针药结合康复治疗膝骨关节炎的临床试验研究

发布时间：2018-06-12 07:19

本文选题：膝骨关节炎 + 肝肾亏虚　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:通过观察电针透穴疗法配合补正续骨丸治疗膝骨关节炎(肝肾亏虚证)的临床疗效,初步证实其对缓解KOA疼痛、肿胀症状的治疗作用,初步评价其对患膝关节运动时和静息时的疼痛评分及彩超指标的治疗效果,为进一步探索此种综合疗法治疗KOA的临床推广应用提供依据。资料与方法:采用随机对照试验设计方法,将60例合格的受试者随机分为试验组和对照组各30例。对照组采用电针透穴疗法和外用扶他林治疗,试验组在对照组的基础上配合口服补正续骨丸治疗,两组均连续治疗15天,即1个疗程。在临床观察期开始和结束时,均须监测受试者的安全性指标,采集两组患者在治疗前、后的患膝关节X线和彩超检查,患膝关节运动时和静息时疼痛NRS评分等疗效评价指标,并密切观察临床不良事件的发生情况。用CRF表进行临床数据管理,用SPSS17.0统计学软件进行数据统计分析。结果:1.60例受试者均完成临床研究,未发生临床不良事件,无病例脱落或失访,其中试验组和对照组均为30例。2.两组一般资料、病情基线比较,差异无统计学意义(P0.05),说明两组具有可比性。3.两组治疗前、后患膝关节彩超指标(滑膜厚度和关节腔积液高度)比较,差异均有统计学意义(P0.05);两组治疗前、后患膝关节运动时和静息时疼痛NRS评分比较,差异均有统计学意义(P0.05);两组疗后-基线的相应指标变化情况比较,试验组优于对照组(P0.05)。4.两组疾病疗效比较,差异有统计学意义(P0.05),说明试验组的临床疗效优于对照组的。结论:1.对照组(电针透穴疗法和外用扶他林治疗)可明显减少KOA患膝关节运动时和静息时的疼痛评分,对患膝关节彩超所示的滑膜增厚和关节腔积液量均有一定的减少或改善作用。2.对照组经自身前后对照可证实,其能有效缓解和减轻KOA(肝肾亏虚证)患膝关节疼痛、肿胀症状,治疗安全有效,临床疗效确切。3.试验组是在对照组治疗的基础上配合口服补正续骨丸,较单独应用电针透穴疗法和外用扶他林治疗KOA(肝肾亏虚证)的临床疗效更明显,具有一定的临床推广和应用价值。
[Abstract]:Objective: to observe the clinical effect of electroacupuncture and acupoint therapy combined with Zhengzhengxuegu pills in treating knee osteoarthritis (deficiency of liver and kidney), and to prove its therapeutic effect on relieving the pain and swelling of KOA. To evaluate the therapeutic effect of the pain score and color Doppler ultrasound index of knee joint during exercise and rest, and to provide the basis for further exploring the clinical application of this kind of combined therapy in the treatment of KOA. Materials and methods: 60 eligible subjects were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). The control group was treated with electroacupuncture acupoint penetration therapy and the external use of Futaline, while the experimental group was treated with oral buzheng Xiegu pill on the basis of the control group. The two groups were treated continuously for 15 days, that is, a course of treatment. At the beginning and the end of the clinical observation period, the safety indexes of the subjects should be monitored, the X ray and color Doppler examination of the knee joint before and after the treatment, the NRS score of pain during the motion and rest of the knee joint, and so on were collected. The occurrence of clinical adverse events was observed closely. CRF table was used for clinical data management and SPSS 17.0 statistical software for statistical analysis. Results 1. 60 subjects completed the clinical study, no adverse clinical events occurred, no cases dropped off or lost visits, 30 cases in the test group and control group were. 2. The two groups of general data, disease baseline comparison, the difference is not statistically significant (P 0.05), indicating that the two groups have comparability. 3. Before and after treatment, there were significant differences in the index of knee joint color Doppler (synovial thickness and height of articular effusion) between the two groups (P 0.05), and the NRS score of knee joint pain before and after treatment was compared with that at rest. The difference was statistically significant (P 0.05), and the changes of the corresponding indexes between the two groups after treatment were better than those in the control group (P 0.05. 4). The difference between the two groups was statistically significant (P 0.05), indicating that the clinical efficacy of the experimental group was better than that of the control group. Conclusion 1. The control group (electroacupuncture acupoint permeation therapy and external treatment) could significantly reduce the pain score of knee joint motion and rest in KOA, and decrease or improve the synovial thickening and articular effusion of the knee joint as shown by color Doppler sonography. The control group can be proved by its own before and after the control, it can effectively alleviate and alleviate KOA( liver and kidney deficiency syndrome) suffering from knee joint pain, swelling symptoms, safe and effective treatment, clinical efficacy is accurate. 3. The experimental group was treated on the basis of the control group combined with oral Buzhengxuegu pills, which was more effective than the treatment of KOA( liver and Kidney deficiency Syndrome) by electroacupuncture through acupoint therapy and external application of Futalin alone, and had certain clinical popularization and application value.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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