【摘要】：目的:本研究旨在觀察利用中藥熏洗配合CPM機(jī)功能鍛煉對改善脛骨平臺骨折術(shù)后膝關(guān)節(jié)功能的臨床療效,并為臨床上治療脛骨平臺骨折術(shù)后關(guān)節(jié)僵硬提供真實(shí)可靠的臨床資料和數(shù)據(jù)支持。方法:分析自2014年6月至2015年8月期間,根據(jù)基本的診斷指標(biāo),經(jīng)過納入和排除方法,選取的44例脛骨平臺骨折術(shù)后患者。本課題將44例脛骨平臺骨折術(shù)后患者分為2組,即治療組和對照組。治療組采用中藥熏洗合CPM機(jī)功能鍛煉,對照組單純采用CPM機(jī)功能鍛煉。兩組患者給予相應(yīng)的術(shù)后處理,且均在術(shù)后1周開始進(jìn)行CPM機(jī)功能鍛煉直至出院,出院后繼續(xù)自主功能鍛煉指導(dǎo)。術(shù)后2周,傷口愈合拆線后除了CPM機(jī)功能鍛煉,治療組給予患肢中醫(yī)骨傷熏洗湯熏洗治療。對兩組患者進(jìn)行住院觀察及門診隨訪,并記錄住院天數(shù)、膝關(guān)節(jié)腫脹程度及活動度、膝關(guān)節(jié)HSS評分、VAS評分等,將數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,比較兩組之間的差異有無統(tǒng)計(jì)學(xué)意義。結(jié)果:1、中藥熏洗組和對照組在住院天數(shù)方面的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2、中藥熏洗組和對照組在術(shù)后2周在腫脹程度上無統(tǒng)計(jì)學(xué)差異(P0.05),經(jīng)過治療后,術(shù)后4周兩組在消腫程度上有明顯的差異,中藥熏洗組明顯優(yōu)于對照組。3、中藥熏洗組和對照組在術(shù)后半年在膝關(guān)節(jié)活動度上有明顯差異,中藥熏洗組明顯優(yōu)于對照組。4、中藥熏洗組和對照組在術(shù)后半年在膝關(guān)節(jié)HSS評分及VAS評分上有明顯差異,中藥熏洗組明顯優(yōu)于對照組。結(jié)論:脛骨平臺骨折術(shù)后在改善局部癥狀、促進(jìn)功能恢復(fù)方面,采用中藥熏洗治療結(jié)合CPM機(jī)功能鍛煉的治療組療效優(yōu)于僅僅采用CPM機(jī)功能鍛煉的對照組。在膝關(guān)節(jié)腫脹程度、活動度、膝關(guān)節(jié)VAS評分和HSS評分方面,治療組的中藥熏洗結(jié)合CPM機(jī)功能鍛煉優(yōu)于對照組的單純使用CPM機(jī)功能鍛煉。由此我們認(rèn)為中藥熏洗配合CPM機(jī)功能鍛煉應(yīng)用于脛骨平臺骨折術(shù)后康復(fù)治療有較好的臨床療效,能夠提高患者的生活質(zhì)量,具有一定的應(yīng)用及推廣價值。
[Abstract]:Objective: to observe the clinical effect of Chinese medicine fumigation combined with CPM machine function exercise on the improvement of knee joint function after tibial plateau fracture. And to provide reliable clinical data and data for the treatment of tibial plateau fracture joint stiffness. Methods: from June 2014 to August 2015, 44 patients with tibial plateau fracture were selected according to the basic diagnostic index and the exclusion method. In this study, 44 patients with tibial plateau fracture were divided into two groups: treatment group and control group. The treatment group was treated with traditional Chinese medicine fumigation and washing combined with CPM machine function exercise, while the control group was only treated with CPM machine function exercise. The patients in both groups were given corresponding postoperative treatment, and all of them underwent CPM machine function exercise until discharge from hospital, and continued to exercise independently after discharge from hospital. 2 weeks after operation, the treatment group was treated with fumigation and washing decoction of traditional Chinese medicine bone injury in the treatment group, except for the function exercise of CPM machine after wound healing and thread removal. The inpatient observation and outpatient follow up of the two groups were carried out, and the days of hospitalization, the degree of knee joint swelling and movement, the knee joint HSS score and the VAS score were recorded. The data were analyzed statistically to compare the difference between the two groups. Results: 1. There was no significant difference in the length of hospitalization between the Chinese medicine fumigation group and the control group (P0.05). 2. There was no significant difference in the swelling degree between the traditional Chinese medicine fumigation group and the control group 2 weeks after operation (P0.05). At 4 weeks after operation, there were significant differences in the degree of swelling reduction between the two groups, the traditional Chinese medicine fumigation group was obviously superior to the control group, the traditional Chinese medicine fumigation group and the control group had obvious difference in knee joint motion at half a year after operation, and the traditional Chinese medicine fumigation group was obviously superior to the control group. The HSS score and VAS score of knee joint were significantly different between the traditional Chinese medicine fumigation group and the control group half a year after operation, and the traditional Chinese medicine fumigation group was better than the control group. Conclusion: in the aspect of improving the local symptoms and promoting the recovery of function after tibial plateau fracture, the curative effect of the treatment group treated with traditional Chinese medicine fumigation combined with CPM machine function exercise is better than that of the control group only using CPM machine function exercise. In terms of knee swelling degree, range of motion, VAS score and HSS score of knee joint, the Chinese medicine fumigation combined with CPM machine function exercise in the treatment group was better than that in the control group. It is concluded that fumigation and washing combined with functional exercise of CPM machine can improve the quality of life of patients with tibial plateau fracture.
【學(xué)位授予單位】：湖北中醫(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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