内经清阳理论在肩关节周围炎中医施治的临床应用观察

发布时间：2018-05-19 22:40

本文选题：肩周炎 + 清阳理论　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的:运用内经清阳理论,予以温阳通脉药物治疗肩周炎患者,观察患者肩部疼痛、活动度、日常活动的恢复情况,以及患者对于治疗效果满意情况。方法:回顾性分析,选择从2015年2月至2016年8月期间在湖北中医药大学附属湖北省中医院骨伤科门诊及凤凰门诊就诊的110例单侧肩周炎患者。分为治疗组A组,对照组B组与C组,其中A组45例,B组37例,C组28例,A组予以口服温阳通脉的中药方黄芪桂枝五物汤加减,每日一剂,分早晚温服。B组予以口服补益肝肾的独活寄生汤加减,每日一剂,分早晚温服。C组予以口服活血化瘀的宣痹汤加减,每日一剂,分早晚温服,3组同时配合予以常规功能锻炼,记录4周后治疗效果。所有患者治疗前后采取白天与夜间VAS视觉模拟评分进行评价,同时患者治疗前后的肩关节功能活动、活动度、疼痛、治疗满意度及临床疗效进行评定分析。结果:1.研究结束后,将110例患者纳入统计学分析,三组病例的基本情况及病情比较,差异无统计学意义,具有可比性。2.A、B、C三组病例治疗前后的肩关节疼痛评分、功能活动评分、肩关节活动度评分、医患满意度评分及总分数分别经配对检验进行组内比较,p值均小于0.05,提示三组病例治疗前后肩关节疼痛评分、功能活动评分、肩关节活动度评分及治疗后满意度评分、总分数差异均有统计学意义;且各组治疗后各项评分均明显高于治疗前。3.A组与B、C组在治疗后肩关节疼痛、肩关节活动度、医患满意度方面,经方差分析,差异具有统计学意义,且A组分数高于B组与C组。4.A组总有效率为91.11%,B组总有效率为81.08%,C组总有效率为75%,经组间两两LSD比较,A组与B、C组之间差异显著,有统计学意义,B组与C组之间差异不明显,无统计学意义。结论:1.黄芪桂枝五物汤、独活寄生汤及宣痹汤均能改善肩周炎患者肩部疼痛、肩关节功能活动及肩关节活动度。2.黄芪桂枝五物汤治疗肩周炎疗效优于独活寄生汤及宣痹汤;3.内经清阳理论指导下黄芪桂枝五物汤加减在减轻患者肩周炎患者疼痛方面具有良好作用,且患者耐受性良好,安全、无明显毒副作用。
[Abstract]:Objective: to observe the recovery of shoulder pain, activity, daily activity and satisfaction of the patients with shoulder periarthritis by using Neijing Qingyang theory. Methods: from February 2015 to August 2016, 110 patients with unilateral periarthritis of shoulder were selected from orthopedics and trauma department of Hubei traditional Chinese Medicine Hospital affiliated to Hubei University of traditional Chinese Medicine and Phoenix outpatient clinic from February 2015 to August 2016. They were divided into treatment group A, control group B and group C. among them, 45 cases in group A, 37 cases in group B, 37 cases in group C, 28 cases in group A were treated with Huangqi Guizhi Wuwu decoction, a traditional Chinese medicine prescription of Wenyang Tongmai, once a day. Group B was given oral decoction of tonifying liver and kidney, one dose per day, and group C was given oral decoction of promoting blood circulation and removing blood stasis. The therapeutic effect was recorded after 4 weeks. All patients were evaluated with VAS visual analogue score before and after treatment, and the shoulder function, motion, pain, treatment satisfaction and clinical efficacy were evaluated and analyzed before and after treatment. The result is 1: 1. After the study, 110 patients were included in the statistical analysis. There was no significant difference in the basic condition and the disease status among the three groups. 2.The shoulder pain score and the functional activity score before and after treatment were comparable. Shoulder motion score, doctor-patient satisfaction score and total score were all less than 0.05 by paired test, indicating that the shoulder joint pain score and functional activity score before and after treatment in the three groups. The scores of shoulder motion and satisfaction after treatment were statistically significant, and the scores after treatment were significantly higher than those before treatment in group A and group B C after treatment, and the range of shoulder motion was significantly higher than that in group A and group C after treatment. In terms of doctor-patient satisfaction, the difference was statistically significant by ANOVA. The total effective rate of group A was higher than that of group B and group C. the total effective rate of group B was 81.08% and the total effective rate of group C was 75.The difference between group A and group C was significant, but there was no significant difference between group B and group C. There is no statistical significance. Conclusion 1. Huangqi Guizhi Wuwu decoction, Duhuzheng decoction and Xuanbi decoction can improve shoulder pain, shoulder functional activity and shoulder motion. 2. Huangqi Guizhi Wuwu decoction is superior to Duhuzheng decoction and Xuanbi decoction in treating shoulder periarthritis. Under the guidance of Neijing Qingyang theory, Huangqi Guizhi Wuwu decoction has a good effect in alleviating the pain of patients with periarthritis of shoulder, and the patient has good tolerance, safety and no obvious side effects.
【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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