针刀治疗股骨头缺血性坏死筋脉瘀滞型的临床研究

发布时间：2019-01-08 08:42

【摘要】：目的:本研究主要通过观察针刀松解髋关节周围的腧穴、髋关节腔减压以及髋关节相应挛缩肌肉松解的治疗方法,对股骨头缺血性坏死筋脉瘀滞型患者疼痛程度的缓解及髋关节功能的影响,与毫针针刺髋三针的治疗效果进行比较,验证针刀治疗的效果,并试图对针刀松解髋周腧穴、髋关节腔减压以及髋关节相应挛缩肌肉松解治疗早期股骨头缺血性坏死的作用机制进行探讨,并为临床治疗股骨头坏死筋脉瘀滞型提供有效的理论依据。方法:将64例股骨头缺血性坏死筋脉瘀滞型患者随机分为2组,其中治疗组32例,其中双髋21例,单髋11例,共53个髋关节;对照组32例,包括双髋15例,单髋17例,共47个髋关节。治疗组每7天治疗1次,3次为1个疗程,双侧同时患病者两髋治疗间隔为3天;对照组每天治疗1次,每周治疗6天,休息1天,治疗21次为1个疗程。每组均治疗1个疗程。疗程结束1周后评定疗效,在3个月时进行随访。观察治疗前、治疗后及治疗3个月后患者疼痛视觉模拟评分(VAS)、髋关节功能评分(Harris),比较差异,进行统计分析。结果:本研究共纳入64例股骨头缺血性坏死筋脉瘀滞型患者共100个髋关节。在VAS评分及髋关节功能评分方面,通过统计分析发现两组治疗后与治疗前都能缓解疼痛,且差异具有统计学意义(P0.05),提示针刀松解髋关节周围的腧穴、髋关节腔减压以及髋关节相应挛缩肌肉松解能更好地缓解疼痛。治疗疗程结束后,治疗组临床治愈9例(双髋2例),显效19例(双髋15例),有效3例(双髋),无效1例(双髋),总有效率为96.22%;对照组临床治愈4例,显效17例(双髋4例),有效9例(双髋9例),无效2例(双髋2例),总有效率为91.49%。两组经统计学分析,在疼痛和髋关节功能恢复方面,差异有显著性意义(P0.05);治疗组能更好的缓解患者的疼痛,能更好的维持髋关节功能的恢复。结论:针刀松解髋关节周围的腧穴、髋关节腔减压以及髋关节相应挛缩肌肉松解能更快、更好的缓解股骨头缺血性坏死筋脉瘀滞引起的髋关节疼痛,能更好的维持髋关节功能的恢复。
[Abstract]:Objective: to observe the treatment of acupoints around hip joint, decompression of hip joint cavity and muscle release of corresponding contracture of hip joint by acupuncture knife. The degree of pain relief and the effect of hip joint function on the patients with avascular necrosis of femoral head and vein stasis were compared with that of three needle acupuncture in the hip, and the effect of acupuncture was verified, and the acupoints around the hip were loosened by acupuncture. The mechanism of hip joint decompression and muscle release of hip contracture in the treatment of early avascular necrosis of femoral head was discussed, and the effective theoretical basis for clinical treatment of femoral head necrotic vein stasis type was provided. Methods: Sixty-four patients with avascular necrosis of femoral head were randomly divided into two groups: treatment group (n = 32), double hip (n = 21) and single hip (n = 11). 32 cases in the control group, including 15 cases of double hip, 17 cases of single hip, 47 hips. The treatment group was treated once every 7 days, 3 times as a course of treatment, the interval between two hips of bilateral patients was 3 days, while the control group was treated once a day, 6 days a week, rest for 1 day, and 21 times as a course of treatment. Each group was treated with one course of treatment. The curative effect was evaluated 1 week after the course of treatment and followed up at 3 months. The visual analogue score (VAS),) and hip function score (Harris),) of patients with pain before treatment, after treatment and 3 months after treatment were observed and analyzed statistically. Results: a total of 100 hips were included in 64 patients with avascular necrosis of femoral head. In terms of VAS score and hip function score, the two groups were found to be able to relieve pain after treatment and before treatment, and the difference was statistically significant (P0.05), suggesting that the needle knife releases the acupoints around the hip joint. Decompression of hip cavity and muscle release of contracture of hip joint can relieve pain better. After the course of treatment, 9 cases were cured (2 cases of double hip), 19 cases (15 cases of double hip) were cured, 3 cases (double hip) were effective, 1 case (double hip) was ineffective in the treatment group, the total effective rate was 96.22%. In the control group, 4 cases were cured, 17 cases were markedly effective (4 cases of double hips), 9 cases were effective (9 cases of double hips), 2 cases were ineffective (2 cases of double hips), the total effective rate was 91.49%. Through statistical analysis, the two groups in pain and hip function recovery, there was a significant difference (P0.05); treatment group can better alleviate the pain of patients, can better maintain the hip function recovery. Conclusion: acupuncture knife can release acupoints around hip joint, decompression of hip joint cavity and muscle release of corresponding contracture of hip joint, which can relieve hip joint pain caused by avascular necrosis of femoral head and vein stasis of femoral head. Can better maintain the recovery of hip function.
【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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