弹拨筋结治疗阳虚寒凝型膝骨关节炎的临床研究

【作者】 阎博华；

【导师】 罗才贵；

【作者基本信息】 成都中医药大学 ， 针灸推拿学， 2006， 硕士

【摘要】 膝骨关节炎(Knee Osteoarthritis，以下均简称为KOA)是一种慢性关节疾患，是骨伤科的常见病、多发病，好发于中老年人，随着我国社会人口结构向老龄化转变，其预防和治疗日益引起重视。本病是发生在膝关节的退行性病变，以膝关节疼痛、僵硬及活动受限为主要临床表现。目前，临床治疗主要侧重于缓解症状，改善膝关节功能，减缓病情的发展。本病相当于中医“痹症”、“伤筋”范畴，是中医骨伤研究的一个重要领域。 目前，治疗KOA的方法较多，除了少数患者采用手术外，多数临床医生采用止痛药和非甾体抗炎药缓解症状，但是止痛药和非甾体抗炎药副作用明显，常常引起恶心、呕吐腹痛，剂量大时还可引起肝脏损伤。因此寻找治疗KOA方便、有效、副作用小的方法是一项迫切而必要的任务。导师针对该病的发病特征及病因病机特点，采用弹拨“筋结”治疗本病，经多年的临床观察，疗效显著，安全易操作。 本文包括文献研究、临床研究、综述三个部分，文献研究系统回顾了对KOA的现代医学病因、发病机制，中医药病因、病机及其治疗概况。临床研究采用随机平行对照临床试验方法，将60例中医辨证为阳虚寒凝型KOA患者随机分为推拿手法组和关节松动术组，观察治疗前后的临床症状、体征改善及膝关节滑液变化，研究弹拨筋结对阳虚寒凝型KOA的治疗作用，探索弹拨筋结治疗阳虚寒凝型KOA的机制，为提高推拿治疗阳虚寒凝型KOA的疗效和安全性提供客观依据。综述总结了近几年膝关节骨性关节炎的推拿治疗进展。更多还原

【Abstract】 Knee Osteoarthritis is a chronic arthrosis occurred frequently in orthopedics department. It is easily happened on the elderly. With the aging transformation of population structure in our society, the prevention and treatment of KOA should be paid enough attention. KOA is a degeneration disease and mainly manifested as pain, stiffness and limited movement in knees. At present, the clinic treatment mostly focuses on reliving symptoms, the improvement of knee function and postponing the development of KOA. It refers to the Bi syndrome and tendon damage in TCM. KOA is a quite important field in Chinese orthopedics departmentAt present, there are many ways to treat KOA. Except few victims adopt operation, most doctors chose anodyne and non-steroidal anti-inflammatory agent to relieve symptoms in clinic. Both the two drugs have serious side effect. They always lead to nausea, vomiting, abdomen pain even liver injury at a high dose. It is quite essential to find a convenient, effective and few side effects therapy for KOA. According to the pathogenesis, etiology of this disease, my tutor applied hitting and striking lump method and achieved curative effect significantly. This manipulation is safe and convenient.This essay includes literature Study , clinic research and summary .The first part systematically reviewed the pathogenesis, pathology and therapy in both Chinese medicine and Western medicine. According to the random, parallel and comparing principle, 60 KOA patients diagnosed as Yang deficiency and blood stagnation syndrome were randomly divided into massage group and arthrolysis group. The indexes were observed before and after the experiment such as clinic symptom, syndrome and knee synovia change thus to explore the effect of hitting and striking lump method for the KOA patients of Yang deficiency and blood stagnation syndrome. The mechanism of this treatment was also discussed. This easy provided objective support to improve the effect of massage treatment for Yang deficiency and blood stagnation syndrome KOA patients. The development of massage therapy for Knee Osteoarthritis was summarized in the review.更多还原