针刀治骨性关节炎的临床研究.ppt
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1、针刀治疗骨性关节炎的临床研究,北京中医药大学Beijing Traditional Chinese Medicine University,Clinical Results in Treatment of Osteoarthritis with acupotome,朱汉章Zhu Hanzhang MD Professor,针 刀 医 学 简 介Brief Introduction Of Acupotomology,针刀医学是将中医和西医的部分基础理论融合为一体,再创造而形成的一种新的医学理论体系。 Acupotomology, a fusion of the basic theories of
2、 traditional Chinese and modern western medicine, has formed a complete system of medical science. This is a revolution in the medical field. Moreover, it symbolizes a new era in the medical science.,针刀医学的四个基础理论,闭合性手术理论 Closed surgery the theory concerning . 慢性软组织组织损伤病因、病理学理论 The theory concerning t
3、he etiology and pathology of chronic lesions to soft tissues.,Basic Theory,骨质增生新的病因学理论 The theory concerning the etiology and pathology of abnormal bony growths 关于经络实质的一些新认识 The theory concerning the essence of channels and collaterals of traditional chinese medicine,六 大 组 成 部 分,Basic Contents,针刀医学的
4、病理生理学Physiopathology of Acupotomology,针刀医学的手法学Manipulation of Acupotomology,针刀医学的影像学Imageology of Acupotomology,针刀医学的护理学Nursing science of Acupotomology,针刀医学的诊断学Diagnostics of Acupotomology,针刀医学的治疗学Therapeutics of Acupotomology,骨性关节炎是以关节面关节软骨破坏、新骨增生为特征的慢性关节病。本病发病率随年龄增长而增高。felson等报告,70岁以下和80岁以上人群的膝骨性
5、关节炎患病率分别为7.0%和11.2% Butter等报告,44岁以下,45-59岁和60岁以上三组人群中,X线片骨性关节炎的患病率分别为6.2%、21.6%和42.0%。,各年龄阶段患膝骨性关节炎的概况,Osteoarthritis is characterized with the injury of joint soft bone and hyperplasia of new bone. The disease is more likely to happen with age increasing .Felson et al 7% in people under 70 years ol
6、d and 11.2% over 80 years old. Butter etc 6.2%,21.6%,42% among people under 44 ,between 45-59 and over 60 years old respectively.,针刀医学提出了“骨性关节炎的发病原因是关节内的力平衡被破坏,使关节周围软组织附着处应力增高所致”的理论。本实验根据此理论应用针刀疗法治疗骨性关节炎,以进一步研究该病的病因和机理,为临床治疗骨性关节炎提供新的思路.,Acupotomology raised the theory that the cause of osteoarthriti
7、s is the force unblance of joint and the increased stress in the attachment point of soft tissue around the joint. The increased stress injured the ligament, and caused the edema and inflammation in the joint .on the other hand,it increased the osteogenesis metabolism and formed spurs.,136例患者中,男性43例
8、,女性93例,年龄41-72岁。病程2-5年54例,6-10年32例。11年以上50例。双膝罹患者87例,单膝罹患者49例。,136 patients,43 male cases and 93 female cases with age between 41-72 years.Course of disease:2-5 years of 32 cases,over 11 years 50 cases. 87 patients suffered from two knees and 49 patients suffered from one knee.,将136例患者随机分为针刀治疗组(I组)和
9、药物治疗组即对照组(II组)作 1 :1 配对观察。 136 patients were randomly devided into acupotome treatment group ( group I ) and drug Treatment group (Group II).,I组中男性23例,女性45例,年龄41岁至69岁间,双膝罹患者47例,单膝罹患者21例。 In group I:23 male,45 female cases aged between 41-69 years.47 cases suffered from two knees and 21 cases suffere
10、d from one knee. II组中男性20例,女性48例,年龄在45至72岁之间双膝罹患者40例,单膝罹患者28例。 In group II:20 male,48female cases aged between 45-72 years.40 cases suffered from two knees and 29 cases suffered from one knee.,关节疼痛 (Joint pain ) 早期可无症状或有轻度关节疼痛,晚期出现骨刺则疼痛明显。关节僵直 (Joint rigidity) 早期可有晨起关节僵直,或久坐起立时感觉关节僵直。晚期关节受限甚至强直。实验室检
11、查( Laboratory test) 类风湿因子阴性、血沉、抗“O”正常。,X 线 检 查(X-ray test),中枢型( Central Form )可见脊柱小关节有骨赘形成,椎体前缘唇样增生。There are osteophyte formations of small joint of spine, the lip-like hyperplasia occurs in anterior margin of vertebral body.,外周型 (Peripheral form)早期可见骨端软骨增生,后期骨质增生明显,形成骨赘或骨刺。The cartilage hyperplasi
12、a of epiphysis may occur in early stage, afterwards the cartilage hyperplasia occurs and osteophyte or spurs were formed.,针刀治疗,患者仰卧屈膝,应用针刀对膝关节髌骨周围、髌上囊、髂下囊、髌下脂肪垫、交叉韧带、髁间嵴和内外侧副韧带及股二头股、半腱肌、半膜肌、髂胫束等附着点处压痛点及骨质增生处的变性、结疤、粘连及挛缩的软组织进行切开松解。Patients were resumed supine position and bent the joint knees. It was
13、 operated on the pain points of patella, suprapatellar bursa, infrapatellar bursa,infrapatellar fat pad, cruciate ligaments,intermal-leolar crest and medio-lateral accessory ligaments around the knee joint and attachment points of biceps muscle of thigh, semitendinous muscle,semimembronous muscle, i
14、liotibial tract, and sites of hyperosteogeny.,外 手 法 治 疗 External manipulation treatment,所有患者均接受该辅助治疗.患者仰卧,应用牵拉晃膝法、牵拉旋膝法、过屈和过伸膝关节和牵引状态下的推弹等手法,将膝内翻或处翻畸形或屈伸功能障碍给予校正,使膝关节内外恢复正常的力学 状态。Patients were adopted this treatment in two groups. Patient lies on own back and with applying of pull and rotation of th
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- 针刀治骨性 关节炎 临床 研究
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