包金山教授学术思想和临床经验的继承整理及夹挤分骨手法治疗前臂双远端骨折的临床研究

发布时间：2018-04-14 00:22

本文选题：学术思想 + 手法复位　；参考：《北京中医药大学》2016年硕士论文

【摘要】：目的：1.收集、整理、继承指导老师包金山教授的学术思想和临床经验。2.通过挖掘整理包金山老师治疗骨折手法复位术临床经验进一步了解老师的学术思想,学习和研究传统手法复位术,学习研究“三诊、六侧、九结合”的科学性及重要性,为临床提供理论依据。3.论包金山教授对祖传下来的蒙医整骨学术思想渊源数据和阐述,研究和提炼包金山教授多年来积累和形成的蒙医整骨学术思想和临床经验,进一步解析该手法的科学性与优势,提炼指导老师的学术思想和临床经验。4.评价蒙医整骨特色疗法“夹挤分骨手法”治疗前臂双远端骨折的优越性与可靠性、选择性。5.通过蒙医整骨疗法和切开复位内固定疗法的临床症状的评价对比研究,进一步验证蒙医整骨疗法治疗前臂双远端骨折的疗效。方法：1.搜集资料,学习经典著作,结合跟师体会总结整理指导老师手法复位治疗及临床经验及学术思想。2.运用包金山老师实际临床经验及学术思想,结合自己临床积累,通过西医临床路径手术治疗的前臂双远端骨折患者和夹挤分骨手法治疗前臂双远端骨折术后治愈的对比研究,对蒙医传统手法复位术法进行疗效评价。手法治疗组共30例,男16例,女14例;年龄30-65岁,平均55.5岁;对照组30例,男17例,女13例;年龄25-65岁,平均58.5岁。手法治疗组用蒙医整骨疗法复位、小夹板外固定、药酒按摩、功能锻炼、辩证用药、特色护理治疗。对照组切开复位内固定治疗。采用PRWE评定方法和蒙医临床疗效评定标准对比两种治疗方法治疗前、治疗后第一天、治疗后第一周、治疗后第二周、治疗后第三周、治疗后第四周的临床症状,评价蒙医整骨疗法治疗前臂双远端骨折的临床疗效。治疗总疗程为28天。骨折由内蒙古民族大学附属医院蒙医传统整骨科诊断。结果：1.导师包金山教授在医疗实践中,创立了以“三诊、六则、九结合”(即“3.6.9三元”疗法)为精髓、独一无二的蒙医骨伤理论,为民族医学蒙医整骨学奠定了理论基础。2.蒙医整骨术遵照以激发与调动人体内在潜能为特征,能动整复与功能愈合为理念,蒙医药学基础理论为向导,以内因为指导、外因为条件,“精、气、神”(精、气、神是人体三宝。气生于精,神生于气,精多气多,气多神就足,只有神足才能发挥功力,才能有神奇疗效。)为重点,手感功能和巧妙手法整复和物力学和几何学原理固定为主,喷酒按摩为特点,对症用药、调节饮食、功能练习、沙袋挟挤,牵引、护理为内容,“天地人和”的自然、绿色,无创伤的生命自然观,是一门奇特疗效的具有强大生命力的学科。3.研究结果：治疗前和治疗后两组PRWE评分数据的比较：治疗前两组患者的PRWE评分分数无明显差异(P0.05)；治疗后第一天两组患者的PRWE评分分数比较后有明显差异(P0.05)；治疗后第一周两组患者的PRWE评分分数比较后无明显差异(P0.05)。治疗后第二周两组患者的PRWE评分分数比较后无明显差异(P0.05)。治疗后第三周两组患者的PRWE评分分数比较有明显差异(P0.05)。治疗后第四周两组患者的PRWE评分分数比有明显差异(P0.05)。治疗后根据蒙医骨折临床疗效评价标准,治疗组好转率达到96.0%,对照组好转率达到90.6%,有明显差异(P0.05)。结论：1.导师包金山教授在医疗实践中,创立了以“三诊、六则、九结合”(即“3.6.9三元”疗法)为精髓、独一无二的蒙医骨伤理论,为民族医学蒙医整骨学奠定了理论基础。2.蒙医整骨疗法治疗尺桡骨下端骨折与手术治疗尺桡骨下端骨折PRWE评分对比后第一周和第二周的临床症状好转情况基本一样。蒙医整骨疗法治疗尺桡骨下端骨折后第三周和第四周临床症状好转情况比手术治疗后较好。3.据蒙医骨折临床疗效评价标准,蒙医整骨疗法治疗尺桡骨下端骨折临床好转率比手术治疗尺桡骨下端骨折的临床好转率高,统计比较后有显著性差异。4.蒙医整骨疗法临床疗效可靠、操作简便、愈合快、经济负担小等优势、值得推广应用。
[Abstract]:Objective: 1. collection, collation, inheriting the academic thought and clinical experience of.2. guidance of Professor Bao Jinshan by excavation of Professor Bao Jinshan in the treatment of fracture clinical experience manual replacement further understand the teacher's academic thoughts, study and research of traditional manual replacement, study and research "of three cases, six sides, nine combination" science and significance and provide a theoretical basis for the theory of Professor.3. package Jinshan ancestral Mongolian traditional osteopathy academic ideological origins and elaborates the data for clinical research and refinement package Jinshan professor for many years accumulation and the formation of Mongolian traditional osteopathy academic thoughts and clinical experience, further analysis of science and the superiority of the technique, therapy "academic thought and clinical experience of.4. evaluation the characteristics of Mongolian traditional osteopathy teacher pinch points extraction technique" in the treatment of double forearm bone fracture of the distal superior reliability and selectivity of.5. by Mongolian whole bone healing Study on the evaluation and comparison of open reduction and internal fixation therapy clinical symptoms, further verify the efficacy treatment of Mongolian traditional osteopathy forearm distal fracture. Methods: 1. to collect information, learning classics, combined with teacher experience summarized the instructor manual reduction for the treatment of and clinical experience and academic thoughts of.2. teachers' actual clinical experience using packet Jinshan according to their clinical and academic thoughts, accumulation, through the western medicine clinical pathway for surgical treatment of forearm fractures of the distal comparative study of patients and squeeze the bone manipulation in the treatment of forearm fracture of the distal end of the cure after surgery, to evaluate the curative effect of Mongolian traditional manual reduction method. Treatment group were 30 cases, male 16 cases, female 14 cases; age 30-65 years, average 55.5 years old; 30 cases in the control group, 17 cases were male, 13 were female; the average age is 25-65 years old, 58.5 years old. Methods the treatment group with Mongolian osteopathy reduction, small splint external fixation, medicine Wine massage, functional exercise, dialectical medication, characteristics of nursing treatment. The control group treated with open reduction and internal fixation. The two kinds of treatment methods PRWE evaluation method and evaluation standard of Mongolian medicine clinical curative effect contrast before treatment, treatment after the first day, the first week after treatment, second weeks after treatment, third weeks after treatment, the clinical symptoms of four after treatment, evaluation of clinical efficacy of Mongolian traditional osteopathy treatment of forearm double fractures of the distal. The total period of treatment was 28 days. Fractures by Mongolian Medicine Affiliated Hospital of Inner Mongolia University for the Nationalities traditional department of orthopedics diagnosis. Results: 1. professor Bao Jinshan in the medical practice, the creation of a "three cases, six, nine (the" 3.6.9 "combination three yuan" therapy) as the essence of the theory of Mongolian medicine and the one and only for national medical science, Mongolian traditional osteopathy lays the theoretical foundation of.2. Mongolian osteopathy according to stimulate and mobilize the body potential as the characteristic, dynamic reduction With the function of healing for the concept of Mongolian medicine basic theory as a guide, because within the guide, because the outside conditions, "fine, gas, God" (fine, gas, God is human Sambo. Gas was born in essence, God was born in gas, refined gas, gas is only God, God enough to play skill in order to have a magical effect.) as the focus, hand function and ingenious manipulation and material mechanics and geometry principle fixed, spraying massage characteristics, symptomatic medication, diet, functional exercise, with sandbags crowded, traction, care for the content, "heaven and earth" natural, green, no trauma life natural view that is a strange effect and strong vitality, the results of.3.: comparison of PRWE scores of the two groups of data before and after the treatment: two groups of patients PRWE scores had no significant difference before treatment (P0.05); after treatment compared to the first day of the two groups of patients with PRWE score after Significant differences (P0.05); the first week after treatment between two groups of patients with PRWE score had no obvious difference after treatment (P0.05). After second weeks of the two groups of patients PRWE score after no significant difference (P0.05). After third weeks of treatment in two groups of patients with PRWE score were significantly different (P0.05) the fourth week after treatment. The two groups of patients with PRWE score than had significant difference (P0.05). After treatment, according to the Mongolian fracture clinical efficacy evaluation criteria, treatment group improvement rate reached 96%, the control group improved rate reached 90.6%, there was significant difference (P0.05). Conclusion: 1. professor Bao Jinshan in medical practice, created in six, three cases, nine combination "(the" 3.6.9 three "therapy) as the essence of the theory of Mongolian medicine and the one and only for national medical science, Mongolian traditional osteopathy lays the theoretical foundation of.2. Mongolian traditional osteopathy therapy in the treatment of ulnar fracture of distal end of radius and surgical treatment The clinical symptoms of treatment of ulnar and radial fracture of lower PRWE score compared after the first week and the second week of the situation is basically the same. Mongolian osteopathy treatment of ulnar fracture of distal end of radius third and 4th weeks after clinical symptoms improved after surgical treatment of.3. is better than according to the evaluation standard of clinical efficacy of Mongolian Mongolian osteopathy fracture, treatment of ulna and radius at the lower end of the clinical improvement the rate of clinical improvement than the surgical treatment of ulnar and radial fracture of the lower end of the high rate of fracture, the statistical comparison has significant difference.4. Mongolian osteopathic clinical curative effect is reliable, simple operation, fast healing, economic burden and other advantages, it is worthy of popularization and application.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R29

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