雷火灸联合双柏散外敷治疗轻中度膝骨关节炎疗效观察
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摘要
目的:比较雷火灸联合双柏散外敷与单纯雷火灸治疗轻中度膝骨关节炎的疗效。方法:将70例轻中度膝骨关节炎患者随机分为观察组与对照组,每组35例。观察组采用雷火灸联合双柏散外敷治疗,雷火灸取穴为血海、梁丘、内膝眼、阳陵泉及阿是穴,在雷火灸治疗完成后对患膝行双柏散外敷;对照组采用单纯雷火灸治疗,均每日1次,7 d为一疗程,疗程间休息1 d,连续观察4个疗程。采用疼痛视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表评分对两组患者治疗前后膝关节疼痛、僵硬、日常活动功能进行评价,并评定两组疗效。结果:两组治疗后VAS评分、WOMAC总分及疼痛、僵硬、日常活动功能各分项评分均较治疗前下降(均P<0.01);治疗后观察组以上各项评分均低于对照组(P<0.01,P<0.05);观察组总有效率为97.0%(32/33),优于对照组的91.2%(31/34,P<0.05)。结论:雷火灸联合双柏散外敷在改善轻中度膝骨关节炎患者症状及延缓病情发展方面效果优于单纯雷火灸治疗。
Objective To compare the therapeutic effect between thunder-fire moxibustion combined with external applicaion of Shuangbai powder and thunder-fire moxibustion alone for mild and moderate knee osteoarthritis. Methods A total of 70 patients with mild and moderate knee osteoarthritis were randomly divided into an observation group and a control group, 35 cases in each group. In the observation group, thunder-fire moxibustion combined with external applicaion of Shuangbai powder were applied, Thunder-fire moxibustion was applied at Xuehai(SP 10), Liangqiu(ST 34), Neixiyan(EX-LE 4), Yanglingquan(GB 34) and ashi point, external applicaion of Shuangbai powder was given to the affected knee after the treatment of thunder-fire moxibustion. Simple thunder-fire moxibustion was given in the control group. All patients in the two groups were treated once a day, 7 days as one course and the consecutive 4 courses were required, with an interval of 1 day between courses. Before and after treatment, the visual analogue scale(VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) score were used to assessed knee pain, stiffness and physical function in the two groups. In addition, the efficacy was evaluated. Results Compared before treatment, the VAS scores, total scores of WOMAC, pain scores, stiffness scores and physical function scores were reduced after treatment in the two groups(P<0.01), and the scores in the observation group were significantly lower than those in the control group(P<0.01, P<0.05). The total effective rate was 97.0%(32/33) in the observation group, which was superior to 91.2%(31/34) in the control group(P<0.05). Conclusion Thunder-fire moxibustion combined with external applicaion of Shuangbai powder are superior to simple thunder-fire moxibustion in improving the symptoms and delaying the development of the disease for mild and moderate knee osteoarthritis.
Objective To compare the therapeutic effect between thunder-fire moxibustion combined with external applicaion of Shuangbai powder and thunder-fire moxibustion alone for mild and moderate knee osteoarthritis. Methods A total of 70 patients with mild and moderate knee osteoarthritis were randomly divided into an observation group and a control group, 35 cases in each group. In the observation group, thunder-fire moxibustion combined with external applicaion of Shuangbai powder were applied, Thunder-fire moxibustion was applied at Xuehai(SP 10), Liangqiu(ST 34), Neixiyan(EX-LE 4), Yanglingquan(GB 34) and ashi point, external applicaion of Shuangbai powder was given to the affected knee after the treatment of thunder-fire moxibustion. Simple thunder-fire moxibustion was given in the control group. All patients in the two groups were treated once a day, 7 days as one course and the consecutive 4 courses were required, with an interval of 1 day between courses. Before and after treatment, the visual analogue scale(VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) score were used to assessed knee pain, stiffness and physical function in the two groups. In addition, the efficacy was evaluated. Results Compared before treatment, the VAS scores, total scores of WOMAC, pain scores, stiffness scores and physical function scores were reduced after treatment in the two groups(P<0.01), and the scores in the observation group were significantly lower than those in the control group(P<0.01, P<0.05). The total effective rate was 97.0%(32/33) in the observation group, which was superior to 91.2%(31/34) in the control group(P<0.05). Conclusion Thunder-fire moxibustion combined with external applicaion of Shuangbai powder are superior to simple thunder-fire moxibustion in improving the symptoms and delaying the development of the disease for mild and moderate knee osteoarthritis.
引文
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[6]李泰标,谢洪武,吴伟,等.雷火灸配合宣氏压痛点强刺激推拿治疗腰腿痛的疗效[J].中国老年学杂志, 2015, 35(24):7133-7135.
[7]庞贤妹.双柏散外敷结合针刺疗法治疗运动性腰肌劳损的临床疗效研究[D].广州:广州中医药大学, 2017.
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[11]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社, 2002:130-131.
[12]刘奇.针刺结合雷火灸治疗膝骨性关节炎(阳虚寒凝型)的临床研究[D].长春:长春中医药大学, 2017.
[13]沈雪勇,丁光宏,褚君浩,等.传统艾灸与替代物灸和人体穴位红外辐射光谱比较[J].红外与毫米波学报, 2003, 22(2):123-126.
[14]赵时碧.中国雷火灸疗法[M].上海:上海远东出版社, 2008:40.
[15]杨华元,刘堂义.艾灸疗法的生物物理机制初探[J].中国针灸, 1996, 16(10):17-18.
[16]石典花,张军,张乐林,等.不同采集季节、地点侧柏叶饮片质量考察及药典相关标准的商榷[J].时珍国医国药, 2017,28(9):2124-2127.
[17]李丽,苗文静,王青.侧柏叶水煎液对耳廓炎症和腹腔炎症模型小鼠的抗炎作用[J].中国药房, 2015, 26(25):3515-3517.
[18]张清,白云静,纪泉,等.虎力散胶囊外敷治疗膝骨关节炎的有效性与安全性研究[J].中华关节外科杂志(电子版), 2015,9(5):603-607.
[2]陆艳红,石晓兵.膝骨关节炎国内外流行病学研究现状及进展[J].中国中医骨伤科杂志, 2012, 20(6):81-84.
[3]保琼楠,赵凌,周玉梅,等.艾灸治疗膝骨关节炎机制的国内外研究进展[J].针灸临床杂志, 2017, 33(1):76-78.
[4]林汉文.毫火针配合运动疗法治疗膝骨关节炎的疗效观察[D].广州:广州中医药大学, 2017.
[5]张华军,徐海东,刘婷婷,等.电针合雷火灸治疗寒湿痹阻型退行性膝关节炎临床研究[J].中国针灸, 2016, 36(12):1266-1270.
[6]李泰标,谢洪武,吴伟,等.雷火灸配合宣氏压痛点强刺激推拿治疗腰腿痛的疗效[J].中国老年学杂志, 2015, 35(24):7133-7135.
[7]庞贤妹.双柏散外敷结合针刺疗法治疗运动性腰肌劳损的临床疗效研究[D].广州:广州中医药大学, 2017.
[8]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中国临床医生杂志, 2008, 36(10):28-30.
[9] Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis[J]. Ann Rheum Dis, 1957, 16(4):494-502.
[10] Bellamy N, Buchanan WW, Goldsmith CH, 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].J Rheumatol, 1988, 15(12):1833-1840.
[11]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社, 2002:130-131.
[12]刘奇.针刺结合雷火灸治疗膝骨性关节炎(阳虚寒凝型)的临床研究[D].长春:长春中医药大学, 2017.
[13]沈雪勇,丁光宏,褚君浩,等.传统艾灸与替代物灸和人体穴位红外辐射光谱比较[J].红外与毫米波学报, 2003, 22(2):123-126.
[14]赵时碧.中国雷火灸疗法[M].上海:上海远东出版社, 2008:40.
[15]杨华元,刘堂义.艾灸疗法的生物物理机制初探[J].中国针灸, 1996, 16(10):17-18.
[16]石典花,张军,张乐林,等.不同采集季节、地点侧柏叶饮片质量考察及药典相关标准的商榷[J].时珍国医国药, 2017,28(9):2124-2127.
[17]李丽,苗文静,王青.侧柏叶水煎液对耳廓炎症和腹腔炎症模型小鼠的抗炎作用[J].中国药房, 2015, 26(25):3515-3517.
[18]张清,白云静,纪泉,等.虎力散胶囊外敷治疗膝骨关节炎的有效性与安全性研究[J].中华关节外科杂志(电子版), 2015,9(5):603-607.