针刀临床治疗股骨头缺血性坏死的规范化研究

发布时间：2018-10-24 17:06

【摘要】：目的：在循证医学原则的基础上,以针刀治疗股骨头缺血性坏死为研究对象,将系统文献研究及问卷调查相结合,重点研究针刀在股骨头缺血性坏死的治疗中的规范化操作流程,探讨针刀治疗股骨头缺血性坏死过程中存在的争议,旨在编写出针刀治疗股骨头缺血性坏死的规范化操作流程,为针刀治疗股骨头缺血性坏死提供安全、有效、简单、详细的规范化操作流程,为后期研究针刀治疗股骨头缺血性坏死的规范化工作奠定基础。方法：将系统文献研究与临床问卷调查法有机结合,编写临床规范化操作流程。系统文献研究方面：采用计算机检索为主,通过互联网数据库,对国内外发表的针刀治疗股骨头缺血性坏死相关文献进行全面检索。采用人工阅读的方法对文件进行初步筛选,制定文献的纳入标准及排除标准,进一步筛选文献。对纳入的文献进行分类,按照美国卫生研究和质量管理局标准(即AHCPR标准),文献可以分为系列病例研究证据、个案报道、专委会或专家意见、随机对照(RCT)研究证据和非随机对照(CCT)研究证据,并进行证据分级,证据分级主要按照美国卫生研究和质量管理局标准(即AHCPR标准)和苏格兰学院间指南工作网的标准(即SIGN标准)。对高等级的证据文献进行归纳总结,对部分高等级证据文献没有涉及的问题,参考低等级文献。参考现有中医治疗规范化研究成果,初步确定推荐意见,编写《针刀临床治疗股骨头缺血性坏死规范化操作(初稿)》问卷调查方面：针对规范化操作方案初稿编写过程中发现的一些争议及问题,结合临床操作,编写《针刀治疗股骨头缺血性坏死临床调查问卷》。通过邮寄、电子邮件、面谈等方法与针刀专业专家学者进行意见交流。对回收的问卷,进行汇总、整理、归纳,将循证证据与临床实践相结合,编写针刀治疗股骨头缺血性坏死操作流程及《针刀临床治疗股骨头缺血性坏死规范化操作(修改稿)》。结果：1、针刀治疗股骨头缺血性坏死规范化操作流程的研究,对于针刀的发展、推广意义重大。2、形成针刀治疗股骨头缺血性坏死操作流程图。3、对针刀治疗股骨头缺血性坏死的临床实验性文献进行系统的整理分析,结合专家意见,最终编写完成了《针刀临床治疗股骨头缺血性坏死规范化操作(修改稿)》。结论：1、将临床研究性文献系统研究与问卷调查相结合,是制定针刀治疗股骨头缺血性坏死的规范化操作的有效方法,实现了临床与文献研究的结合,为今后其他疾病治疗的规范化操作流程的的编写提供参考方法。推动了针刀治疗技术规范化的工作。2、针刀治疗股骨头缺血性坏死操作流程及《针刀临床治疗股骨头缺血性坏死规范化操作》是针刀治疗股骨头缺血性坏死规范化研究过程中的重要组成结构,为针刀治疗股骨头缺血性坏死的规范化奠定基础。
[Abstract]:Objective: on the basis of the principle of evidence-based medicine, the treatment of avascular necrosis of the femoral head by needle knife was used as the research object, and the systematic literature study and questionnaire survey were used to study the treatment of avascular necrosis of the femoral head. The standardized operation procedure of acupuncture knife in the treatment of avascular necrosis of femoral head was studied emphatically, and the controversy existed in the treatment of avascular necrosis of femoral head with needle knife was discussed. The purpose of this study was to compile the standardized operation flow of acupuncture knife for treating avascular necrosis of femoral head. It provides a safe, effective, simple and detailed standardized procedure for the treatment of avascular necrosis of the femoral head by acupuncture, and lays a foundation for the later study on the standardization of acupuncture in the treatment of avascular necrosis of the femoral head. Methods: the systematic literature research and the clinical questionnaire were combined to compile the clinical standardized operation flow. In the aspect of systematic literature research, the related literatures about the treatment of avascular necrosis of femoral head at home and abroad were searched by computer retrieval and internet database. The method of manual reading was used to screen the documents, and the inclusion criteria and exclusion criteria of the documents were established, and the documents were further screened. According to the United States Health Research and quality Administration (AHCPR) standards, the literature can be divided into a series of case study evidence, case reports, panel or expert advice, Randomized controlled (RCT) study evidence and non-randomized controlled (CCT) study evidence, and the evidence classification, Evidence ratings are based mainly on the AHCPR standard of the United States Health Research and quality Authority and the standard of the Scottish Intercollege work Network (SIGN standard). The paper sums up the high-grade evidential literature, and refers to the low-grade literature for some problems which are not involved in the high-grade evidential literature. Referring to the existing research results on the standardization of TCM treatment, we have preliminarily determined the recommended opinions. Compiling "standardized Operation of Acupuncture Clinical treatment of Avascular Necrosis of femoral head (first draft)" questionnaire: in view of some disputes and problems found in the preparation of the first draft of the standardized operation, combined with clinical operation, To compile the questionnaire of clinical investigation on the treatment of avascular necrosis of femoral head with needle knife. Exchange views with experts and scholars of needleknife by mail, e-mail, interview and so on. The collected questionnaires were collected, sorted and summarized, and combined with the evidence based on evidence and clinical practice, the operation procedure of acupuncture for the treatment of avascular necrosis of the femoral head and the standardized operation for clinical treatment of avascular necrosis of the femoral head with needle knife (revised draft) were compiled. Results: 1. For the development of needle knife, the study of standardized operation procedure for the treatment of avascular necrosis of femoral head, It is of great significance to popularize. 2, to form the flow chart of the operation of acupuncture knife treatment of avascular necrosis of the femoral head. 3. To systematize and analyze the clinical experimental literature on the treatment of avascular necrosis of the femoral head by needle knife, and combine the expert opinion, Finally, the standardized operation (revision) of clinical treatment of avascular necrosis of femoral head by needle knife was completed. Conclusion: 1. Combining the systematic study of clinical research literature with questionnaire survey is an effective method to establish the standardized operation of acupuncture for the treatment of avascular necrosis of the femoral head, which realizes the combination of clinical and literature research. To provide a reference for the preparation of standardized procedures for the treatment of other diseases in the future. 2, the operation flow of acupuncture knife treatment of avascular necrosis of femoral head and "standardized operation of clinical treatment of avascular necrosis of femoral head" is standardization of acupuncture treatment of avascular necrosis of femoral head. Important components in the research process, To lay a foundation for standardization of acupuncture in the treatment of avascular necrosis of femoral head.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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