三联疗法治疗膝骨性关节炎80例临床疗效观察

目的观察三联疗法治疗膝骨性关节炎的临床疗效。方法对 80例膝骨性关节炎患者给予三联治疗 ,即透明质酸钠关节腔内注射、关节周围痛点阻滞麻醉和针刀松解关节周围软组织。结果患者的膝关节疼痛症状明显好转 ,运动功能明显提高 ,治疗有效率 98.3 %。结论三联疗法治疗膝骨性关节炎疗效可靠 ,不破坏关节结构 ,无严重后遗症     

针刀松解疗法治疗膝骨性关节炎的临床研究

对60例经X线片确诊为膝骨性关节炎(OA)的患者,给予关节周围痛点阻滞麻醉,4#针刀纵行切割剥离手法做关节周围局部松解治疗。采用视觉类比测试法(VAS)及关节活动功能评分法进行评分。除1例效果不明显外,59例膝关节疼痛症状明显好转,发现明显副反应。     

针刀改善重症膝关节骨性关节炎关节僵直

膝关节骨性关节炎(OA)发病率高,既往对其确切病因了解不多,治疗上除了对症、缓解症状及人工关节置换外,目前缺乏有效的治疗方法。以外因造成膝关节内力学平衡失调是骨性关节炎的基本病理机制这一理论为根据,应用针刀闭合松解+膝关节间断主动活动治疗严重膝关节骨性关节炎粘连164例,有效率100%,膝关节活动度平均改善105°。     

针刀松解疗法治疗膝骨性关节炎的临床研究

对60例经X线片确诊为膝骨性关节炎(OA)的患，给予关节周围痛点阻滞麻醉，4#针刀纵行切割剥离手法做关节周围局部松解治疗。采用视觉类比测试法(VAS)及关节活动功能评分法进行评分。除1例效果不明显外，59例膝关节疼痛症状明显好转，发现明显副反应。     

针刀改善重症膝关节骨性关节炎关节僵直

膝关节骨性关节炎（OA）发病率高，既往对其确切病因了解不多，治疗上除了对症、缓解症状及人工关节置换外，目前缺乏有效的治疗方法。以外因造成膝关节内力学平衡失调是骨性关节炎的基本病理机制这一理论为根据，应用针刀闭合松解+膝关节间断主动活动治疗严重膝关节骨性关节炎粘连164例，有效率100%，膝关节活动度平均改善105&;#176;     

针刀配合透明质酸钠关节内注射治疗膝骨性关节炎疗效观察

骨性关节炎（osteoarthritis,OA）是一种发生在关节部位以关节软骨退变为主要病理特征的疾病。膝关节是骨性关节炎好发部位,膝骨性关节炎以关节软骨退变、膝关节周围疼痛、肿胀、跛行、伸屈受限,X线摄片示“骨质增生”为主要特征,治愈较困难。本次研究采用针刀配合透明质酸钠（sodium hyaluronate．SH）关节内注射治疗膝关节骨性关节炎,取得满意效果,现报道如下。     

三种疗法治疗膝关节骨性关节炎的疗效评价与机制探讨

目的：观察三种疗法对膝关节骨性关节炎的临床疗效。方法：将120例膝关节骨性关节炎患者随机分为针刀组、熨疗组和理疗组，三组病例均以手法治疗为基础，针刀组以小针刀针刺松解；熨疗组以中草药熨；理疗组以红外线照射，以症状、体征为观察指标，评价各组近、远期疗效。结果：三种保守疗法对膝关节骨性关节炎均有一定的疗效，其近期疗效由高到低依次为：针刀组>熨疗组>理疗组；远期疗效：针刀组优于熨疗组和理疗组，并较熨疗组和理疗组更能改善膝关节骨性关节炎的局部症状和体征。结论：小针刀疗法在这三种疗法中具有起效快、疗效稳定的特点，值得进一步研究。     

五指体表定位法对确定KOA针刀治疗点的指导作用

目的：探讨五指体表定位法对确定针刀治疗点的指导作用。方法：膝关节骨性关节炎患者70例，均采用五指体表定位法定位，针刀整体松解治疗，每周1次。结果：治疗3～6次，随访4～6个月，70例患者中痊愈18例，显效35例，有效15例，无效2例，总有效率97．1％。结论：五指体表定位法可准确确定治疗点处的解剖结构，为针刀精确松解病变处的粘连瘢痕创造较好条件。     

经筋理论在膝关节骨性关节炎发病机制及治疗中的作用

膝关节骨性关节炎（osteoarthritis,OA）是一种常见的慢性关节疾病．其主要病变是关节软骨的退行性变和继发性骨质增生．临床上因严重的疼痛和膝关节功能障碍而备受关注。本病多见于中老年人。是影响中老年人生存质量的重要因素。现阶段的康复治疗主要包括药物治疗、非药物治疗和手术治疗三大类。近年来。中医对其研究不断深入．在中医《内经》经筋学理论指导下的针灸推拿及针刀等疗法是膝关节骨性关节炎康复治疗的重要手段。     

关节镜配合膝关节周围针刀松解治疗退行性骨关节炎的临床效果

目的观察关节镜配合膝关节周围针刀松解治疗退行性骨关节炎(DOA)的临床效果。方法将86例DOA患者根据手术方案分为联合组(n=43,关节镜配合膝关节周围针刀松解治疗)与针刀组(n=43,膝关节周围针刀松解治疗)。比较两组的临床效果。结果联合组的治疗优良率高于针刀组(P<0.05)。联合组的关节疼痛缓解时间、关节肿胀缓解时间及关节活动功能恢复时间均短于针刀组(P<0.05)。术后6个月,联合组的疼痛、关节功能、僵硬评分均低于针刀组,物质生活状态、心理功能、躯体功能、社会功能评分均高于针刀组(P<0.05)。结论关节镜配合膝关节周围针刀松解治疗DOA患者的临床效果显著,可有效恢复患者关节功能,提高生活质量。     

痛风性膝关节炎治疗方法及效果比较

目的探讨不同治疗方法对痛风性膝关节炎的治疗效果。方法自2001年2月一2006年2月共收治29例痛风性膝关节炎患者，对8例痛风性关节炎患者采取药物保守治疗，7例行关节冲洗术治疗，14例行关节镜手术治疗。术后常规坚持正规的降尿酸治疗。结果经保守治疗及行关节冲洗术治疗组不能发现关节内结构的病变情况及采取相应治疗措施阻止关节内结构的损伤，随访发现关节症状好转不明显。14例关节镜手术患者术后症状均明显缓解，关节功能有良好的恢复，伤口均甲级愈合，术后无并发症出现。随访关节功能良好。结论比较以上3种治疗方法，关节镜治疗痛风性膝关节炎具有起效快、效果明显、关节功能恢复满意等特有优势，结合药物治疗，能取得良好的治疗效果。     

青岛地区自然疗养因子结合运动疗法对关节病的康复作用

目的研究青岛海滨疗养因子结合运动疗法对疗养员关节疾病的康复作用。方法选择320例有关节疼痛疾病的疗养员,其中特勤疗养员224例,干部疗养员96例,给予青岛海滨疗养因子结合运动疗法平均治疗4周,观察治疗前后关节疼痛缓解程度。结果 320例关节疼痛患者痊愈39例,好转251例,无效30例,总有效率90.6%。结论海滨自然疗养因子结合运动疗法可有效减轻关节疼痛症状,改善关节功能。     

骨关节炎的物理治疗进展

骨关节炎是发生在骨关节的一种慢性退行性疾病。目前,对于骨关节炎的治疗方法较多,大体可分为手术治疗和非手术治疗;非手术治疗又包括合理的休息与功能锻炼、药物治疗、物理治疗、运动疗法、注射疗法以及中医治疗等。其中,作为一种无创伤无痛苦的治疗方式,物理因子(如红外线、磁场等)治疗骨关节软组织损伤,可以有效缓解症状和体征,并改善功能、矫正畸形;对于患者来说易于接受,切实可行。通过动物实验,施加相应的物理治疗于骨关节炎的动物模型,就可以更加清晰地了解本病的发生发展过程,为临床推广应用提供实验参考。     

Damage control in rheumatoid arthritis

PREVIEW

Right from the onset, rheumatoid arthritis is an aggressive disease that can quickly alter joint structure and integrity. Such rapid pathogenesis requires that the diagnosis be established early and aggressive therapy initiated swiftly. In this article, Drs Issa and Ruderman describe what is known about the cause, progression, and outcomes of rheumatoid arthritis. They review the steps toward its diagnosis and urge that treatment be started promptly—to both contain disease and reduce joint destruction as soon as possible.     

Shoulder osteoarthritis: diagnosis and management

Osteoarthritis of the shoulder is a gradual wearing of the articular cartilage that leads to pain and stiffness. As the joint surface degenerates, the subchondral bone remodels, losing its sphericity and congruity. The joint capsule also becomes thickened, leading to further loss of shoulder rotation. This painful condition is a growing problem in the aging population. In most cases, diagnosis of degenerative joint disease of the shoulder can be made with careful history, physical examination, and radiography. The symptoms and degree of shoulder arthritis visible on radiography determine the best treatment option. Mild degenerative joint disease can be treated with physical therapy and over-the-counter anti-inflammatory medications such as acetaminophen or nonsteroidal anti-inflammatory drugs. More advanced cases of osteoarthritis that are refractory to nonoperative management can be managed with corticosteroid injections. In severe cases, surgery is indicated. Surgical options include arthroscopic debridement, arthroscopic capsular release, and, in the most severe instances, hemiarthroplasty or total shoulder arthroplasty.     

Damage control in rheumatoid arthritis. Hard-hitting, early treatment is crucial to curbing joint destruction

Right from the onset, rheumatoid arthritis is an aggressive disease that can quickly alter joint structure and integrity. Such rapid pathogenesis requires that the diagnosis be established early and aggressive therapy initiated swiftly. In this article, Drs Issa and Ruderman describe what is known about the cause, progression, and outcomes of rheumatoid arthritis. They review the steps toward its diagnosis and urge that treatment be started promptly--to both contain disease and reduce joint destruction as soon as possible.     

The painful shoulder: when to inject and when to refer

Physicians can usually diagnose the cause of shoulder pain by performing a focused history and physical examination and ordering anteroposterior and lateral radiographs. Treatment depends on the cause and can include physical therapy, injections of corticosteroids into the joint space or bursa, and surgery. This paper reviews the diagnosis and treatment of impingement syndrome, adhesive capsulitis, rotator cuff tears, and arthritis of the glenohumeral joint and acromioclavicular (AC) joint.     

A rationale for the treatment of back pain and joint pain by manual therapy.

Manual therapy, with its emphasis on joint movement and exercise, has become increasingly important for the treatment of pain and dysfunction of the musculoskeletal system. The rationale used to explain the success of manual therapy has changed radically in recent years. Early explanations, which included concepts such as adjusting joint subluxations, restoring bony alignment, and reducing nuclear protrusion, have been shown to have no basis in fact. Current biological research shows the value of movement in maintaining the health and strength of collagenous, muscular, and bony tissues and emphasizes the need for joint movement and for relatively high levels of activity throughout the life cycle. The musculoskeletal system thrives on stress and movement and reacts adversely to prolonged rest or immobilization. The problems associated with working or recreational postures involving prolonged loading at or near the limit of joint range of motion are considered together with a rationale for appropriate therapeutic management. Explanations are provided to enable an understanding of the success of intensive physical therapy for chronic back pain and for manipulation in the treatment of the acute painful locked back.     

Sph��re odontognathique et th��rapies manuelles

Orofacial pathologies are not only temporomandibular joint disorders and may be treated by manual therapy. Constraints caused by orthodontics treatment and temporomandibular joint traumatism can be controlled as well. Manual therapy has to be considered as a way to reinitialize muscle, joint and skin transducers. The main error signal is coming from muscles, which is the major part of the myofascial pain syndrome. The most efficient therapeutic approach is multidisciplinary, including orthodontics, occlusion, oral surgery and manual therapy.     

腰椎小关节不对称与小关节综合征关系CT研究

目的：本文对84例临床诊断为腰椎小关节综合征病例的临床、CT资料进行了回顾性分析。CT能够清晰地显示椎小关节增生肥大、骨赘形成、关节间隙狭窄、关节对合不良、关节面改变、关节面倾角异常等椎小关节病变,特别能发现小关节的不对称现象及其并存症;探讨了腰椎小关节综合征与小关节不对称的相关机理,提出小关节不对称是引起本征的重要原因之一。CT对小关节不对称发现及本征的诊断和临床治疗具有重要价值。