微针刀解结法治疗膝骨性关节炎的临床疗效观察

发布时间：2018-03-04 11:52

本文选题：微针刀解结法　切入点：普通针刺　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:当今社会的现代化发展愈发迅猛,致使人们对自身生活质量和身体健康状况的要求渐渐提高,因此出现许多营养过剩的饮食习惯,而且科技的进步让人们的体力劳动逐年减少,肥胖人数不断攀升,超出正常范围的体重给双膝关节带来的负荷也越来越大,导致膝骨性关节炎的患病率升高、患病年龄降低,明显影响患者的生活质量。当前治疗该病的常用药是非留体抗炎镇痛口服药,其疗效较为明显,可是会引起消化系统的不良反应;而现有的中药疗法效果并不明确,常常良莠不齐;西医手术治疗则损伤较大,麻醉风险也高,因此寻求一种简、验、廉、便的膝骨性关节炎治疗方法是一个亟待解决的问题。本课题根据临床病例观察微针刀解结法对膝骨性关节炎的治疗结果,从患者的膝关节疼痛、僵硬和关节生理功能几个方面,分析该疗法对本病的具体疗效,从而证实其有效性和安全性并指导实践治疗。研究结果对于改善中老年患者们的生活质量有重大的医学和社会意义。方法:本课题的受试者均来自2016年06月至2017年01月于广东省第二中医院针康科门诊和住院部的病人,均切合所设定的诊断标准和纳入标准。本课题采用的是随机对照、单盲的前瞻性研究方法来进行试验。将收集到的患者按就诊顺序随机分为微针刀组(采用微针刀解结法治疗)和针刺组(采用普通针刺法治疗)。观察经微针刀组和针刺组治疗后患者膝关节疼痛、僵硬、生理功能的改善程度。所有患者每周进行3次操作,连续4周。在治疗前、后分别采用国际视觉模拟评分量表(VAS)、骨关节炎指数评分(W0MAC)量表对患者进行评估。先对两组的一般资料、X线分级情况和每个量表评分进行基线比较,在发现两组之间无差异,具有可比性后,接着分别比较两组治疗前后的量表数据改变,以及两组组间在改善膝关节疼痛、僵硬、生理功能之间的差别,最终根据疗效评定标准比较两组的总体疗效。结果:疗程结束,二组的VAS评分、WOMAC各指标评分及其总积分都比治疗之前明显降低,且两者具有显著统计学差异(P0.01),说明微针刀解结法和普通针刺法都可以明显影响患者的膝关节疼痛、僵硬以及生理功能。治疗后,微针刀组和针刺组在减轻患者的膝关节僵硬症状方面效果相当,两组治疗后评分没有明显的差异(P0.05),两组治疗前后的积分差值比较亦没有显著性差异(P0.05);而在疼痛症状的减轻以及生理功能的改善方面,微针刀组的治疗效果比针刺组更佳,两组治疗后评分有显著差异(P0.05),各组治疗前后评分的差值比较也有统计学差异(P0.05)。并且它们治疗后的总体临床疗效相比,二者具有统计学差异(P0.05),微针刀组治疗效果明显比针刺组更好。结论:使用微针刀解结法和普通针刺法治疗膝骨性关节炎,二者治疗前后都具有显著性差异,效果明显,且微针刀组各量表指标的结果大多优于针刺组,说明微针刀组的治疗效果较针刺组更明显。总之,微针刀解结法是一种疗效佳、操作易、无不良反应的疗法,可以从很大程度上改善患者膝关节疼痛、僵硬及活动受限的情况,值得推广使用。
[Abstract]:Objective: the modernization of the social development rapidly, resulting in the demand for quality and health status of their own life gradually increased, so there are many nutritional excess eating habits, and the progress of science and technology make people's physical labor decreased year by year, the number of overweight is not broken up, beyond the normal range of the weight of the load of double knee joint more and more, resulting in knee osteoarthritis prevalence rate increased, age decreased, significantly affect the quality of life of patients. The current commonly used drugs for the treatment of the disease is left non oral medicine anti-inflammatory analgesic, its curative effect is obvious, but can cause adverse reactions in the digestive system; while the existing Chinese medicine therapy effect is not clear often, western medicine treatment is uneven in quality; the larger damage, the risk of anesthesia is also high, so seeking a simple, low-cost, and knee osteoarthritis of the treatment is an urgent To solve the problem. According to the clinical observation of micro needle therapy results untie the knot of knee osteoarthritis of the knee pain from patients, several stiffness and joint physiological function, analysis of the specific effect of the treatment of this disease, so as to confirm the effectiveness and safety of the treatment. The results of the study and practice is of great significance for improving the medical and social elderly patients' quality of life. Methods: the subjects of this research were from 2016 06 to 2017 01 months in the second hospital of Guangdong Province Department of outpatient and inpatient rehabilitation patients were cut by setting the diagnostic criteria and inclusion criteria in this paper. Using the randomized, prospective study of single blind method to test. The collected patients were randomly divided into treatment group (using micro micro needle knife solution method and node treatment) acupuncture group (the ordinary acupuncture law ). Observe the micro needle therapy group and acupuncture group after treatment of patients with knee joint pain, stiffness, improve the degree of physiological function. All of the patients was 3 times a week, for 4 weeks. Before treatment, after using the international visual analogue scale (VAS), index of osteoarthritis score (W0MAC) amount the table for the evaluation of patients. The general data of the two groups, and each X-ray grading score were compared in the baseline, found no differences between the two groups are comparable, then the two groups were compared before and after treatment, the scale of data change, and between the two groups in the improvement of knee joint pain. Stiff, the physiological function of the difference between the final according to the overall curative effect evaluation standard of two groups were compared. Results: the end of treatment, two groups of VAS score, WOMAC score and the total score of each index than before treatment significantly decreased, and both have significant difference (P0.01) That shows the micro needle knife solution node method and ordinary acupuncture can significantly affect patients with knee joint pain, stiffness and physiological function. After treatment, the micro needle group and acupuncture group in reducing patients' symptoms of knee joint stiffness effect is equivalent to that of the two groups after treatment were not significantly difference (P0.05), integral difference before and after two groups of treatment as compared with no significant difference (P0.05); while the pain reduction of symptoms and physiological function improvement, micro needle knife group treatment effect better than the acupuncture group, the two groups after treatment were significantly different (P0.05), the difference between the groups before and after treatment were compared with significant differences (P0.05) the overall clinical efficacy. And compared them after treatment, two showed a significant difference (P0.05), micro needle knife treatment effect is obviously better than the acupuncture group. Conclusion: the use of micro needle knife solution method and ordinary acupuncture treatment of knee osteoarthritis Inflammation, before and after the two treatment has significant difference, the effect is obvious, and the micro scale index of the Acupotomy group results are better than the acupuncture group, indicating that the micro needle knife group than in the acupuncture group treatment effect is more obvious. In short, micro needle knot solving method is a good curative effect, easy operation, no adverse reaction in the therapy from, can greatly improve the knee joint pain, stiffness and limitation of activity situation, which is worthy of promotion.

【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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