本文關(guān)鍵詞：四逆湯餅灸治療膝骨性關(guān)節(jié)炎的臨床觀察及對其血清相關(guān)細胞因子影響的研究　出處：《寧夏醫(yī)科大學》2017年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 四逆湯餅灸 膝骨性關(guān)節(jié)炎 白介素-1 白介素-6 瘤壞死因子-α

【摘要】：目的1.觀察四逆湯餅灸治療膝骨性關(guān)節(jié)炎(Knee osteoarthritis,KOA)的臨床療效。2.觀察血清中白介素-1(Interleukin-1,IL-1),白介素-6(Interle ukin-6,IL-6)和腫瘤壞死因子-α(Tumor necrosis factor-alpha,TNF-α)表達水平的變化,探討四逆湯餅灸治療KOA的部分作用機理。方法將2015年9月至2016年9月于寧夏醫(yī)科大學總醫(yī)院中醫(yī)骨傷科、寧夏醫(yī)科大學總醫(yī)院集團陽光醫(yī)院中醫(yī)骨傷科、寧夏彭陽縣中醫(yī)醫(yī)院院針灸康復(fù)科門診和住院收集的170例符合標準的患者通過隨機數(shù)字編碼的方法分為兩組,分別給予四逆湯餅灸(85例)和安慰劑餅灸(85例)治療,采用雙盲法進行臨床研究,由參與本次試驗的三個科室經(jīng)過培訓的護士以及其他人員進行操作。四逆湯餅灸組和安慰劑餅灸組受試者均選取雙膝關(guān)節(jié)的犢鼻穴、內(nèi)膝眼、鶴頂穴、足三里四個穴位進行治療。10天(d)為一個療程,療程間隔2d,連續(xù)治療2個療程。治療前后運用“膝關(guān)節(jié)骨性關(guān)節(jié)炎自評量表”(Western Ontario and Memaster university Osteoarthritis index,WOMAC)結(jié)合視覺疼痛模擬法(Visual A nalogue Scale/score VAS)進行臨床療效評價。采用雙抗體夾心酶聯(lián)免疫吸附法(Enzyme-linked Immunosorbent assay,ELISA)檢測患者血清中IL-1、IL-6和TNF-α的水平。采用SPSS19.0統(tǒng)計分析軟件分析數(shù)據(jù),數(shù)據(jù)結(jié)果均采用均數(shù)±標準差(?X±s)表示,計數(shù)資料采用卡方檢驗,符合正態(tài)分布的計量資料采用t檢驗,不符合正態(tài)分布的計量資料采用秩和檢驗,P0.05為差異有統(tǒng)計學意義。結(jié)果1.治療前,四逆湯餅灸組和安慰劑餅灸組受試患者的膝關(guān)節(jié)WOMAC總分比較,差異均無統(tǒng)計學意義(P0.05);治療后,四逆湯餅灸組和安慰劑餅灸組受試者膝關(guān)節(jié)WOMAC評分均有明顯降低,差異有統(tǒng)計學意義(P0.05),治療過程中所有受試患者未出現(xiàn)不良事件;與安慰劑餅灸組相比較,四逆湯餅灸組的WOMAC評分下降更明顯,差異有統(tǒng)計學意義(P0.05)。2.與治療前比較,四逆湯餅灸組和安慰劑餅灸組受試患者血清中IL-1、IL-6和TNF-α的表達水平均明顯降低,差異有統(tǒng)計學意義(P0.05);與安慰劑餅灸相比,四逆湯餅灸組血清IL-1、IL-6和TNF-α的水平下降更明顯,差異有統(tǒng)計學意義(P0.05)。3.治療后四逆湯餅灸組的總有效率(96.25%)優(yōu)于安慰劑餅灸組(77.22%),差異有統(tǒng)計學意義(P0.05)。結(jié)論1.四逆湯餅灸治療KOA的臨床療效顯著且安全性高,能夠很好地改善KOA患者膝關(guān)節(jié)的臨床癥狀以及提高膝關(guān)節(jié)功能;2.四逆湯餅灸可能是通過有效地抑制KOA患者血清中IL-1、IL-6和TNF-α的表達水平,延緩KOA的發(fā)病進程,達到治療KOA的目的。
[Abstract]:Objective 1. To observe the effect of Sini decoction moxibustion on knee osteoarthritis (osteoarthritis). The clinical efficacy of KOA.2.To observe the serum interleukin-1 Interleukin-1 ukin-6 and Interleukin-1 Interleukin-1 ukin-6. IL-6) and Tumor necrosis factor-alpha TNF- 偽. To explore the mechanism of treating KOA by Sinii decoction moxibustion. Methods from September 2015 to September 2016, the orthopedics and injury department of traditional Chinese medicine in Ningxia Medical University General Hospital were selected. Department of Orthopaedics and Trauma of traditional Chinese Medicine, Sunshine Hospital, General Hospital of Ningxia Medical University. 170 patients who met the standard were divided into two groups by random number coding method. The clinical study was carried out by using double blind method to treat 85 cases of Si-ni decoction and 85 cases of placebo moxibustion. Trained nurses and other personnel from the three departments involved in the experiment were operated. The subjects of the Si-Ni soup cake moxibustion group and the placebo cake moxibustion group all selected the calf nose point, the inner knee eye and the craning point of the knee joint. Four acupoints of Zusanli were treated for 10 days) as a course of treatment, with a course of treatment interval of 2 days. Two consecutive courses of treatment. Self-Rating knee Osteoarthritis scale before and after treatment (. Western Ontario and Memaster university Osteoarthritis index. WOMAC (Visual A nalogue Scale/score vas) combined with visual pain simulation. The clinical efficacy was evaluated. Enzyme-linked Immunosorbent assay was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). The levels of IL-6 and TNF- 偽 in serum of patients were detected by Elisa. The data were analyzed by SPSS19.0 statistical analysis software, and the data were analyzed with mean 鹵standard deviation. X 鹵s) indicated that the counting data was chi-square test, the normal distribution data was t test, and the non-normal distribution data was rank sum test. Before treatment, the total score of WOMAC of knee joint of the patients in the SINI decoction moxibustion group and the placebo cake moxibustion group were compared. 2. The difference was not statistically significant (P 0.05). After treatment, the WOMAC score of knee joint of the subjects in the Sinii decoction moxibustion group and the placebo cake moxibustion group were significantly decreased (P 0.05). There were no adverse events in all the patients during the treatment. Compared with placebo cake moxibustion group, the WOMAC score of Sini decoction cake moxibustion group decreased more obviously, and the difference was statistically significant (P 0.05) .2.Compared with that before treatment. The expression levels of IL-6 and TNF- 偽 in serum of patients with Sini decoction moxibustion group and placebo cake moxibustion group were significantly decreased, and the difference was statistically significant (P 0.05). Compared with placebo cake moxibustion, the serum levels of IL-1- 6 and TNF- 偽 decreased more significantly in Sini decoction moxibustion group. After treatment, the total effective rate of Sini decoction moxibustion group (96.25) was better than that of placebo cake moxibustion group (77.22). The difference was statistically significant (P 0.05). Conclusion 1. The clinical efficacy of SINI decoction moxibustion in treating KOA is significant and the safety is high. 2. It can improve the clinical symptoms of knee joint and improve the function of knee joint in patients with KOA. 2.Simi decoction moxibustion may be an effective way to inhibit the expression of IL-6 and TNF- 偽 in serum of patients with KOA, delay the pathogenesis of KOA and achieve the purpose of treating KOA.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.9

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