本文選題：針刀 + 手法松解�。� 參考：《濟(jì)南大學(xué)》2016年碩士論文

【摘要】：目的運(yùn)用針刀技術(shù)聯(lián)合手法松解的治療手段,以傳統(tǒng)針灸推拿的治療方法做對(duì)照,通過(guò)治療前后各項(xiàng)肩關(guān)節(jié)功能活動(dòng)的評(píng)分比較,評(píng)價(jià)不同方法的臨床療效,探究針刀聯(lián)合手法松解治療粘連性肩周炎的療效及作用機(jī)制。方法將90例肩關(guān)節(jié)周圍炎患者隨機(jī)分為兩組,試驗(yàn)組45例采用針刀聯(lián)合手法松解治療,對(duì)照組45例采用傳統(tǒng)針灸推拿治療。根據(jù)“全國(guó)第二屆肩周炎學(xué)術(shù)研討會(huì)”上制定的診斷標(biāo)準(zhǔn)進(jìn)行診斷和評(píng)定療效,采用疼痛視覺(jué)模擬評(píng)分法(Visual Analogue Score,VAS)評(píng)估患者肩關(guān)節(jié)疼痛程度,采用調(diào)整后的Constant-Murley肩關(guān)節(jié)功能評(píng)分(CMS),包括日常功能活動(dòng)(ADL)、肩關(guān)節(jié)活動(dòng)度(ROM)、肌力(MMT),對(duì)患肩部治療前及治療一定時(shí)間后進(jìn)行肩關(guān)節(jié)功能活動(dòng)量化評(píng)分。分析患者治療前后臨床癥狀指標(biāo)的變化,包括:VAS評(píng)分及肩關(guān)節(jié)各項(xiàng)功能活動(dòng)評(píng)分,計(jì)算出各組有效率。應(yīng)用SPSS統(tǒng)計(jì)分析軟件作數(shù)據(jù)分析。結(jié)果1.治療后,兩組患者的VAS、ADL、ROM、MMT等各項(xiàng)評(píng)分均較治療前有優(yōu)化,組內(nèi)差異比較具有統(tǒng)計(jì)學(xué)意義(p0.05)。2.治療后,兩組患者在VAS、ADL、ROM的評(píng)分對(duì)比上,組間差異具有統(tǒng)計(jì)學(xué)意義(p0.05),試驗(yàn)組在評(píng)分改善上優(yōu)于對(duì)照組。3.治療后兩組患者在MMT評(píng)分的比較上,無(wú)顯著性差異(p0.05)。4.臨床療效上,試驗(yàn)組治愈32例,好轉(zhuǎn)8例,無(wú)效3例,有效率93.02%;對(duì)照組治愈25例,好轉(zhuǎn)11例,無(wú)效6例,有效率85.71%。兩組之間的療效差異具有統(tǒng)計(jì)學(xué)意義(p0.05),試驗(yàn)組療效優(yōu)于對(duì)照組。結(jié)論1、針刀技術(shù)聯(lián)合手法松解治療粘連性肩周炎療效肯定,且優(yōu)于傳統(tǒng)針灸推拿療法。2、針刀技術(shù)可有效松解肩周炎患者患周組織的粘連和攣縮,刺激局部神經(jīng)和改善微循環(huán)代謝,減輕炎癥反應(yīng)。在此基礎(chǔ)上,手法松解可增加松解粘連的效果。二者聯(lián)合能大幅度地改善患者的活動(dòng)受限、疼痛的臨床癥狀,提高患者生活質(zhì)量。
[Abstract]:Objective to evaluate the clinical efficacy of different methods by comparing the scores of shoulder joint function before and after treatment with the traditional acupuncture and massage therapy. To explore the therapeutic effect and mechanism of acupuncture knife combined with manual release in the treatment of adherent shoulder periarthritis. Methods 90 patients with periarthritis of shoulder were randomly divided into two groups: the experimental group (n = 45) was treated with acupuncture and knife combined with manual release, and the control group (n = 45) was treated with traditional acupuncture and massage. According to the diagnostic criteria established in the second National Symposium on Periarthritis of shoulder, the curative effect was evaluated. Visual Analogue score was used to evaluate the degree of shoulder pain. The modified Constant-Murley functional score was used to evaluate the shoulder function before and after treatment, including daily functional activities, shoulder motion and muscle strength. The changes of clinical symptom indexes before and after treatment were analyzed, including the score of VAS and the score of functional activities of shoulder joint. The effective rate of each group was calculated. SPSS statistical analysis software was used for data analysis. Result 1. After treatment, the scores of VASA ADL rom MMT in the two groups were optimized as compared with those before treatment, and the difference was statistically significant (P 0.05). 2. After treatment, the scores of VAS-ADLL ROM in the two groups were compared, the difference between the two groups was statistically significant (p0.05), and the improvement of the scores in the experimental group was better than that in the control group (.3.) After treatment, there was no significant difference in MMT score between the two groups (p 0.05. 4). In clinical effect, 32 cases were cured, 8 cases were improved, 3 cases were ineffective, and the effective rate was 93.02% in the experimental group, while in the control group, 25 cases were cured, 11 cases were improved, 6 cases were ineffective, and the effective rate was 85.71%. The difference of curative effect between the two groups was statistically significant (p 0.05), and the curative effect of the experimental group was better than that of the control group. Conclusion 1. The treatment of adherent shoulder periarthritis with needle knife technique combined with manipulation is effective and superior to that of traditional acupuncture and massage therapy. The needle knife technique can effectively relieve the adhesion and contracture of periarthritis of shoulder tissue. Stimulate the local nerves and improve the metabolism of microcirculation, reduce inflammation. On this basis, manual release can increase the effect of loosening adhesion. The combination of the two can significantly improve the patient's limited activity, pain clinical symptoms and improve the patient's quality of life.
【學(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.9

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