【作者】 曲震；

【导师】 林晓生；

【作者基本信息】 广州中医药大学 ， 中医骨伤科学， 2011， 硕士

【摘要】 目的：观察中药封包配合持续被动活动(Continuous Passive Motion, CPM)功能锻炼对膝关节骨性关节炎的治疗效果。为临床治疗膝关节骨性关节炎提供中西医结合治疗的新思路。方法：根据筛选的标准,选择来自深圳市宝安区中医院门诊及住院部的膝关节骨性关节炎患者共60例,根据就诊及住院的时间先后顺序编号,随机分为两组,即治疗组(CPM功能锻炼+中药封包外敷)及对照组(CPM功能锻炼+玻璃酸钠关节腔内注射)。治疗组使用CPM机器进行患膝关节持续性被动功能锻炼,保持活动在无痛范围内,从小角度(0°~30°)开始,逐步增加活动度(每日增加5°~30°),直至病人的最大耐受程度,每日1次,每次30min；同时外敷我院自拟中药封包外敷患膝关节疼痛部位,每次约30分钟,每天使用2次。对照组同样使用CPM行患膝关节功能锻炼,但行玻璃酸钠关节腔内注射,2ml/次·周,四周后停药。治疗前后计分均参照JOA膝关节功能评分标准拟订评价标准,并通过症状体征的评分对比来评价疗效。结果：1、治疗组及对照组患者治疗前均有不同程度的膝部疼痛,经治疗后,两组患者膝部疼痛有显著差异性(P<0.01),两组治疗后膝关节疼痛有显著性差异(P<0.01)。2、治疗组和对照组患者治疗前有不同程度的膝部肿胀,经治疗后,治疗组和对照组在治疗前后的膝部肿胀有显著改善(P<0.01),但两组治疗后膝部肿胀程度无显著性差异(P>0.05)。3、治疗组和对照组患者治疗前均有不同程度的活动受限。经治疗后,治疗组和对照组在治疗前后的膝关节活动度都有显著改善(P<0.01),两组治疗后膝关节活动度有显著性差异(P<0.01)。结论：中药封包配合CPM被动功能锻炼对膝关节骨性关节炎的症状及体征有明显的改善作用,且优于玻璃酸钠对膝关节骨性关节炎的治疗作用。更多还原

【Abstract】 Objective:To observe the therapeutic effect of medicine packet and continuous passive motion (CPM) on knee osteoarthritis (KOA). It supplies new methods for treating KOA with combination of TCM with Western medicine.Methods:According to the selection criteria,60 patients with knee osteoarthritis from Baoan hospital of TCM were randomly divided into two groups:1, Treatment group, in which patients received CPM applications and medicine packet treatment;2, Control group, in which patients received CPM applications and sodium hyaluronate injection of articular cavity. Compare and analyse the two groups of patients’sings and symptoms according to JOA scoring system before and after treatment.Results:1. The knee joint ache of two groups were significant relieved after treatment(P<0.01), and there were significant difference between the treatment group and the control group (P<0.01).2. The knee swell of two groups were significant relieved after treatment, but there were no difference between the treatment group and the control group(P>0.05).3. The knee active range of joint motion of two groups were significant relieved after treatment, and there were significant difference between the treatment group and the control group(P<0.01).Conclusion:The medicine packet treatment and CPM application can significantly improve the signs and symptoms of knee osteoarthritis.更多还原