针刀联合透明质酸钠关节内注射治疗膝骨性关节炎的临床研究
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摘要
目的观察针刀法联合透明质酸钠(sodium hyaluronate,SH)关节内注射治疗膝骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法选取KOA患者60例,抽签随机分为试验组和对照组,比例为1∶1。对照组行针刀疗法,试验组行针刀手术的过程中复合注射SH。评价两组间临床疗效、Lequene评分及步态相关指标差异。结果试验组优良率80.0%显著高于对照组53.3%(P<0.05);治疗后,两组Lequene评分较治疗前均降低(P<0.01),试验组Lequene评分低于对照组(P<0.05);治疗后,两组左右足负荷、时间及负重积分比例均高于治疗前(P<0.05);治疗后试验组左右足负荷、时间及负重积分比例均高于对照组(P<0.05)。结论针刀法联合SH关节内注射治疗KOA具有较好临床疗效,能显著改善患者晨僵、关节肿胀等一系列症状,并可改善步态,提高患者负重及时间耐力,临床价值较高。
Objective To observe the clinical effect of acupotomy combined with sodium hyaluronate(SH) on knee osteoarthritis(KOA). Methods 60 patients with KOA were selected and randomly divided into experimental group and control group, with a ratio of 1:1. The control group was treated with acupotomy, the experimental group was given the injection of SH during the process of acupotomy. The differences of clinical efficacy, Lequene score and gait related indexes between the two groups were compared. Results The excellent and good rate of the experimental group 80.00% was significantly higher than that of the control group 53.33%(P<0.05). After treatment, the Lequene scores of the two groups were lower than those before treatment(P<0.01), and the score of Lequene in the experimental group was lower than that in the control group(P<0.05). After treatment, the load, time and integral load ratio of left and right foot in the two groups were higher than those before treatment(P<0.05). After treatment, the load, time and integral load ratio of left and right foot in the experiment group were higher than those in the control group, the difference was statistically significant(P<0.05). Conclusion Acupuncture combined with intra-articular injection of SH treatment has significant clinical efficacy in treatment of KOA, which could significantly improve patients with morning stiffness, joint swelling and other symptoms, gait, weight-bearing and endurance time in patients with high clinical value.
Objective To observe the clinical effect of acupotomy combined with sodium hyaluronate(SH) on knee osteoarthritis(KOA). Methods 60 patients with KOA were selected and randomly divided into experimental group and control group, with a ratio of 1:1. The control group was treated with acupotomy, the experimental group was given the injection of SH during the process of acupotomy. The differences of clinical efficacy, Lequene score and gait related indexes between the two groups were compared. Results The excellent and good rate of the experimental group 80.00% was significantly higher than that of the control group 53.33%(P<0.05). After treatment, the Lequene scores of the two groups were lower than those before treatment(P<0.01), and the score of Lequene in the experimental group was lower than that in the control group(P<0.05). After treatment, the load, time and integral load ratio of left and right foot in the two groups were higher than those before treatment(P<0.05). After treatment, the load, time and integral load ratio of left and right foot in the experiment group were higher than those in the control group, the difference was statistically significant(P<0.05). Conclusion Acupuncture combined with intra-articular injection of SH treatment has significant clinical efficacy in treatment of KOA, which could significantly improve patients with morning stiffness, joint swelling and other symptoms, gait, weight-bearing and endurance time in patients with high clinical value.
引文
[1]董福慧.针刀技术的特色与优势[J].中医正骨,2015,27(9):1-2.
[2]吴亚同.针刀治疗运动系统疾病临床研究进展[J].河北中医,2014,36(5):786-788.
[3]牛时季,孟庆才,刘颖.小针刀治疗膝骨关节炎的临床疗效观察[J].成都中医药大学学报,2013,36(2):45-46,50.
[4]周磊.针刀松解术治疗膝关节骨性关节炎的临床疗效及安全性评价[J].针灸临床杂志,2015,3(5):34-36.
[5]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.2007,10(10):79-81.
[6]张勇,逯红英,曲成燕.针刀配合玻璃酸钠关节内注射治疗膝骨性关节炎临床疗效观察[J].中国医学创新,2011,8(35):129-130.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,,2002:353.
[8]Lequene MG,Mery C,Samson M.Indexes of severity for osteoarthritis of hip and knee.Validation value in comparison with other assessment tests[J].Scand J Rheumatol Suppl,1987,2(8):85-89.
[9]税建军.针刀疗法治疗膝骨性关节炎119例[J].中医外治杂志,2011,20(4):38-39.
[10]彭溶.针刀治疗膝骨性关节炎的研究现状[J].北京中医药大学学报(中医临床版),2012,19(1):59-60.
[11]郭华洋.关节腔冲洗并注射透明质酸钠结合针刀松解治疗膝骨关节炎126例[J].中医药临床杂志,2013,(5):423-424.
[12]徐传华.针刀治疗对膝骨性关节炎患者TNF-α和MMP-9的影响[J].新中医,2014,46(5):188-190.
[13]谭华儒,彭静涛.骨痹消胶囊对膝骨性关节炎患者血浆SOD、MDA、NO的影响[J].湖北中医学院学报,2014,8(4):9-10.
[14]尤笑迎.膝骨性关节炎的发病机制及降钙素的治疗作用[J].江苏医药,2012,38(9):1004-1007.
[15]杨智军.膝OA患者训练前后痛阈负荷及平衡功能的研究[D].太原:山西大学,2013.
[16]李刚,朱彬,李香,等.小针刀治疗膝关节炎的疗效观察及部分机理研究[J].世界中医药,2016,11(6):1077-1081.
[17]宋艳玲.氨基葡萄糖联合关节腔内注射透明质酸钠治疗膝骨关节炎的疗效观察[J].湖南中医药大学学报,2013,33(10):19.
[2]吴亚同.针刀治疗运动系统疾病临床研究进展[J].河北中医,2014,36(5):786-788.
[3]牛时季,孟庆才,刘颖.小针刀治疗膝骨关节炎的临床疗效观察[J].成都中医药大学学报,2013,36(2):45-46,50.
[4]周磊.针刀松解术治疗膝关节骨性关节炎的临床疗效及安全性评价[J].针灸临床杂志,2015,3(5):34-36.
[5]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.2007,10(10):79-81.
[6]张勇,逯红英,曲成燕.针刀配合玻璃酸钠关节内注射治疗膝骨性关节炎临床疗效观察[J].中国医学创新,2011,8(35):129-130.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,,2002:353.
[8]Lequene MG,Mery C,Samson M.Indexes of severity for osteoarthritis of hip and knee.Validation value in comparison with other assessment tests[J].Scand J Rheumatol Suppl,1987,2(8):85-89.
[9]税建军.针刀疗法治疗膝骨性关节炎119例[J].中医外治杂志,2011,20(4):38-39.
[10]彭溶.针刀治疗膝骨性关节炎的研究现状[J].北京中医药大学学报(中医临床版),2012,19(1):59-60.
[11]郭华洋.关节腔冲洗并注射透明质酸钠结合针刀松解治疗膝骨关节炎126例[J].中医药临床杂志,2013,(5):423-424.
[12]徐传华.针刀治疗对膝骨性关节炎患者TNF-α和MMP-9的影响[J].新中医,2014,46(5):188-190.
[13]谭华儒,彭静涛.骨痹消胶囊对膝骨性关节炎患者血浆SOD、MDA、NO的影响[J].湖北中医学院学报,2014,8(4):9-10.
[14]尤笑迎.膝骨性关节炎的发病机制及降钙素的治疗作用[J].江苏医药,2012,38(9):1004-1007.
[15]杨智军.膝OA患者训练前后痛阈负荷及平衡功能的研究[D].太原:山西大学,2013.
[16]李刚,朱彬,李香,等.小针刀治疗膝关节炎的疗效观察及部分机理研究[J].世界中医药,2016,11(6):1077-1081.
[17]宋艳玲.氨基葡萄糖联合关节腔内注射透明质酸钠治疗膝骨关节炎的疗效观察[J].湖南中医药大学学报,2013,33(10):19.