针刀治疗骨性关节炎的临床研究.ppt
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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
针 刀 医 学 简 介
Brief Introduction Of Acupotomology
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 the etiology and pathology of chronic lesions to soft tissues.
六 大 组 成 部 分
Basic Contents
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
Acupotomology raised the theory that the cause of osteoarthritis 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.
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.
136例患者中,男性43例,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).
* 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。
* 实验室检查( Laboratory test) 类风湿因子阴性、血沉、抗"O"正常。
X 线 检 查
(X-ray test)
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 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, iliotibial 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 the knee, and over flexion and over extension of knee joint,under the traction condition ,to correct the genu valgum and genu valgum abnormalities and functional disorders of flexion and extension.
康 复 疗 法
Rehabilitation Therapy
* 治疗后三周内以间断性下肢牵引和自我锻练患肢屈伸功能为主。三周后下肢负重(1公斤沙袋)直腿抬高锻炼股四头肌收缩功能 ......
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
针 刀 医 学 简 介
Brief Introduction Of Acupotomology
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 the etiology and pathology of chronic lesions to soft tissues.
六 大 组 成 部 分
Basic Contents
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
Acupotomology raised the theory that the cause of osteoarthritis 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.
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.
136例患者中,男性43例,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).
* 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。
* 实验室检查( Laboratory test) 类风湿因子阴性、血沉、抗"O"正常。
X 线 检 查
(X-ray test)
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 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, iliotibial 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 the knee, and over flexion and over extension of knee joint,under the traction condition ,to correct the genu valgum and genu valgum abnormalities and functional disorders of flexion and extension.
康 复 疗 法
Rehabilitation Therapy
* 治疗后三周内以间断性下肢牵引和自我锻练患肢屈伸功能为主。三周后下肢负重(1公斤沙袋)直腿抬高锻炼股四头肌收缩功能 ......
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