平乐正骨“平衡理论”在痰瘀痹阻型膝骨性关节炎中的运用研究

发布时间：2018-02-02 09:17

本文关键词： 平乐正骨平衡理论膝骨性关节炎痰瘀闭阻量表　出处：《安徽中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的在平乐正骨“平衡理论”指导下,运用平衡综合疗法诊疗痰瘀痹阻型膝骨性关节炎,探讨平衡综合疗法的疗效;评析膝骨性关节炎平衡量表的合理性。方法基于平乐正骨“平衡理论”、相关文献、书籍、病历资料,探讨平乐正骨“平衡理论”在痰瘀闭阻型膝骨性关节炎中的具体运用,并以此制定平衡综合疗法,自拟膝骨性关节炎平衡量表;将75例痰瘀痹阻型膝骨性关节炎随机分成两组,治疗组37例,对照组38例,治疗组患者予以平衡综合疗法治疗,对照组患者予以塞来昔布联合盐酸氨基葡萄糖胶囊,治疗4周,观察并记录两组患者一般资料、VAS评分、KOOS评分、膝关节周径、膝骨性关节炎平衡量表、安全性等相关资料,分析两组治疗的疗效,进行综合评价分析。结果75例患者,治疗组和对照组分别脱落2例、3例,治疗组和对照组完成整个观察疗程的各35例,具体如下:(1)两组在性别、年龄、体重、身高、病程、X线分级,差异无统计学意义(P0.05),具有可比性;(2)疗效治疗组临床治愈4例,显效18例,有效8例,无效5例,总有效率85.71%;对照组临床治愈2例,显效10例,有效16例,无效7例,总有效率80%;治疗组疗效分布优于对照组,且有统计学差异(Z=-2.054,P=0.0400.05),说明平衡综合疗法治疗痰瘀痹阻型膝骨性关节炎疗效肯定;(3)治疗前VAS评分、KOOS评分、KOOS-症状评分、KOOS-疼痛评分、KOOS-日常活动评分、KOOS-运动和娱乐功能评分、KOOS-生活质量评分、膝关节周径、膝骨性关节炎平衡量表评分组间比较,差异无统计学意义(P0.05),具有可比性;(4)两组治疗后VAS评分、KOOS评分、KOOS-症状评分、KOOS-疼痛评分、KOOS-日常活动评分、KOOS-运动和娱乐功能评分、KOOS-生活质量评分、膝关节周径、膝骨性关节炎平衡量表评分分别与治疗前组内比较,差异有统计学意义(P0.05);(5)两组治疗后KOOS评分、KOOS-症状评分、KOOS-日常活动评分、KOOS-生活质量评分、膝关节周径、膝骨性关节炎平衡量表评分比较,差异有统计学意义(P0.05),且所有指标治疗组改善优于对照组;(6)两组治疗后VAS评分、KOOS-疼痛评分、KOOS-运动和娱乐功能评分,差异无统计学意义(P0.05);(7)KOOS评分变化与膝骨性关节炎平衡量表评分变化,相关系数r=0.919,P=0.0000.05,差异有统计学意义。结论(1)基于平乐正骨“平衡理论”的平衡综合疗法治疗痰瘀痹阻型膝骨性关节炎疗效肯定;(2)平衡综合疗法治疗痰瘀痹阻型膝骨性关节炎在改善患者KOOS评分、KOOS-症状评分、KOOS-日常活动评分、KOOS-生活质量评分、膝关节周径、膝骨性关节炎平衡量表评分上优于塞来昔布联合盐酸氨基葡萄糖胶囊;(3)平乐正骨“平衡理论”运用于疾病的诊断、治疗、预防等方面值得进一步研究与推广;(4)膝骨性关节炎平衡量表值得进一步修订、研究、验证。
[Abstract]:Objective under the guidance of "balance theory" of Pingle Zhenggu, to explore the curative effect of balanced comprehensive therapy in diagnosis and treatment of knee osteoarthritis caused by phlegm and stasis obstruction. Methods to evaluate the rationality of the knee osteoarthritis balance scale. Methods based on the "balance theory", relevant literature, books and medical records. To discuss the application of the "balance theory" of Pingle Zhenggu in the knee osteoarthritis of phlegm and blood stasis blocking type, and to formulate the balance comprehensive therapy, and to draw up the balance scale of knee osteoarthritis. 75 cases of knee osteoarthritis caused by phlegm and stasis obstruction were randomly divided into two groups: treatment group (n = 37) and control group (n = 38). The patients in the control group were treated with celecoxib combined with glucosamine hydrochloride capsule for 4 weeks. The general data of the two groups were observed and recorded. Results 75 cases of patients, 2 cases of treatment group and 3 cases of control group were dropped off. Treatment group and control group completed the whole course of treatment of 35 cases, as follows: 1) the two groups in sex, age, weight, height, course of disease X ray grading, there was no significant difference (P 0.05). Comparability; 2) in the treatment group, 4 cases were clinically cured, 18 cases were markedly effective, 8 cases were effective, 5 cases were ineffective, and the total effective rate was 85.71%; In the control group, 2 cases were clinically cured, 10 cases were markedly effective, 16 cases were effective, 7 cases were ineffective, and the total effective rate was 80%. The distribution of therapeutic effect in the treatment group was better than that in the control group, and there was statistical difference between the two groups. (3) before treatment, VAS score / Koos score / symptom score / Kos pain score / daily activity score / motor and entertainment function score. There was no significant difference in quality of life score, knee circumference and knee osteoarthritis balance scale between the two groups (P 0.05). (4) after treatment, the VAS score and the Kos symptom score of the two groups were compared with the KOOS-pain score and the daily activity score and the motor and entertainment function score. The scores of quality of life, knee circumference and knee osteoarthritis balance scale were significantly different from those before treatment (P 0.05). (5) after treatment, the KOOS score and the symptom score were compared between the two groups. The scores of quality of life, knee circumference and knee osteoarthritis balance scale were compared between the two groups. The difference was statistically significant (P 0.05), and the improvement of all indexes in the treatment group was better than that in the control group. (6) there was no significant difference between the two groups in VAS score and KOOS-pain score (P 0.05). The change of KOOS score and the score of knee osteoarthritis balance scale were correlated with the correlation coefficient (r = 0.919) P = 0.0000.05. Conclusion the balance therapy based on the "balance theory" of Pingle Zhenggu is effective in the treatment of knee osteoarthritis with phlegm and stasis obstruction. (2) balance therapy in the treatment of knee osteoarthritis with phlegm and stasis obstruction was used to improve the KOOS score and the symptom score and the daily activity score and the quality of life score (QOL) in patients with osteoarthritis of knee caused by phlegm and stasis obstruction. The knee joint circumference and knee osteoarthritis balance scale score were better than celecoxib combined with glucosamine hydrochloride capsule. (3) the "balance theory" of Pingle and Zhenggu is worth studying and popularizing in the diagnosis, treatment and prevention of disease. The knee osteoarthritis balance scale deserves further revision, study and verification.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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