热敏灸联合中药熏洗治疗髌骨软化症（气滞血淤型）的临床疗效研究
发布时间：2018-07-17 01:53
【摘要】：目的：应用Lysholm膝关节评分量表和视觉模拟评分法,评价热敏灸联合中药熏洗对髌骨软化症(气滞血瘀型)的临床疗效,目的在于探索出一种能为临床治疗髌骨软化症提供更多参考的有效的、综合的且安全的治疗方案。方法：将96名患者按照1：1：1随机分为热敏灸组、中药熏洗组和热敏灸联合中药熏洗组。热敏灸组女18例,男14例,平均病程6.69±3.24月,平均年龄29.72±5.33岁；中药熏洗组女15例,男17例,平均病程6.78±3.14月,平均年龄30.38±5.07岁；联合组男15例,女17例,平均年龄30.03±5.58岁,平均病程6.84±3.12月。热敏灸组的操作方法如下：选取阿是穴、犊鼻、足三里、太溪、悬钟、梁丘、内外膝眼、阳陵泉、血海,同时以选取的穴位为中心,并在以3cm为半径的范围内,保持与皮肤距离在3-4cm处,施以回旋灸和温和灸。在施灸过程中,如若出现患者对远离施灸部位或者施灸部位感受到以下情况即可确定热敏点,如：痛、麻、重、冷、肿、压、酸等。并选取最敏感点3-4个予以灸疗。每次1剂,每日1次,10次为1个疗程,疗程间隙2天,治疗2个疗程。中药熏洗组的具体操如下：用煎煮好后的中药蒸汽熏膝关节,随后在以外洗。具体组方为：独活、红花、没药、防风各15g,地龙5g,草乌、川乌、威灵仙20g,伸筋草、鸡血藤、透骨草各30g组方。每次1剂,每日1次,10次为1个疗程,疗程间隙2天,治疗2个疗程。热敏灸联合中药熏洗组的操作方法是同时采用前面两组的治疗方案,每次1剂,每日1次,10次为1个疗程,疗程间隙2天,治疗2个疗程。于患者治疗的开始前与结束后,运用Lysholm膝关节评分量表、视觉模拟评分法对患者进行评分,并比较临床疗效。结果：治疗前,三组Lysholm评分差别无统计学意义(P0.05)；治疗后,分别与治疗前比较,三组Lysholm评分均有显著性升高(均有P0.05)；与中药熏洗组比较,热敏灸组和联合组Lysholm评分均有显著性升高(P0.05)；与热敏灸组比较,联合组Lysholm评分有显著性升高(P0.05)。治疗前,三组VAS评分差别无统计学意义(P＞0.05)；治疗后,分别与与治疗前比较,三组VAS评分均有显著性降低(均有P0.05)；与中药熏洗组比较,热敏灸组和联合组VAS评分均有显著性降低(P0.05)；与热敏灸组比较,联合组VAS评分有显著性降低(P0.05)。治疗后,热敏灸组和联合组总有效率分别为75.00%、84.37%和93.74%；与中药熏洗组比较,热敏灸组合联合组总有效率有显著性提高(均有P0.05);与热敏灸组比较,联合组总有效率有显著性提高(P0.05)。结论：中药熏洗和热敏灸都能有效改善髌骨软化症患者的症状体征(显著提高Lysholm膝关节评分量表评分),但中药熏洗联合热敏灸的治疗方案效果更优；中药熏洗和热敏灸都能有效改善髌骨软化症患者的自觉疼痛情况(显著降低VAS评分),但中药熏洗联合热敏灸的治疗方案效果更优；中药熏洗和热敏灸对髌骨软化症均有较好的疗效,但中药熏洗联合热敏灸的治疗方案效果更优,中药熏洗联合热敏灸值得在髌骨软化症(气滞血瘀型)临床治疗中进一步推广。
[Abstract]:Objective: To evaluate the clinical effect of thermosensitive moxibustion combined with traditional Chinese medicine fumigation on patellar softening (qi stagnation and blood stasis type) by using the Lysholm knee score scale and the visual analogue scale, and to explore an effective, comprehensive and safe treatment for the clinical treatment of patellar softening. Methods: 96 patients were treated. According to 1:1:1 randomly divided into hot sensitive moxibustion group, traditional Chinese medicine fumigation group and heat sensitive moxibustion combined with traditional Chinese medicine fumigation group, 18 women in hot moxibustion group and 14 males, with an average course of 6.69 + 3.24 months, with an average age of 29.72 + 5.33 years, 15 women and 17 men, average course 6.78 + 3.14 months, average age of 30.38 + 5.07 years, combined group of male 15 cases, female 17 cases, average Age 30.03 + 5.58 years old, the average course of disease was 6.84 + 3.12 months. The methods of operation of hot moxibustion group were as follows: select the acupoints, calf nose, Zusanli, Tai Xi, hang clocks, beam colliculus, internal and external knee eyes, Yang Ling spring, blood sea, and take the selected acupoints as the center, and keep the distance from the skin with the skin in the range of 3cm, and apply the moxibustion and mild moxibustion at the distance from the skin. During the process of moxibustion, if the patient felt the following conditions, such as pain, hemp, weight, cold, swelling, pressure and acid, 3-4 of the most sensitive points were selected. 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The specific exercises of the Chinese medicine fumigating and washing group Below: fumigate knee joint with decocted Chinese medicine steam, and then wash out the knee joint. Specific groups are: single live, safflower, myrrh, 15g, 5g, Radix Aconiti, kubun, 20g, extensor grass, chicken blood, 1 times a day, 10 times for 2 days, 2 courses of treatment. Thermosensitive moxibustion combined with traditional Chinese medicine. The operation method of the group was used at the same time with the treatment plan of the first two groups, 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The Lysholm knee score scale, the visual analogue score method was used to score the patients and the clinical effect was compared. The results were before treatment, The difference between the three groups of Lysholm scores was not statistically significant (P0.05). After the treatment, the scores of the three groups were significantly higher than before the treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the Lysholm scores of the thermal moxibustion group and the combined group were significantly higher (P0.05). Compared with the thermal moxibustion group, the Lysholm score of the combined group was significantly higher. (P0.05) before treatment, there was no significant difference between the three groups of VAS scores (P > 0.05). After treatment, the three groups of VAS scores were significantly lower than before and before treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the VAS scores of the thermal moxibustion group and the combined group were significantly lower (P0.05). Compared with the thermal moxibustion group, the VAS score of the combined group was significant. After treatment, the total effective rate of the heat sensitive moxibustion group and the combined group was 75%, 84.37% and 93.74%, respectively. Compared with the traditional Chinese medicine fumigation group, the total effective rate of the combined group was significantly improved (P0.05). Compared with the thermal moxibustion group, the total effective rate of the combined group was significantly improved (P0.05). Conclusion: both Chinese medicine fumigating and thermosensitive moxibustion can all be improved (P0.05). The symptoms and signs of patellar softening patients were improved (significantly improved Lysholm knee score scale), but the effect of traditional Chinese medicine fumigation and thermosensitive moxibustion was better. Traditional Chinese medicine fumigation and thermosensitive moxibustion could effectively improve the conscious pain of patellar softening patients (significantly lower VAS score), but Chinese herbal fumigation and washing combined heat sensitive moxibustion The effect of the treatment scheme is better. The Chinese herbal fumigation and thermosensitive moxibustion has a good effect on the softening of the patella, but the effect of the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is better, and the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is worth further promoting in the clinical treatment of the patellar softening syndrome (qi stagnation and blood stasis type).
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9
本文编号：2128505
[Abstract]:Objective: To evaluate the clinical effect of thermosensitive moxibustion combined with traditional Chinese medicine fumigation on patellar softening (qi stagnation and blood stasis type) by using the Lysholm knee score scale and the visual analogue scale, and to explore an effective, comprehensive and safe treatment for the clinical treatment of patellar softening. Methods: 96 patients were treated. According to 1:1:1 randomly divided into hot sensitive moxibustion group, traditional Chinese medicine fumigation group and heat sensitive moxibustion combined with traditional Chinese medicine fumigation group, 18 women in hot moxibustion group and 14 males, with an average course of 6.69 + 3.24 months, with an average age of 29.72 + 5.33 years, 15 women and 17 men, average course 6.78 + 3.14 months, average age of 30.38 + 5.07 years, combined group of male 15 cases, female 17 cases, average Age 30.03 + 5.58 years old, the average course of disease was 6.84 + 3.12 months. The methods of operation of hot moxibustion group were as follows: select the acupoints, calf nose, Zusanli, Tai Xi, hang clocks, beam colliculus, internal and external knee eyes, Yang Ling spring, blood sea, and take the selected acupoints as the center, and keep the distance from the skin with the skin in the range of 3cm, and apply the moxibustion and mild moxibustion at the distance from the skin. During the process of moxibustion, if the patient felt the following conditions, such as pain, hemp, weight, cold, swelling, pressure and acid, 3-4 of the most sensitive points were selected. 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The specific exercises of the Chinese medicine fumigating and washing group Below: fumigate knee joint with decocted Chinese medicine steam, and then wash out the knee joint. Specific groups are: single live, safflower, myrrh, 15g, 5g, Radix Aconiti, kubun, 20g, extensor grass, chicken blood, 1 times a day, 10 times for 2 days, 2 courses of treatment. Thermosensitive moxibustion combined with traditional Chinese medicine. The operation method of the group was used at the same time with the treatment plan of the first two groups, 1 doses each time, 1 times a day, 10 times for 1 courses, 2 days for the course of treatment, and 2 courses of treatment. The Lysholm knee score scale, the visual analogue score method was used to score the patients and the clinical effect was compared. The results were before treatment, The difference between the three groups of Lysholm scores was not statistically significant (P0.05). After the treatment, the scores of the three groups were significantly higher than before the treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the Lysholm scores of the thermal moxibustion group and the combined group were significantly higher (P0.05). Compared with the thermal moxibustion group, the Lysholm score of the combined group was significantly higher. (P0.05) before treatment, there was no significant difference between the three groups of VAS scores (P > 0.05). After treatment, the three groups of VAS scores were significantly lower than before and before treatment (P0.05). Compared with the traditional Chinese medicine fumigation group, the VAS scores of the thermal moxibustion group and the combined group were significantly lower (P0.05). Compared with the thermal moxibustion group, the VAS score of the combined group was significant. After treatment, the total effective rate of the heat sensitive moxibustion group and the combined group was 75%, 84.37% and 93.74%, respectively. Compared with the traditional Chinese medicine fumigation group, the total effective rate of the combined group was significantly improved (P0.05). Compared with the thermal moxibustion group, the total effective rate of the combined group was significantly improved (P0.05). Conclusion: both Chinese medicine fumigating and thermosensitive moxibustion can all be improved (P0.05). The symptoms and signs of patellar softening patients were improved (significantly improved Lysholm knee score scale), but the effect of traditional Chinese medicine fumigation and thermosensitive moxibustion was better. Traditional Chinese medicine fumigation and thermosensitive moxibustion could effectively improve the conscious pain of patellar softening patients (significantly lower VAS score), but Chinese herbal fumigation and washing combined heat sensitive moxibustion The effect of the treatment scheme is better. The Chinese herbal fumigation and thermosensitive moxibustion has a good effect on the softening of the patella, but the effect of the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is better, and the traditional Chinese medicine fumigation and washing combined with thermosensitive moxibustion is worth further promoting in the clinical treatment of the patellar softening syndrome (qi stagnation and blood stasis type).
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9
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