针刀结合内热针治疗慢性肩袖损伤的临床研究

发布时间：2018-06-15 21:27

本文选题：慢性肩袖损伤 + 针刀　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：研究目的随着人们生活方式及工作环境的变化,肩袖损伤患者逐年增多,并有逐渐年轻化趋势,肩袖损伤是十分常见的一类肩关节退行性病变,临床主要表现为肩周疼痛、活动受限、上肢无力、肌肉萎缩。本课题主要通过探讨针刀松解术结合内热针治疗慢性肩袖损伤的临床疗效,并与常规针刺疗法进行对照研究,验证其治疗慢性肩袖损伤可行性,评价其疗效、治疗周期,找出并建立一种疗效突出,治疗周期短,安全可靠,患者易于接受,并且能在临床上应用与推广的治疗方式。研究方法本课题研究对象60例患者,均选自2015年05月至2016年10月于十堰市太和医院康复中心住院治疗患者,均符合本课题纳入标准,按照随机、对照、单盲原则进行分类,分为治疗组(针刀结合内热针疗法)及对照组(针刺+电针综合疗法),每组各30例患者。参照“中华人民共和国中医药行业标准《中医病症诊断疗效标准》,治疗组采用针刀松解结合内热针疗法,先予患者行针刀松解术治疗,术后第3、第5天行内热针治疗,治疗后嘱患者行功能锻炼,7天为1疗程;对照组行常规针刺得气后接用电针治疗,治疗后嘱患者行肩关节功能锻炼,每日1次,治疗6天后休息一天,7天为一疗程。两组均连续治疗两个疗程。疗程结束后,采用美国加州大学(UCLA)肩关节功能评分及视觉模拟评分法(VAS)评分表,作为观察及疗效指标,并对其进行统计学分析。研究结果治疗后观察数据采用SPSS19.0统计软件进行分析。结果:1.实验组痊愈9例,有效19例,无效2例,总有效率93.33%,针刺综合疗法组治疗后痊愈5例,有效19例,无效6例,总有效率80.00%。针刀结合内热针治疗组疗效明显高于综合针刺治疗组,差异具有显著性(P0.05)2.视觉模拟评分(VAS):治疗前两组的VAS评分比较无明显差异(P0.05),具有可比性。治疗后两组VAS评分均下降,与治疗前相比,差异具有统计学意义(P0.05),且针刀结合内热针组优于针刺加电针组(P0.05)。3.肩关节功能评分(UCLA):两组患者治疗后,疼痛、功能、向前侧屈曲活动、前屈曲力量、病人满意度评分均较治疗前升高,且治疗前后组内比较差异具有统计学意义(P0.05),两种治疗方式均可治疗慢性肩袖损伤。治疗后,两组间疼痛评分比较(P0.05),提示两组在改善疼痛时,效果相当;两组其余各项评分组间比较(P0.05),差异明显,针刀结合内热针治疗慢性肩袖损伤效果更优,患者满意度更高。结论实验组及对照组均能缓解慢性肩袖损伤患者疼痛症状、增加关节活动度及肌力,提高患者满意度,但针刀结合内热针疗法优于针刺加电针疗法,是一种疗效确切,操作简单可行性高的治疗手段,且无明显不良反应,值得临床推广。
[Abstract]:Objective with the change of people's life style and working environment, the number of patients with rotator cuff injury increases year by year and tends to be younger. Rotator cuff injury is a kind of common degenerative disease of shoulder joint. Limited movement, upper limb weakness, muscular atrophy. This paper mainly discusses the clinical effect of needle knife loosening combined with internal heat acupuncture in the treatment of chronic rotator cuff injury, and carries out a comparative study with conventional acupuncture therapy to verify the feasibility of treatment of chronic rotator cuff injury, to evaluate its curative effect, and to evaluate the treatment period. To find out and establish a treatment that is effective, short, safe and reliable, easily accepted by patients, and can be applied and popularized in clinic. Methods 60 patients were selected from May 2015 to October 2016 in the rehabilitation center of Taihe Hospital, Shiyan City. The patients were divided into treatment group (acupuncture knife combined with internal heat acupuncture therapy) and control group (acupuncture electroacupuncture combined therapy) with 30 patients in each group. Referring to the Standard of traditional Chinese Medicine (TCM) Industry Standard of the people's Republic of China for the diagnosis of TCM Diseases, the treatment group was treated with needle knife release combined with internal heat acupuncture therapy, the patients were treated with needle knife release first, and the patients were treated with internal heat acupuncture on the 3rd and 5th day after operation. The patients in the control group were treated with electroacupuncture after routine acupuncture. After the treatment, the patients were told to exercise the shoulder joint once a day. After 6 days of treatment, the patients were given a day off for 7 days as a course of treatment. The two groups were treated continuously for two courses. After the course of treatment, the shoulder function score and visual analogue score of UCLA-VAS-scale were used as the observation and curative effect index, and the statistical analysis was carried out. Results the observation data were analyzed by SPSS 19.0 statistical software. The result is 1: 1. In the experimental group, 9 cases were cured, 19 cases were effective, 2 cases were ineffective, the total effective rate was 93.33%. In the combined acupuncture therapy group, 5 cases were cured, 19 cases were effective, 6 cases were ineffective, and the total effective rate was 80.003%. The curative effect of acupuncture knife combined with internal heat acupuncture treatment group was significantly higher than that of comprehensive acupuncture group, and the difference was significant (P 0.05). Visual analogue score (VAS): there was no significant difference in VAS score between the two groups before treatment (P 0.05), which was comparable. The VAS scores of the two groups decreased after treatment, and the difference was statistically significant compared with that before treatment, and the combination of needle knife and internal hot acupuncture group was better than that of acupuncture plus electroacupuncture group. Shoulder function score: after treatment, pain, function, anterior flexion activity, anterior flexion strength, patient satisfaction were increased in both groups. The difference before and after treatment was statistically significant (P 0.05). Both methods could treat chronic rotator cuff injury. After treatment, the pain scores of the two groups were compared with that of the two groups, indicating that the two groups had the same effect in improving the pain, and the other scores of the two groups were significantly different. The effect of needle knife combined with internal heat acupuncture on treating chronic rotator cuff injury was better and the patient satisfaction was higher. Conclusion both the experimental group and the control group can relieve the pain symptoms of the patients with chronic rotator cuff injury, increase the joint motion and muscle strength, and improve the satisfaction of the patients. But the acupuncture knife combined with internal heat acupuncture therapy is better than acupuncture plus electroacupuncture therapy, which is an effective method. Simple operation, high feasibility and no obvious adverse reaction, it is worth popularizing in clinic.
【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】：R246.9

【参考文献】