六指六穴点压结合消瘀定痛散治疗膝关节慢性滑膜炎的临床研究

发布时间：2018-05-25 05:20

本文选题：六指六穴 + 点压　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:在治疗膝关节慢性滑膜炎的临床研究中,根据对六指六穴点压结合消瘀定痛散外敷的治疗方案进行研究,从而找到一种有效缓解膝关节屈伸功能,以及肿胀、疼痛等症状的治疗方案。这种治疗方案以减轻患者的痛苦及经济负担为目的,具有治疗效果最佳,见效最快,创伤最小,能够最大限度地避免软骨损伤的特点。方法:在河南中医药大学第一附属医院骨伤科一区门诊中,根据《骨伤科学》及《中药新药临床研究指导原则》而确定的膝关节慢性滑膜炎诊断标准,选取慢性膝关节滑膜炎的患者,并根据纳入标准和排除标准的筛选,从膝关节慢性滑膜炎的病人中选取符合纳入标准的60例作为观察对象,根据随机单盲法将临床观察对象随机分为治疗组30例和对照组30例。治疗组的患者经辨证后给予六指六穴点压结合消瘀定痛散外敷的治疗方案;对照组的患者给予滑膜炎片口服结合消瘀定痛散外敷的治疗方案。两组患者均连续治疗15天,治疗期间,两组患者均在医生指导下进行规范的股四头肌功能锻炼。通过对患者WOMAC膝关节功能评估(包括总评分、疼痛、僵硬、日常功能)、VAS总体疼痛评分直观模拟量表,膝关节周径变化、膝关节活动度变化进行观察并记录治疗前及治疗后两组数据,根据两组患者治疗后的有效率情况,然后进行统计学分析,进行组内对比及组间对比。结果:治疗组治疗15d后,5例治愈,效果显著的有15例,有效8例,无效2例,总有效率93.33%;对照组治疗15d后,3例治愈,7例疗效显著,有效14例,无效6例,总有效率80.00%,两组经治疗后总的有效率进行比较,治疗组六指六穴手法与对照组滑膜炎片药物对膝关节慢性滑膜炎疗效差异具有统计学意义(P0.05)。两组患者在膝关节VAS评分、WOMAC评分上、膝关节周径、膝关节活动度等观察指标方面,治疗后较治疗前均有显著的改善(P0.05),且治疗组与对照组进行比较,临床疗效更为显著,差异有统计学意义(P0.05)。结论:通过本课题临床观察发现:1.六指六穴点压结合消瘀定痛散外敷治疗膝关节慢性滑膜炎有效,六指六穴点压结合外用消瘀定痛散治疗膝关节慢性滑膜炎临床疗效较口服滑膜炎片结合外用消瘀定痛散治疗相比疗效显著;2.两组治疗方案对于改善膝关节慢性滑膜炎的临床症状、减轻关节的疼痛以及关节活动功能方面均有确切疗效,且治疗组方案明显优于对照组。
[Abstract]:Objective: in the clinical study of treating chronic synovitis of knee joint, according to the treatment scheme of point pressure of six fingers and six points combined with external application of Xiaoyu Dingtong Powder, to find a kind of effective relief of knee joint flexion and extension function, as well as swelling. A treatment for symptoms such as pain. The purpose of this treatment is to alleviate the pain and economic burden of patients. It has the characteristics of best effect, quickest effect and minimal trauma, and can avoid cartilage injury to the maximum extent. Methods: the diagnostic criteria of chronic synovitis of knee joint were determined in the first affiliated Hospital of Henan University of traditional Chinese Medicine. Patients with chronic synovitis of knee joint were selected, and 60 patients with chronic synovitis of knee joint were selected according to inclusion criteria and exclusion criteria. According to the random single blind method, the clinical observation objects were randomly divided into treatment group (n = 30) and control group (n = 30). The patients in the treatment group were treated with six fingers and six points of point pressure combined with the external application of Xiaoyu Dingtong Powder after syndrome differentiation; the patients in the control group were given the treatment plan of oral synovitis tablet combined with the external application of Xiaoyu Dingtong Powder. The patients in both groups were treated continuously for 15 days. During the treatment, the patients in both groups underwent regular quadriceps femoris exercise under the guidance of doctors. The knee joint function (including total score, pain, stiffness, daily function, total pain score and total pain score) were evaluated by visual simulation scale, and the changes of knee joint circumference were evaluated. The changes of knee motion were observed and recorded before and after treatment. According to the effective rate of the two groups after treatment, statistical analysis was carried out, and then the intra-group and inter-group comparison were carried out. Results: in the treatment group, 5 cases were cured after 15 days of treatment, 15 cases were effective, 8 cases were effective, 2 cases were ineffective, the total effective rate was 93.33%, while in the control group, 7 cases were cured after 15 days of treatment, 14 cases were effective, 6 cases were ineffective. The total effective rate was 80.00g. The total effective rate of the two groups was compared after treatment. The curative effect of the treatment group on chronic synovitis of knee joint was significantly different from that of the control group (P 0.05). The VAS score, knee circumference and knee motion of the two groups were significantly improved after treatment than before, and compared with the control group, the clinical curative effect was more significant in the treatment group than in the control group, and compared with the control group, the clinical effect of the treatment group was more significant than that of the control group, and there was no significant difference between the treatment group and the control group. The difference was statistically significant (P 0.05). Conclusion: through the clinical observation of this subject, we found that 1. 1. The treatment of chronic synovitis of knee joint with six fingers and six points of point pressure combined with external application of Xiaoyu Dingtong Powder is effective. The clinical efficacy of Six-finger six-point pressure combined with external application of Xiaoyu Dingtong Powder in the treatment of chronic synovitis of knee joint was significantly higher than that of oral synovitis tablet combined with external application of Xiaoyu Dingtong Powder. The two groups have definite curative effect on improving the clinical symptoms of chronic synovitis of knee joint, relieving joint pain and joint movement function, and the treatment group is obviously superior to the control group.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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