耳穴贴压治疗与常规西药治疗膝关节骨性关节炎的对比研究
发布时间：2020-11-01 20:48
根据中医理论,膝关节骨性关节炎疼痛属于痹综合征。“痹”指经络气血循环的僵硬和阻塞。痹综合征表现为肌肉、肌腱、骨骼和关节的疼痛、麻木或沉重,以及这些结构的活动障碍或变形。骨痹综合征引起的关节炎疼痛是患者寻求针灸和草药治疗的最常见原因之一,无论是否使用西方疗法。在美国,2010年男性膝关节炎的患病率为10%,60岁或60岁以上的成年人中,女性膝关节炎的患病率为13%。耳针疗法可能在疼痛治疗中发挥重要作用。然而,目前所有的科学依据不够以证实对于膝关节骨性关节炎疼痛患者耳针治疗的临床效果。本研究的目的是研究耳科治疗对患有KOA的患者疼痛、活动性和生活质量的影响。目的:评价中药子耳穴贴治疗膝关节骨性关节炎疼痛的疗效及常规药物治疗。方法:本研究是一项随机临床试验(RCT),于2018年6月至2019年3月在伊朗设拉子的诊所进行。本研究将46名受试者随机分为耳穴穴位组和对照药物组。研究组采用一次性中药种子贴于耳穴名AH4,为膝关节对应点。在膝关节骨性关节炎的情况下,当操作或施加压力时,其点会感到疼痛。三四天后,必须更换种子。药物治疗组将按照常规西药的标准剂量服药(塞来昔布片100mg,每天两次)。两组治疗疗程为4周。结果:两组在干预前(P值=0.152)、试验后(P值=0.981)和随访时(P值=0.063)的WOMAC结果无统计学差异。耳穴穴位组采用重复测量方差分析测试的WOMAC评分结果,前测(均数±标准差=61.82±13.33)、后测(均数±标准差=40.26±12.28)以及随访(均数±标准差=50.69±12.68)之间均有显著性差异(P=0.000)。药物组试验相似得出的结果在统计学上几乎相同,在基线、试验后和随访的平均值±标准差方差分析试验中分别为67.13±11.27、40.17±12.60和58.26±14.13,显示出试验前和试验后、试验前和随访的显著差异(P=0.000),以及试验后和随访的显著差异(P=0.001)。针刺组治疗前后和随访时VAS评分的平均值和标准差有显著性差异(P=0.000)。然而,与所有治疗疗程相比,随访时的VAS评分也显著增加(P≤0.05),尽管随访时的VAS评分与基线时相比显著降低(P=0.000)。重复测量10次用药组方差分析结果,证实VAS评分存在显著性差异(P=0.000)。同时,Bonferroni事后测试结果显示,与基线相比,所有疗程后的VAS评分均显著降低(P=0.000)。与所有疗程相比,随访时的VAS评分显著增加(P≤0.05),但与基线相比,随访时的VAS评分显著降低(P=0.000)。采用独立样本t检验,两组患者在基线、治疗后和随访时的VAS参数在基线(P=0.999)和治疗后(P=0.719)无显著差异。结论:中药种子耳穴压法(ATT)和非甾体抗炎药(NSAIDS)常规治疗膝关节骨性关节炎均有效,但前者治疗膝关节骨性关节炎的疗效明显优于后者。
【学位单位】：北京中医药大学
【学位级别】：硕士
【学位年份】：2019
【中图分类】：R246.9
【文章目录】：
Abstract
摘要
Abbreviations
1 Review of literature
1.1 Knee osteoarthritis, regarding Western medicine
1.2 Knee osteoarthritis, Chinese Medicine aspect
1.3 Advantage and shortcoming of previous studies
2 Introduction
3 Methods and materials
3.1 Study design
3.2 Algorithm
3.3 Material and method
3.3.1 Diagnostic Criteria
3.3.2 Inclusion criteria
3.3.3 Exclusion criteria
3.3.4 Intervention
3.4 Outcome and variables assessment scales
3.4.1 Visual analogue scale （VAS）
3.4.2 The Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）
3.4.3 Objective
3.5 -Patient Randomization
3.6 Statistical data analysis
3.7 Result
3.7.1 comparing age and gender of participants between two groups
3.7.2 Mean and Standard deviation for VAS and WOMAC data before and after treatments inAcupuncture group
3.7.3 WOMAC parameter between two groups at baseline
3.7.4 WOMAC parameter between two groups at post test
3.7.5 WOMAC parameter between two groups at follow-up
3.7.6 Mean and standard deviation for WOMAC score at pretest, posttest and follow-up sessions forAcupuncture group
3.7.7 Mean and standard deviation for WOMAC score at pretest, posttest and follow-up sessions forMedication group
3.7.8 Mean and standard deviation for VAS score at baseline and after each visit in Acupuncture groups
3.7.9 Mean and standard deviation for VAS score at baseline and after each visit in Medication groups
3.7.10 VAS parameter between two groups at pretest and posttest
4 Discussion
4.1 Explaining the treatment protocol
4.1.1 Auricular acupressure
4.1.2 Medication
4.2 Explaining the results and statistical analysis and evaluation of similarities and differences withother studies
4.2.1 Age and gender
4.2.2 The effect of treatment on WOMAC
4.2.3 The effect of treatment on VAS
4.3 Advantage and shortcoming of this study
4.4 Recommendations for future study
5 Conclusion
6 References
7 Appendices
7.1 WOMAC Questionnaire
7.2 Visual analogue scale （VAS） questionnaire
8 Acknowledgements
【相似文献】
本文编号：2866078
【学位单位】：北京中医药大学
【学位级别】：硕士
【学位年份】：2019
【中图分类】：R246.9
【文章目录】：
Abstract
摘要
Abbreviations
1 Review of literature
1.1 Knee osteoarthritis, regarding Western medicine
1.2 Knee osteoarthritis, Chinese Medicine aspect
1.3 Advantage and shortcoming of previous studies
2 Introduction
3 Methods and materials
3.1 Study design
3.2 Algorithm
3.3 Material and method
3.3.1 Diagnostic Criteria
3.3.2 Inclusion criteria
3.3.3 Exclusion criteria
3.3.4 Intervention
3.4 Outcome and variables assessment scales
3.4.1 Visual analogue scale （VAS）
3.4.2 The Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）
3.4.3 Objective
3.5 -Patient Randomization
3.6 Statistical data analysis
3.7 Result
3.7.1 comparing age and gender of participants between two groups
3.7.2 Mean and Standard deviation for VAS and WOMAC data before and after treatments inAcupuncture group
3.7.3 WOMAC parameter between two groups at baseline
3.7.4 WOMAC parameter between two groups at post test
3.7.5 WOMAC parameter between two groups at follow-up
3.7.6 Mean and standard deviation for WOMAC score at pretest, posttest and follow-up sessions forAcupuncture group
3.7.7 Mean and standard deviation for WOMAC score at pretest, posttest and follow-up sessions forMedication group
3.7.8 Mean and standard deviation for VAS score at baseline and after each visit in Acupuncture groups
3.7.9 Mean and standard deviation for VAS score at baseline and after each visit in Medication groups
3.7.10 VAS parameter between two groups at pretest and posttest
4 Discussion
4.1 Explaining the treatment protocol
4.1.1 Auricular acupressure
4.1.2 Medication
4.2 Explaining the results and statistical analysis and evaluation of similarities and differences withother studies
4.2.1 Age and gender
4.2.2 The effect of treatment on WOMAC
4.2.3 The effect of treatment on VAS
4.3 Advantage and shortcoming of this study
4.4 Recommendations for future study
5 Conclusion
6 References
7 Appendices
7.1 WOMAC Questionnaire
7.2 Visual analogue scale （VAS） questionnaire
8 Acknowledgements
【相似文献】
相关硕士学位论文 前1条
1 法尔（Farhad Zare Daryooni）;耳穴贴压治疗与常规西药治疗膝关节骨性关节炎的对比研究[D];北京中医药大学;2019年
本文编号：2866078
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