针刀松解治疗膝关节骨性关节炎气滞血瘀证的临床研究

发布时间：2018-12-06 10:31

【摘要】：目的:观察针刀松解治疗膝关节骨性关节炎气滞血瘀证的临床疗效并与针刺治疗对比。探讨针刀治疗膝关节骨性关节炎的机理以期为患者探寻更有效、简单、方便的治疗方案,以改善病人的生活质量。方法:选取2015年5月-2015年10月期间山东大学附属千佛山医院疼痛科门诊和住院患者中符合膝关节骨性关节炎中医诊断标准和西医诊断标准,并属于中医气滞血瘀证的患者72例。将72例患者按照随机对照的原则,分为针刀组和针刺组。经统计学分析针刀组与针刺组在年龄、性别、病程、影像学分级等方面的差别没有统计学意义。治疗方案:针刀组采用小针刀松解治疗,针刺组采用单纯针刺治疗。针刀组5天治疗一次,共治疗3次;针刺组每天针刺一次,针刺15天。评价指标:WOMAC骨关节炎指数评分量表评分、《中药新药临床研究指导原则》骨关节炎的疾病疗效判定标准。评价时间:(1)治疗前对针刀组和针刺组进行评价;(2)针刀组于第3次治疗后的第5天进行评价,针刺组于第15次治疗后的第2天进行评价,评价结束后进行治疗前后组内的对比和两组之间的对比;(3)治疗结束1个月后再次进行评价,并做组间比较。结果:(1)治疗结束后第一次评价组内比较:(1)治疗后针刀组和针刺组的WOMAC骨关节炎三项指数评分和本组治疗前比较均有降低,同时组内比较P0.05,说明针刀组和针刺组的治疗有统计学意义,都能够改善患者的临床症状。(2)临床疗效:经治疗后针刀组的总有效率为91.67%;针刺组的总有效率为83.33%。(2)治疗结束后第一次评价组间比较:(1)针刀组在WOMAC骨关节炎三项指数评分方面均优于针刺组,P0.05说明针刀组和针刺组比较有统学意义,针刀组的治疗效果优于针刺组。(2)临床疗效:针刀组的总有效率为91.67%,针刺组的总有效率为83.33%。P0.05有统计学意义说明和针刺组比较有更好的临床疗效。(3)治疗结束后第二次评分组内比较:(1)针刀组和针刺组在WOMAC骨关节炎三项指数评分方面和治疗前比较,P0.05,说明在治疗结束1个月后,针刀组和针刺组患者的临床症状仍然比治疗前减轻。(2)临床疗效:针刀组患者在治疗后1个月,总有效率为88.89%。针刺组治疗后1个月,总有效率为77.78%。(4)治疗结束后第二次评分组间比较:(1)针刀组在WOMAC骨关节炎三项指数评分面均优于针刺组,P0.05说明针刀组的治疗效果在1个月后仍优于针刺组。(2)临床疗效:针刀组患者总有效率为88.89%。针刺组患者总有效率为77.78%。P0.05,说明针刀组和针刺组相比,在治疗后1个月临床症状减轻更明显。结论:针刀松解治疗膝关节骨性关节炎气滞血瘀证,可以明显改善患者的疼痛、僵硬的临床症状,提高患者的生活质量,是一种较好的的治疗方案。
[Abstract]:Objective: to observe the clinical effect of acupuncture-knife loosening on qi stagnation and blood stasis syndrome of knee osteoarthritis and compare with acupuncture treatment. To explore the mechanism of needle knife in the treatment of knee osteoarthritis in order to find a more effective, simple and convenient treatment for patients, in order to improve the quality of life of patients. Methods: from May 2015 to October 2015, the patients in the Department of pain, Qianfoshan Hospital, affiliated to Shandong University, met the criteria of traditional Chinese medicine and western medicine for diagnosis of knee osteoarthritis. And belongs to the TCM Qi stagnation blood stasis syndrome of 72 cases. According to the principle of random control, 72 patients were divided into acupuncture group and acupuncture group. There was no significant difference in age, sex, course of disease and imaging grade between acupuncture group and needle knife group. Treatment plan: the acupuncture group was treated with small needle knife, and the acupuncture group was treated with simple acupuncture. The acupuncture group was treated once every 5 days for 3 times, and the acupuncture group was treated once a day for 15 days. Evaluation measures: WOMAC Osteoarthritis Index scoring scale, Clinical Research guidelines of New drugs of traditional Chinese Medicine, criteria for judging the curative effect of Osteoarthritis. Evaluation time: (1) the acupuncture group and acupuncture group were evaluated before treatment; (2) the acupuncture group was evaluated on the 5th day after the third treatment, and the acupuncture group on the second day after the 15th treatment. (3) one month after the end of treatment, the evaluation was done again, and the comparison between groups was made. Results: (1) comparison of the first evaluation group after treatment: (1) the scores of WOMAC osteoarthritis index in acupuncture group and acupuncture group were lower than those before treatment, and there was a significant difference between the two groups (P 0.05). The results show that the treatment of acupuncture group and acupuncture group have statistical significance, can improve the clinical symptoms of patients. (2) Clinical efficacy: after treatment, the total effective rate of acupuncture knife group is 91.67; The total effective rate of the acupuncture group was 83.33. (2) the comparison of the first evaluation group after treatment: (1) the acupuncture group was superior to the acupuncture group in three indexes of WOMAC osteoarthritis. P05 indicated that the acupuncture group and acupuncture group have general significance, the treatment effect of acupuncture group is better than acupuncture group. (2) Clinical effect: the total effective rate of acupuncture knife group is 91.67. The total effective rate of acupuncture group is 83.33%.P0.05 has statistical significance compared with acupuncture group has better clinical efficacy. (3) after the end of treatment the second score group comparison: (1) acupuncture group and acupuncture group in WOMAC The three index scores of osteoarthritis were compared with those before treatment. P0.05, indicating that the clinical symptoms of the patients in the acupuncture group and the acupuncture group were still alleviated one month after the treatment. (2) Clinical efficacy: the total effective rate of the acupuncture knife group was 88.89 after one month of treatment. The total effective rate of acupuncture group was 77.78 months after treatment. (4) the comparison of the second score group after the end of treatment: (1) the three index scores of WOMAC osteoarthritis in the acupuncture group were better than those in the acupuncture group. P05 indicated that the treatment effect of acupuncture group was still better than that of acupuncture group after 1 month. (2) Clinical efficacy: the total effective rate of acupuncture knife group was 88.89. The total effective rate of the acupuncture group was 77.78. P0.05, which indicated that the clinical symptoms of the acupuncture group were more obviously alleviated than that of the acupuncture group. Conclusion: the treatment of Qi stagnation and blood stasis syndrome of knee osteoarthritis with acupuncture knife loosening can obviously improve the pain, stiff clinical symptoms and improve the quality of life of the patients. It is a better treatment scheme.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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