针刀操作“三法”结合治疗膝骨性关节炎
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摘要
目的:探讨针刀操作"三法"结合治疗膝骨性关节炎的临床疗效。方法:由第三方将60例膝骨性关节炎患者遵循完全随机设计的原则,分为治疗组和对照组,每组30例。治疗组采用针刀操作"三法"结合方法,对照组采用针灸疗法。分别进行为期6周临床干预。治疗6周后对膝关节Kellgren&LawreneeX线分级、膝关节疼痛视觉模拟评分法(visual analogue scale,VAS)评分、膝关节骨性关节炎自评量表(western Ontario and me-master university osteoarthritis index,WOMAC)评分和总体有效率进行统计学分析。结果:两组治疗前后Kellgren&LawreneeX线分级比较,差异无统计学意义(P>0.05);两组治疗前后膝关节VAS评分、WOMAC评分比较,差异有统计学意义(P<0.05);治疗组有效率为96.66%,对照组为90.00%。结论:两种治疗方法对膝骨性关节炎患者的放射学表现无显著影响,但针刀"三法"结合和针灸对缓解膝骨性关节炎患者膝关节的疼痛、功能障碍和症状改善方面均有治疗作用,且针刀"三法"结合优于针灸组。
Objective:To explore the clinical efficacy of "three methods" combination of acupuncture operation in treatment of knee osteoarthritis.Methods:Sixty patients with knee osteoarthritis were randomized to a treatment group and a control group,with 30 patients in each group.The treatment group used a needle knife to operate the "three methods" combination method,and the control group used acupuncture therapy.A 6-week clinical intervention was performed.Kellgren & Lawrenee X-ray grading,knee analogue pain visual analogue scale(VAS) score,and Western Ontario and me-master university osteoarthritis index(WOMAC) after 6 weeks of treatment Scores and overall effectiveness were statistically analyzed.Results:There was no significant difference in Kellgren&Lawrenee X-ray grading before and after treatment between the two groups(P>0.05).There was significant difference in the VAS pain score and WOMAC function score between the two groups before and after treatment(P<0.05).The effective rate of the group was 96.66%,and that of the acupuncture group was 90.00%.Conclusion:The two treatment methods have no significant effect on the radiological performance of patients with knee osteoarthritis;however,the combination "three methods" of acupuncture have alleviated the pain,dysfunction and symptoms of knee joint in patients with knee osteoarthritis.The efficiency has a therapeutic effect,and the combination of the "three methods" of needle knife is better than that of the acupuncture group.
Objective:To explore the clinical efficacy of "three methods" combination of acupuncture operation in treatment of knee osteoarthritis.Methods:Sixty patients with knee osteoarthritis were randomized to a treatment group and a control group,with 30 patients in each group.The treatment group used a needle knife to operate the "three methods" combination method,and the control group used acupuncture therapy.A 6-week clinical intervention was performed.Kellgren & Lawrenee X-ray grading,knee analogue pain visual analogue scale(VAS) score,and Western Ontario and me-master university osteoarthritis index(WOMAC) after 6 weeks of treatment Scores and overall effectiveness were statistically analyzed.Results:There was no significant difference in Kellgren&Lawrenee X-ray grading before and after treatment between the two groups(P>0.05).There was significant difference in the VAS pain score and WOMAC function score between the two groups before and after treatment(P<0.05).The effective rate of the group was 96.66%,and that of the acupuncture group was 90.00%.Conclusion:The two treatment methods have no significant effect on the radiological performance of patients with knee osteoarthritis;however,the combination "three methods" of acupuncture have alleviated the pain,dysfunction and symptoms of knee joint in patients with knee osteoarthritis.The efficiency has a therapeutic effect,and the combination of the "three methods" of needle knife is better than that of the acupuncture group.
引文
[1]张霆,施杞.施杞教授系统性治疗膝骨关节病经验[J].中华中医药杂志,2014,29(3):760-762.
[2]王新军,沈明球,刘俊昌.膝关节骨性关节炎的病因研究现状[J].新疆中医药,2011,29(3):77-79.
[3]高树中.针灸治疗学[M].上海:上海科学技术出版社,2009:36.
[4]JACK FARR I I.MILLER L E,BLOCK J E.Quality of life in patients with knee osteoarthritis:a commentary on nonsurgical and surgical treatments[J].J Open Orthopaedics,2013,7:619-623.
[5]李明辉,刘洋,王彩民,等.盐酸氨基葡萄糖联合塞来昔布治疗膝骨性关节炎的随机对照[J].中国组织工程研究,2013,17(43):7654-7660.
[6]MARICAR N,CALLAGHAN M J,FELSON D T,et al.Predictors of response to intra-articular steroid injections in knee osteoarthritis-a systematic review[J].Rheumatology,2013,52(6):1022-1032.
[7]李丽,李宁,吴滨.针灸治疗膝关节骨性关节炎的文献计量学分析[J].中国针灸,2007,27(11):862-864.
[8]KELLGREN J H,LAWRENCE J S.Rasiological assessment of osteoarthritis[J].Ann Rheum Dis,1957,16:494-502.
[9]MANDELL B F,LIPANI J.Refractory osteoarthritis.Differential diagnosis and therapy[J].Rheumatic Diseases Clinics of North America,1995,21(1):163.
[10]韦贵康,施杞.实用中医骨伤科学[M].上海:上海科学技术出版社,2006:624-627.
[11]沈雪勇,许能贵.经络腧穴学[M].北京:人民卫生出版社,2012.
[12]石学敏.针灸学[M].北京:中国中医药出版社,2006.
[13]李瑞国,王占有.针刀操作的指法、刀法与心法[J].河南中医,2017,37(9):1651-1653.
[14]王占有.针刀治疗股骨头缺血性坏死的meta分析与临床诊疗操作推荐方案的文献研究[D].南宁:广西中医药大学,2017.
[15]BELLAMY N,BUCHANAN W W,GOLDSMITH C H,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].Rheumatol,1988,15(12):1833-1840.
[16]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:349-353.
[17]丰哲,闫腾龙,韦坚.韦贵康分期辨证治疗膝骨性关节炎[J].中华中医药杂志,2014,29(7):2234-2237.
[18]谭其琛.NX-DJ01智能电子针灸系统电针治疗膝骨性关节炎的临床研究[D].广州:广州中医药大学,2014.
[19]张金禄,叶丽红,刘喜德,等.蜂针疗法治疗膝骨性关节炎86例疗效观察[J].中国中医药科技,2011,18(2):144-145.
[20]张耀昌.温针灸配合中药治疗膝骨性关节炎的临床研究[D].广州:广州中医药大学,2010.
[21]HOLSERBAUM D,HAQQI T M.Genetics and osteoarthritis.Exposing the iceberg[J].Arth itis Rheum,1999,42:397-405.
[22]卢亮宇,王予彬.膝骨关节炎疼痛机制及治疗研究现状[J].中国运动医学杂志,2007,26(4):512-514.
[2]王新军,沈明球,刘俊昌.膝关节骨性关节炎的病因研究现状[J].新疆中医药,2011,29(3):77-79.
[3]高树中.针灸治疗学[M].上海:上海科学技术出版社,2009:36.
[4]JACK FARR I I.MILLER L E,BLOCK J E.Quality of life in patients with knee osteoarthritis:a commentary on nonsurgical and surgical treatments[J].J Open Orthopaedics,2013,7:619-623.
[5]李明辉,刘洋,王彩民,等.盐酸氨基葡萄糖联合塞来昔布治疗膝骨性关节炎的随机对照[J].中国组织工程研究,2013,17(43):7654-7660.
[6]MARICAR N,CALLAGHAN M J,FELSON D T,et al.Predictors of response to intra-articular steroid injections in knee osteoarthritis-a systematic review[J].Rheumatology,2013,52(6):1022-1032.
[7]李丽,李宁,吴滨.针灸治疗膝关节骨性关节炎的文献计量学分析[J].中国针灸,2007,27(11):862-864.
[8]KELLGREN J H,LAWRENCE J S.Rasiological assessment of osteoarthritis[J].Ann Rheum Dis,1957,16:494-502.
[9]MANDELL B F,LIPANI J.Refractory osteoarthritis.Differential diagnosis and therapy[J].Rheumatic Diseases Clinics of North America,1995,21(1):163.
[10]韦贵康,施杞.实用中医骨伤科学[M].上海:上海科学技术出版社,2006:624-627.
[11]沈雪勇,许能贵.经络腧穴学[M].北京:人民卫生出版社,2012.
[12]石学敏.针灸学[M].北京:中国中医药出版社,2006.
[13]李瑞国,王占有.针刀操作的指法、刀法与心法[J].河南中医,2017,37(9):1651-1653.
[14]王占有.针刀治疗股骨头缺血性坏死的meta分析与临床诊疗操作推荐方案的文献研究[D].南宁:广西中医药大学,2017.
[15]BELLAMY N,BUCHANAN W W,GOLDSMITH C H,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].Rheumatol,1988,15(12):1833-1840.
[16]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:349-353.
[17]丰哲,闫腾龙,韦坚.韦贵康分期辨证治疗膝骨性关节炎[J].中华中医药杂志,2014,29(7):2234-2237.
[18]谭其琛.NX-DJ01智能电子针灸系统电针治疗膝骨性关节炎的临床研究[D].广州:广州中医药大学,2014.
[19]张金禄,叶丽红,刘喜德,等.蜂针疗法治疗膝骨性关节炎86例疗效观察[J].中国中医药科技,2011,18(2):144-145.
[20]张耀昌.温针灸配合中药治疗膝骨性关节炎的临床研究[D].广州:广州中医药大学,2010.
[21]HOLSERBAUM D,HAQQI T M.Genetics and osteoarthritis.Exposing the iceberg[J].Arth itis Rheum,1999,42:397-405.
[22]卢亮宇,王予彬.膝骨关节炎疼痛机制及治疗研究现状[J].中国运动医学杂志,2007,26(4):512-514.