基于“整体观念”推拿治疗膝骨关节炎的随机、阳性药平行对照临床研究
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摘要
目的观察在整体观念指导下,采用推拿手法治疗膝骨关节炎的临床疗效。方法将74例患者随机分为对照组与治疗组,每组37例。对照组予塞来昔布口服,治疗组予整体观念指导下的推拿疗法。两组疗程均为3周,观察临床疗效,比较WOMAC评分的变化情况。结果 (1)最终完成试验者73例,治疗组36例、对照组37例。(2)治疗组、对照组总有效率分别为94.4%、81.1%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。(3)治疗前后组内比较,两组WOMAC各分项评分及总分差异均有统计学意义(P<0.05)。组间治疗后比较,治疗组WOMAC各分项评分及总分明显低于对照组(P<0.05)。结论在整体观念指导下,采用推拿疗法治疗膝骨关节炎,可明显改善患者关节的疼痛、僵硬程度及活动能力,从而提高患者的生活质量。
Objective To observe the clinical efficacy of tuina under the guidance of concept of holism in the treatment of knee osteoarthritis. Methods 74 patients were randomly divided into the control group and treatment group,37 cases in each group. The control group was orally treated with celecoxib,and the treatment group was treated with tuina under the guidance of concept of holism,with a course of 3 weeks. The clinical efficacy was observed,and the changes on WOMAC scores were compared. Results(1)Finally 73 cases completed the trial,among 36 cases in the treatment group and 37 cases in the control group.(2)The total effective rates were 94.4% in the treatment group and 81.1% in the control group,the clinical efficacy of the treatment group was obviously better than that of the control group( P<0.05).(3)In both groups,there were statistically significant differences on all item scores and total score of WOMAC between treatment before and after( P<0.05). After treatment,all item scores and total score of WOMAC in the treatment group were obviously lower than those in the control group( P<0.05). Conclusion The application of Tuina under the guidance of concept of holism in treating knee osteoarthritis can remarkably ameliorate the pain of joint,improve the degree of stiffness and capacity of action in patients,and thus enhance the quality of life of patients.
Objective To observe the clinical efficacy of tuina under the guidance of concept of holism in the treatment of knee osteoarthritis. Methods 74 patients were randomly divided into the control group and treatment group,37 cases in each group. The control group was orally treated with celecoxib,and the treatment group was treated with tuina under the guidance of concept of holism,with a course of 3 weeks. The clinical efficacy was observed,and the changes on WOMAC scores were compared. Results(1)Finally 73 cases completed the trial,among 36 cases in the treatment group and 37 cases in the control group.(2)The total effective rates were 94.4% in the treatment group and 81.1% in the control group,the clinical efficacy of the treatment group was obviously better than that of the control group( P<0.05).(3)In both groups,there were statistically significant differences on all item scores and total score of WOMAC between treatment before and after( P<0.05). After treatment,all item scores and total score of WOMAC in the treatment group were obviously lower than those in the control group( P<0.05). Conclusion The application of Tuina under the guidance of concept of holism in treating knee osteoarthritis can remarkably ameliorate the pain of joint,improve the degree of stiffness and capacity of action in patients,and thus enhance the quality of life of patients.
引文
[1]刘康妍,郑聪,胡海澜.骨关节炎流行病学研究[J].中华关节外科杂志(电子版),2017,11(3):320-323.
[2]TANG X,WANG S,ZHAN S,et al.The prevalence of symptomatic knee osteoarthritis in China:results from the China health and retirement longitudinal study[J].Arthritis Rheumatol,2016,68(3):648-653.
[3]张喜林,沈国权.脊柱微调手法中整体观念思想的基础及临床实践[J].按摩与康复医学,2015,6(7):19-22.
[4]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):793-796.
[5]宋柏林,于天源.推拿治疗学[M].北京:人民卫生出版社,2013:181.
[6]沈国权.脊柱推拿的理论与实践——脊柱微调手法体系[M].北京:人民卫生出版社,2016:45-56.
[7]庞坚,曹月龙,郭朝卿,等.“石氏手法”治疗膝骨关节炎的临床疗效回顾性分析[J].时珍国医国药,2013,24(8):1936-1937.
[8]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:48-49.
[9]BELLAMY N,BUCHANAN W W,GOLDSMITH C H,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patients relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].J Rheumatol,1988,15(12):1833-1840.
[10]龚利,孙武权,张宏,等.严隽陶“从筋论治”膝骨关节炎推拿学术经验探要[J].上海中医药杂志,2016,50(4):1-4.
[11]邱建文,王禹燕,麦少云,等.针灸治疗膝关节骨性关节炎45例临床观察[J].中医药导报,2012,18(12):62-64.
[12]黄骥,周淳,张晶莹,等.推拿结合膝痛洗方热敷治疗膝骨关节炎疗效观察[J].上海中医药杂志,2014,48(8):57-58.
[13]周海江,徐福.不同温针灸量治疗膝骨关节炎的疗效对比研究[J].上海针灸杂志,2016,35(3):1-3.
[14]殷磊,褚立希,朱鸿飞,等.石氏伤科辨治膝骨关节炎临证经验撷菁[J].上海中医药杂志,2016,50(5):1-3.
[15]宋献文,庞坚,石印玉,等.石氏方药内服外敷治疗膝骨关节炎60例[J].上海中医药杂志,2013,47(5):62-63.
[16]刘锦涛,姜宏.金黄膏外敷治疗膝骨关节炎的随机、双盲、安慰剂对照临床观察[J].上海中医药杂志,2015,49(12):31-34.
[17]朱智,李恩慧,朱清广,等.太极拳锻炼结合针刺干预膝骨关节炎的临床观察[J].上海中医药杂志,2017,51(3):54-56.
[18]马晓蓉,柴臻,刘飞燕,等.艾灸治疗膝骨关节炎的系统评价及Meta分析[J].上海中医药杂志,2017,51(9):19-24.
[19]孙铁铮.骨关节炎(膝关节)诊断和治疗共识[C]//中国老年学学会骨质疏松委员会.第十二届国际骨矿研究学术会议暨第十四届国际骨质疏松研讨会论文集.杭州:中国老年学学会骨质疏松委员会工作组,2014:156-157.
[20]李建华,龚利,房敏,等.推拿对膝骨关节炎患者膝屈伸肌肌张力的影响[J].中国骨伤,2011,24(7):575-577.
[2]TANG X,WANG S,ZHAN S,et al.The prevalence of symptomatic knee osteoarthritis in China:results from the China health and retirement longitudinal study[J].Arthritis Rheumatol,2016,68(3):648-653.
[3]张喜林,沈国权.脊柱微调手法中整体观念思想的基础及临床实践[J].按摩与康复医学,2015,6(7):19-22.
[4]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):793-796.
[5]宋柏林,于天源.推拿治疗学[M].北京:人民卫生出版社,2013:181.
[6]沈国权.脊柱推拿的理论与实践——脊柱微调手法体系[M].北京:人民卫生出版社,2016:45-56.
[7]庞坚,曹月龙,郭朝卿,等.“石氏手法”治疗膝骨关节炎的临床疗效回顾性分析[J].时珍国医国药,2013,24(8):1936-1937.
[8]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:48-49.
[9]BELLAMY N,BUCHANAN W W,GOLDSMITH C H,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patients relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].J Rheumatol,1988,15(12):1833-1840.
[10]龚利,孙武权,张宏,等.严隽陶“从筋论治”膝骨关节炎推拿学术经验探要[J].上海中医药杂志,2016,50(4):1-4.
[11]邱建文,王禹燕,麦少云,等.针灸治疗膝关节骨性关节炎45例临床观察[J].中医药导报,2012,18(12):62-64.
[12]黄骥,周淳,张晶莹,等.推拿结合膝痛洗方热敷治疗膝骨关节炎疗效观察[J].上海中医药杂志,2014,48(8):57-58.
[13]周海江,徐福.不同温针灸量治疗膝骨关节炎的疗效对比研究[J].上海针灸杂志,2016,35(3):1-3.
[14]殷磊,褚立希,朱鸿飞,等.石氏伤科辨治膝骨关节炎临证经验撷菁[J].上海中医药杂志,2016,50(5):1-3.
[15]宋献文,庞坚,石印玉,等.石氏方药内服外敷治疗膝骨关节炎60例[J].上海中医药杂志,2013,47(5):62-63.
[16]刘锦涛,姜宏.金黄膏外敷治疗膝骨关节炎的随机、双盲、安慰剂对照临床观察[J].上海中医药杂志,2015,49(12):31-34.
[17]朱智,李恩慧,朱清广,等.太极拳锻炼结合针刺干预膝骨关节炎的临床观察[J].上海中医药杂志,2017,51(3):54-56.
[18]马晓蓉,柴臻,刘飞燕,等.艾灸治疗膝骨关节炎的系统评价及Meta分析[J].上海中医药杂志,2017,51(9):19-24.
[19]孙铁铮.骨关节炎(膝关节)诊断和治疗共识[C]//中国老年学学会骨质疏松委员会.第十二届国际骨矿研究学术会议暨第十四届国际骨质疏松研讨会论文集.杭州:中国老年学学会骨质疏松委员会工作组,2014:156-157.
[20]李建华,龚利,房敏,等.推拿对膝骨关节炎患者膝屈伸肌肌张力的影响[J].中国骨伤,2011,24(7):575-577.