本文選題：宣痹湯 + 膝關(guān)節(jié)滑膜炎　； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察宣痹湯治療膝骨性關(guān)節(jié)炎合并滑膜炎的臨床療效,客觀評價宣痹湯對膝關(guān)節(jié)滑膜炎(濕熱痹阻型)的療效,進(jìn)一步臨床推廣應(yīng)用。方法:將滿足納入標(biāo)準(zhǔn)的60名患者隨機(jī)分為兩組,治療組與對照組各30例。治療組口服宣痹湯,對照組口服滑膜炎顆粒,療程8周。兩組受試者接受藥物治療的同時,適當(dāng)加強(qiáng)股四頭肌肌力鍛煉。治療4周、8周分別記錄兩組患者癥狀體征評分、生化指標(biāo),觀測不良反應(yīng)及并發(fā)癥,依據(jù)《中藥新藥臨床研究指導(dǎo)原則》比較兩組患者的癥狀、體征、生化指標(biāo)、WOMAC總積分及整體功能,運(yùn)用SPSS17.0軟件進(jìn)行統(tǒng)計學(xué)處理,評價總體療效。結(jié)果:治療4周、8周后兩組WOMAC總評分改善率比較,評分均有顯著減少,組間無明顯差異(P0.05)。治療4周治療組有效率93.33%,控顯率為16.70%,對照組有效率93.33%,控顯率為20.00%,治療組與對照組相比無顯著性差異(P0.05)。治療8周治療組有效率93.33%,控顯率為80.00%,對照組有效率96.67%,控顯率為76.66%,兩組比較無顯著性差異(P0.05)。綜合比較兩組治療結(jié)果,兩組藥物治療膝骨性關(guān)節(jié)炎合并滑膜炎均有顯著療效。WOMAC評分三項比較:兩組治療4周、8周疼痛程度、僵硬程度、功能活動較治療前均明顯改善(P0.05),有顯著性差異;治療4周與8周疼痛、功能活動組間比較,有顯著差異(P0.05),而僵硬程度比較無顯著性差異(P0.05);兩組疼痛程度、僵硬程度、功能活動在三個觀察點組間比較,均無顯著差異(P0.05)。腫脹程度比較:兩組治療4周、8周腫脹程度較治療前均明顯減輕(P0.05),有顯著性差異;治療4周、8周組內(nèi)比較有顯著差異(P0.05),組間比較無顯著差異(P0.05)。說明兩組藥物均能明顯緩解疼痛、減輕腫脹、改善膝關(guān)節(jié)僵硬及功能活動。結(jié)論:宣痹湯和滑膜炎顆粒治療膝關(guān)節(jié)骨性關(guān)節(jié)炎合并滑膜炎(濕熱痹阻型)均有較好療效,有效控制膝關(guān)節(jié)腫脹、改善疼痛和僵硬程度,改善膝關(guān)節(jié)功能活動,提高患者生活質(zhì)量,二者治療滑膜炎療效相當(dāng),值得臨床推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of Xuanbi decoction in treating knee osteoarthritis with synovitis and evaluate the curative effect of Xuanbi decoction on knee joint synovitis (damp-heat arthralgia obstruction type). Methods: 60 patients who met the inclusion criteria were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Xuanbi decoction and the control group with synovitis granule for 8 weeks. Two groups of subjects received drug treatment, appropriate strengthening of quadriceps femoris muscle strength exercise. Symptoms and signs scores, biochemical indexes, adverse reactions and complications were recorded at 4 weeks and 8 weeks after treatment. The symptoms and signs of the two groups were compared according to the guiding principles of Clinical Research of New drugs of traditional Chinese Medicine. The total score and the whole function of the biochemical index WOMAC were analyzed by SPSS17.0 software to evaluate the overall curative effect. Results: after 4 weeks and 8 weeks of treatment, the improvement rate of total WOMAC score in the two groups was significantly reduced, and there was no significant difference between the two groups (P 0.05). In the treatment group, the effective rate was 93.33 and the control rate was 16.70. In the control group, the effective rate was 93.33 and the control rate was 20.00. There was no significant difference between the treatment group and the control group (P 0.05). The effective rate of the treatment group was 93.33 and the control rate was 80.00.The effective rate of the control group was 96.67 and the control rate was 76.666.There was no significant difference between the two groups (P 0.05). Compared with the results of two groups, the two groups had significant curative effect in treating knee osteoarthritis with synovitis. WOMAC scores were compared among three groups: pain degree and stiffness degree of the two groups were 4 weeks and 8 weeks after treatment. Compared with before treatment, there was a significant difference in functional activity between the four and eight weeks of treatment, but there was no significant difference in the degree of stiffness between the two groups, and the degree of pain and stiffness in the two groups were significantly higher than that in the control group (P < 0.05), but there was no significant difference between the two groups in the degree of pain and stiffness, and there was no significant difference between the two groups in the degree of pain, the degree of stiffness and the degree of stiffness. There was no significant difference in functional activities among the three observation points (P 0.05). Comparison of swelling degree: the swelling degree of the two groups was significantly reduced after 4 weeks and 8 weeks compared with that before treatment, and there was a significant difference between the two groups in 4 weeks and 8 weeks of treatment, and there was no significant difference between the two groups. The results showed that both groups could relieve pain, relieve swelling, improve knee stiffness and function. Conclusion: Xuanbi decoction and synovitis granule are effective in treating knee osteoarthritis with synovitis (damp-heat arthralgia obstruction type), which can effectively control the swelling of knee joint, improve the degree of pain and stiffness, and improve the function of knee joint. To improve the quality of life of patients, both treatment of synovitis is equivalent, worthy of clinical application.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9

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