四步手法结合中烫疗治疗膝骨性关节炎的临床研究.pdfVIP

目 录 中文摘要 ················································1 英文摘要 ················································3 引言 ·····················································6 正文 ·····················································7 1. 临床资料 ··············································7 2.诊疗标准 ···············································9 3.结果 ··················································12 4.讨论 ··················································15 5.结果分析 ··············································22 6.结论 ·················································24 问题与展望 ············································24 参考文献 ··············································25 附表 ···················································28 附图 ···················································29 综述 ···················································32 参考文献 ··············································37 致 谢 ···············································39 攻读学位期间发表的学术论文目录 ····················40 作者声明 ··············································41 个人简历 ··············································42 中 文 摘 要 目的：观察四步手法结合中药烫疗治疗早中期膝骨性关节炎 （KOA ） 的临床疗效，并探讨其作用机理。 方法：自2007 年1 月到2008 年1 月，在广西中医学院附属瑞康医 院骨科门诊选择早中期KOA 患者60 例，随机分成治疗组和对照组进行治 疗，治疗组运用四步手法结合中药烫疗治疗，对照组运用玻璃酸钠注射 液膝关节腔内注射治疗，治疗五个疗程 （一周一疗程），治疗后采用 HSS 评分标准进行疗效对比评价。 结果：两组临床疗效评定 （HSS评分）中治疗组优良率为73.4%，对 照组的优良率为50%，两组经统计学处理分析比较，具有显著性差异 （p ＜0.05 ），治疗组疗效优于对照组。治疗5周后，两组各项HSS积分均获不 同程度改善，通过组间比较，两组在总分、疼痛、功能三个方面疗效具 有极显著性差异（p ＜0.01）；在活动度、肌力、屈膝畸形、稳定性、减 分项目方面疗效无显著性差异（p ＞0.05 ）。而组内治疗前后比较，治疗 组在总分、疼痛、功能、活动度、屈膝畸形、稳定性、减分项目方面疗 效具有显著性差异（p ＜0.05 ）；在肌力方面疗效无显著性差异（p ＞0.05）。 对照组在总分、疼痛、功能、活动度、肌力、减分项目方面疗效具有显 著性差异（p ＜0.05 ）；屈膝畸形、稳定性方面疗效无显著性差异（p ＞ 0.05）。治疗组的疗效与患者的年龄越小、病程越短、X线分级越低间比 较均无显著性差异 （p ＞0.05 ），与年龄越大、病程越长、病情越重间比 较临床疗效具有显著性差异 （p ＜0.05 ）。 结论：四步手法结合中药烫疗治疗KOA的疗效显著，能明显改善患者 的疼痛、关节活动度、行走等功能；其作用机理是四步手法结合中药烫 疗具有改善患者膝关节血液循环、关节软骨营养和代谢，