本文選題：經(jīng)筋　切入點(diǎn)：膝骨性關(guān)節(jié)炎　出處：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:運(yùn)用激光散斑成像技術(shù)觀察健康志愿者筋結(jié)點(diǎn)與膝骨性關(guān)節(jié)炎患者結(jié)筋病灶點(diǎn)體表血流灌注量的差異,印證經(jīng)筋結(jié)構(gòu)-功能相關(guān)性,進(jìn)一步探索經(jīng)筋實(shí)質(zhì)。材料與方法:健康組:健康志愿者全部來自2016.3~2017.3間在遼沈地區(qū),經(jīng)診斷無膝骨性關(guān)節(jié)炎及其他腿部疾病的健康社區(qū)居民100名,年齡40~70歲,并征得志愿者書面同意。KOA組:全部足陽明經(jīng)筋型KOA病例為2016.3~2017.3間在遼寧中醫(yī)藥大學(xué)附屬第一、第二醫(yī)院門診及住院的患者共103名。通過診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)篩選病例。符合納入標(biāo)準(zhǔn)的患者按次序進(jìn)入研究,均自愿簽署知情同意書。KOA患者經(jīng)觸診后,記錄結(jié)筋病灶點(diǎn)出現(xiàn)頻次,并進(jìn)行統(tǒng)計(jì);健康組與KOA組均仰臥位平躺,保持環(huán)境安靜,光線、溫度穩(wěn)定。待呼吸、心情平穩(wěn)后,標(biāo)記頻次最高的前5個(gè)結(jié)筋病灶點(diǎn),以激光散斑成像儀進(jìn)行掃描,以1cm*1cm為ROI。若身體不穩(wěn)造成圖像抽動(dòng),則在數(shù)據(jù)處理時(shí)避開該運(yùn)動(dòng)偽跡部分,選擇感興趣時(shí)間段。利用moorFLPI-2Review V4.0圖像在計(jì)算機(jī)顯示器上同步生成血液灌注圖、強(qiáng)度圖和彩色照片,并記錄這五個(gè)筋結(jié)點(diǎn)(結(jié)筋病灶點(diǎn))的血流灌注量(血流灌注單位,prefusion unit,PU值)。保持體位15min后,采用新杏林牌0.35*50mm一次性毫針分別針刺這五個(gè)筋結(jié)點(diǎn)(結(jié)筋病灶點(diǎn)),以激光散斑成像儀進(jìn)行掃描,以1cm*1cm為ROI,記錄這五個(gè)筋結(jié)點(diǎn)(結(jié)筋病灶點(diǎn))5min、10min、15min、20min的血流灌注量。觀察指標(biāo):(1)KOA患者結(jié)筋病灶點(diǎn)定位和臨床出現(xiàn)比率;(2)記錄、統(tǒng)計(jì)、比較靜態(tài)情況下KOA患者結(jié)筋病灶點(diǎn)以及健康志愿者相應(yīng)筋結(jié)點(diǎn)的血流灌注量;(3)記錄、統(tǒng)計(jì)、比較動(dòng)態(tài)(針刺)情況下KOA患者結(jié)筋病灶點(diǎn)以及健康志愿者相應(yīng)筋結(jié)點(diǎn)針刺即刻、5min、10min、15min、20min的血流灌注量。結(jié)果:1.觀察103例足陽明經(jīng)筋型KOA患者,頻次最高的前5個(gè)結(jié)筋病灶點(diǎn)分別是:髕內(nèi)下98例,比率為95.15%;脛骨內(nèi)髁95例,比率為92.23%;髕下87例,比率為84.47%;髕外85例,比率為82.52%;足三里次75例,比率為72.82%。2.兩組髕內(nèi)下、脛骨內(nèi)髁、髕下、髕外、足三里次的靜態(tài)體表血流灌注量經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P均0.05,具有統(tǒng)計(jì)學(xué)意義。3.兩組臏內(nèi)下、脛骨內(nèi)髁、髕下、髕外、足三里次針刺即刻的體表血流灌注量經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P均0.05,具有統(tǒng)計(jì)學(xué)意義;5min體表血流灌注量的體表血流灌注量經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P均0.05,具有統(tǒng)計(jì)學(xué)意義;10min的體表血流灌注量經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P均0.05,具有統(tǒng)計(jì)學(xué)意義;15min的體表血流灌注量經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P均0.05,具有統(tǒng)計(jì)學(xué)意義;20min的體表血流灌注量經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P均0.05,具有統(tǒng)計(jì)學(xué)意義結(jié)論:1.足陽明經(jīng)筋型膝骨性關(guān)節(jié)炎患者髕骨內(nèi)下側(cè)的結(jié)筋病灶點(diǎn)損傷機(jī)會(huì)較多;2.與健康志愿者相比,在靜態(tài)情況下足陽明經(jīng)筋型KOA患者的結(jié)筋病灶點(diǎn)體表血流灌注量呈顯著升高的特征;3.與健康志愿者相比,在動(dòng)態(tài)情況下足陽明經(jīng)筋型KOA患者的結(jié)筋病灶點(diǎn)體表血流灌注量呈顯著升高的特征;4.膝骨性關(guān)節(jié)炎患者經(jīng)筋損傷存在結(jié)構(gòu)-功能特征的相關(guān)性,激光散斑成像技術(shù)有助于建立膝骨性關(guān)節(jié)炎客觀療效評(píng)價(jià)體系;5.體表血流灌注量增高、組織微循環(huán)改善可能是針刺結(jié)筋病灶點(diǎn)臨床起效的機(jī)制之一。
[Abstract]:Objective: To study the difference and reinforcement of healthy volunteers of knee osteoarthritis, rib lesions skin blood perfusion imaging of laser spot node observation, confirmed by band structure function correlation, to further explore the essence of the tendons. Materials and methods: healthy group: healthy volunteers from all 2016.3~2017.3 in Liaoning Province, the community health residents in diagnosis of knee osteoarthritis and other leg disease in 100, aged 40~70 years, and obtain the written consent of the volunteer group.KOA: all meridian bar type KOA cases of 2016.3~2017.3 in Liaoning University of Traditional Chinese Medicine First Affiliated Hospital, second outpatient and inpatient patients were 103. The diagnostic criteria, inclusion criteria, exclusion criteria cases. Patients who met the inclusion criteria in order to enter the study voluntarily signed the informed consent of patients with.KOA by palpation, rib lesions frequently recorded, And statistics; health group and KOA group were lying supine, keep quiet, light, stable temperature. When breathing, feeling smooth, marking the highest frequency of the first 5 rib lesions, were scanned with laser speckle imaging instrument, using 1cm*1cm as ROI. if the body image is instability caused by TiC to avoid the motion artifacts in the part of the data processing, select the interest period. Blood perfusion maps generated synchronously on a computer monitor using moorFLPI-2Review V4.0 image intensity map and color photos, and record the five tendons node (node rib lesions) of blood perfusion (blood flow perfusion unit, prefusion unit, PU keep the position.) after 15min, the new brand 0.35*50mm disposable needle acupuncture respectively Xinglin the five tendons node (rib lesions), scanning by laser speckle imaging, 1cm*1cm ROI, to record the five tendons node (rib lesions) 5min, 10min,15min,20min鐨勮嫻佺亴娉ㄩ噺.瑙傚療鎸囨爣:(1)KOA鎮(zhèn)ｈ，

本文編號(hào)：1620303