combined with syndrome differentiation prescription, the combination of cleaning and nourishing, both the symptoms and the symptoms are treated. It is a method worth popularizing in clinical treatment of chronic knee joint synovitis.
【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】：2017
【分类号】：R274.9

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