正骨松筋疗法结合筋氏葆熏洗对老年重度骨性关节炎患者膝关节功能及关节力线的影响
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摘要
目的:探讨正骨松筋疗法结合筋氏葆熏洗对老年重度骨性关节炎患者膝关节功能及关节力线的影响。方法:2015年6月—2017年11月选择本院老年重度骨性关节炎患者78例,随机分为2组,对照组和观察组各39例,对照组采用常规推拿治疗;观察组采用正骨松筋疗法结合筋氏葆熏洗治疗,持续治疗3周为1个疗程,共3个疗程。比较两组间临床疗效、Lysholm评分、视觉模拟量表评分(Visual analogue scale,VAS)及胫骨-股骨机械轴夹角(The angle of the shaft of the tibia and femur,MFTA)、股骨远端外侧角(Lateral angle of distal femur,LDFA)、胫骨近端内侧角(Medial angle of proximal tibia,MPTA)水平,进行随访记录不良反应状况。结果:对照组有效率79.49%低于观察组有效率94.87%,差异具有统计学意义(P<0.05)。治疗后对照组和观察组Lysholm评分分别为(78.14±8.15)(85.62±7.64),VAS评分分别为(1.74±1.03)(0.85±0.61),MFTA分别为(3.34±1.31)(1.68±1.05),LDFA分别为(2.67±1.10)(1.89±1.01),MPTA分别为(3.24±1.45)(1.96±1.26),对照组和观察组上述指标比较,差异具有统计学意义(P<0.05)。两组患者治疗期间无不良反应出现。结论:正骨松筋疗法结合筋氏葆熏洗对老年重度骨性关节炎患者的疗效确切,改善膝关节功能,调节关节力线,且患者可以耐受,值得推广。
Objective:To investigate the effect of bone loosening therapy combined with Jinshibao fumigation in the treatment of severe osteoarthritis in elderly in knee function and joint line.Methods:Seventy-eight elderly patients with severe osteoarthritis in our hospital from June 2015 to November 2017 were randomly divided into the control group and the treatment group,39 cases in each.The control group received conventional massage and the treatment group received bone loosening therapy combined with Jinshibao fumigation,3 weeks for a course and two groups were treated for 3 courses.The clinical efficacy,Lysholm score,visual analogue scale score(VAS)and the angle of the tibial femur mechanical axis(MFTA),the lateral distal femur angle(LDFA)and the medial tibia near end angle(MPTA)were compared,and all patients were followed up to record adverse reactions.Results:The effective rate of the control group(79.49%)was lower than the treatment group's(94.87%),and the difference was statistically significant(P<0.05).After treatment,the Lysholm scores in the control group and the treatment group were(78.14±8.15)and(85.62±7.64).The VAS scores were(1.74±1.03)and(0.85±0.61),MFTA were(3.34±1.31)and(1.68±1.05).LDFA scors were(2.67±1.10) and(1.89±1.01).MPTA were(3.24±1.45)and(1.96±1.26).All indexes in two groups had statistically significant(P<0.05).Two groups had no adverse reaction occurred during the treatment.Conclusion:Bone loosening therapy combined with Jinshibao fumigation in the treatment of severe osteoarthritis in elderly is effective,and it can improve the function of the knee joint,and adjust the joint force line,which was worthy of popularizing.
Objective:To investigate the effect of bone loosening therapy combined with Jinshibao fumigation in the treatment of severe osteoarthritis in elderly in knee function and joint line.Methods:Seventy-eight elderly patients with severe osteoarthritis in our hospital from June 2015 to November 2017 were randomly divided into the control group and the treatment group,39 cases in each.The control group received conventional massage and the treatment group received bone loosening therapy combined with Jinshibao fumigation,3 weeks for a course and two groups were treated for 3 courses.The clinical efficacy,Lysholm score,visual analogue scale score(VAS)and the angle of the tibial femur mechanical axis(MFTA),the lateral distal femur angle(LDFA)and the medial tibia near end angle(MPTA)were compared,and all patients were followed up to record adverse reactions.Results:The effective rate of the control group(79.49%)was lower than the treatment group's(94.87%),and the difference was statistically significant(P<0.05).After treatment,the Lysholm scores in the control group and the treatment group were(78.14±8.15)and(85.62±7.64).The VAS scores were(1.74±1.03)and(0.85±0.61),MFTA were(3.34±1.31)and(1.68±1.05).LDFA scors were(2.67±1.10) and(1.89±1.01).MPTA were(3.24±1.45)and(1.96±1.26).All indexes in two groups had statistically significant(P<0.05).Two groups had no adverse reaction occurred during the treatment.Conclusion:Bone loosening therapy combined with Jinshibao fumigation in the treatment of severe osteoarthritis in elderly is effective,and it can improve the function of the knee joint,and adjust the joint force line,which was worthy of popularizing.
引文
[1] 王庆甫,马玉峰,殷岳杉.重新认识膝骨性关节炎的诊断和防治[J].中国骨伤,2016,29(9):779-781.
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[11] 余洋,樊效鸿,陈日高,等.中医内外治法联合治疗膝骨性关节炎临床疗效观察[J].成都中医药大学学报,2017,40(2):70-72.
[12] 胡志俊,唐占英,叶秀兰,等.调衡筋骨法在骨伤康复中的应用与研究[J].上海中医药杂志,2017,51(8):1-4.
[13] 范志勇,吴栓,谢兵,等.基于“筋为骨用”探讨“舒筋”手法治疗膝骨关节炎的力学机制[J].上海中医药大学学报,2014,28(3):15-17.
[14]黄胜杰,王和鸣.刍议“筋骨并重”治筋痹[J].中医杂志,2012,53(12):1072-1074.
[15]许志宇,孟和.由“动静结合、筋骨并重”谈孟氏学术理念[J].西部中医药,2016,29(1):58-60.
[16]王旭昀,张宏,孙占学,等.熏洗疗法在中医外科疾病应用研究进展[J].中华中医药学刊,2015,33(1):146-148.
[17]潘建科,何於,刘军,等.基于属性偏序结构图方法的膝骨关节炎熏洗处方用药规律研究[J].中华中医药杂志,2014,29(5):1677-1681.
[2] 田晓美,赵紫砚,侯丽.膝关节骨性关节炎中西医结合康复治疗进展[J].现代中西医结合杂志,2016,25(1):105-108.
[3] 李西海,刘献祥.基于筋骨理论探讨膝骨关节炎筋骨失衡的治疗策略[J].中华中医药杂志,2017,32(8):3344-3346.
[4] 陈祖平,董森,李辉,等.舒筋散熏洗治疗早中期膝关节骨性关节炎120例[J].中医杂志,2012,53(22):1959-1960.
[5] 杨洸,李翠翠.护髌松筋手法结合综合疗法治疗中老年膝关节骨性关节炎41例临床观察[J].中医药导报,2013,19(5):48-50.
[6] 付博,杨宝林.骨性关节炎研究进展[J].辽宁中医药大学学报,2014,16(7):243-246.
[7] 赵昌盛,钟群杰,林剑浩.中国膝关节骨关节炎流行病学调查现状[J].广东医学,2016,37(13):2050-2052.
[8] 尹志强,潘惟丽,金昊,等.骨性关节炎病因的研究进展[J].现代生物医学进展,2016,16(7):1369-1371.
[9] 张师侥,关雪峰.中医外治法治疗膝骨性关节炎最新进展[J].中国骨质疏松杂志,2016,22(7):907-911.
[10] 韩廷成,周临东,董松林.中医外治法治疗膝骨关节炎的现状与分析[J].现代中西医结合杂志,2012,21(5):566-568.
[11] 余洋,樊效鸿,陈日高,等.中医内外治法联合治疗膝骨性关节炎临床疗效观察[J].成都中医药大学学报,2017,40(2):70-72.
[12] 胡志俊,唐占英,叶秀兰,等.调衡筋骨法在骨伤康复中的应用与研究[J].上海中医药杂志,2017,51(8):1-4.
[13] 范志勇,吴栓,谢兵,等.基于“筋为骨用”探讨“舒筋”手法治疗膝骨关节炎的力学机制[J].上海中医药大学学报,2014,28(3):15-17.
[14]黄胜杰,王和鸣.刍议“筋骨并重”治筋痹[J].中医杂志,2012,53(12):1072-1074.
[15]许志宇,孟和.由“动静结合、筋骨并重”谈孟氏学术理念[J].西部中医药,2016,29(1):58-60.
[16]王旭昀,张宏,孙占学,等.熏洗疗法在中医外科疾病应用研究进展[J].中华中医药学刊,2015,33(1):146-148.
[17]潘建科,何於,刘军,等.基于属性偏序结构图方法的膝骨关节炎熏洗处方用药规律研究[J].中华中医药杂志,2014,29(5):1677-1681.