魏氏手法联合外用蒸敷方对膝骨关节炎患者生存质量的改善作用
|
摘要
目的:探讨魏氏伤科手法与外用中药蒸敷方联合应用对膝骨关节炎(KOA)患者生存质量的影响。方法:采用随机数字表法将71例KOA患者分为治疗组(35例)和对照组(36例),治疗组予以魏氏手法及外用蒸敷方联合治疗,对照组予消炎止痛药美洛昔康口服及股四头肌功能锻炼。治疗前及1月后,采用VAS评价患者膝关节疼痛变化情况,Lysholm膝关节功能评分标准评定治疗前后患者膝关节功能,SF-36量表评定治疗前后患者生存质量状况。结果:治疗后,两组患者的疼痛及膝关节功能与治疗前比较均有明显改善(P<0.01),其中治疗组的疼痛改善更为明显,且膝关节功能也明显优于对照组(P<0.05或P<0.01);治疗后,两组患者在躯体健康(PF)、躯体角色功能(RP)、躯体疼痛(BP)、总体健康(GH)、社会功能(SF)、活力(VT)、情绪角色功能(RE)、心理健康(MH)8个维度上均有明显改善(P<0.01),且除MH外,在其余7个维度上治疗组均优于对照组(P<0.05);在临床疗效方面,治疗组总有效率为91.4%、对照组为69.4%,治疗组明显优于对照组(P<0.05)。结论:魏氏手法及外用蒸敷方联合治疗能有效改善KOA患者的关节功能,且能明显提高患者的生存质量。
Objective: To investigate the effects of Wei's manipulation combined with external application of Zhengfu Formula on improving the life quality of patients with knee osteoarthritis( KOA). Methods: Seventy-one KOA patients were divided into the treatment group( 35 cases) and the control group( 36 cases) according to random number table. The patients in the treatment group were treated with Wei 's manipulation combined with external application of Zhengfu Formula. The patients in the control group were treated with meloxicam and functional exercise of quadriceps. Before treatment and one month after treatment,the changes of knee pain in patients were evaluated by visual analogue scale( VAS),the function of knee was evaluated by Lysholm knee function scoring scale before and after treatment,the life quality of patients was evaluated by short form-36 survey questionnaire( SF-36) before and after treatment. Results: After treatment,the pain and the motor function of knee were significantly improved in both groups compared with treatment before( P < 0. 01),and the improvement on the pain and knee function in the treatment group were more significant than those in the control group( P < 0. 05 or P < 0. 01). After treatment,the items of physical fitness( PF),role of physical( RP),body pain( BP),general health( GH),social function( SF),vitality( VT),role of emotion( RE) and mental health( MH) were all significantly improved in both groups( P < 0. 01). The scores of PF,RP,BP,GH,SF,VT,RE in the treatment group were higher than those in the control group( P < 0. 05). The total effective rate of the treatment group and control group were 91. 4% and 69. 4% respectively,and the clinical efficacy of the treatment group was significantly better than that of the control group( P < 0. 05). Conclusion: Wei's manipulation combined with external application of Zhengfu Formula can effectively improve the function of knee in patients with knee osteoarthritis,and significantly improve the life quality of patients.
Objective: To investigate the effects of Wei's manipulation combined with external application of Zhengfu Formula on improving the life quality of patients with knee osteoarthritis( KOA). Methods: Seventy-one KOA patients were divided into the treatment group( 35 cases) and the control group( 36 cases) according to random number table. The patients in the treatment group were treated with Wei 's manipulation combined with external application of Zhengfu Formula. The patients in the control group were treated with meloxicam and functional exercise of quadriceps. Before treatment and one month after treatment,the changes of knee pain in patients were evaluated by visual analogue scale( VAS),the function of knee was evaluated by Lysholm knee function scoring scale before and after treatment,the life quality of patients was evaluated by short form-36 survey questionnaire( SF-36) before and after treatment. Results: After treatment,the pain and the motor function of knee were significantly improved in both groups compared with treatment before( P < 0. 01),and the improvement on the pain and knee function in the treatment group were more significant than those in the control group( P < 0. 05 or P < 0. 01). After treatment,the items of physical fitness( PF),role of physical( RP),body pain( BP),general health( GH),social function( SF),vitality( VT),role of emotion( RE) and mental health( MH) were all significantly improved in both groups( P < 0. 01). The scores of PF,RP,BP,GH,SF,VT,RE in the treatment group were higher than those in the control group( P < 0. 05). The total effective rate of the treatment group and control group were 91. 4% and 69. 4% respectively,and the clinical efficacy of the treatment group was significantly better than that of the control group( P < 0. 05). Conclusion: Wei's manipulation combined with external application of Zhengfu Formula can effectively improve the function of knee in patients with knee osteoarthritis,and significantly improve the life quality of patients.
引文
[1]任伟亮,朱艳风,韩昆,等.骨氏葆方治疗肾虚血瘀型膝重度骨关节炎的临床研究[J].南京中医药大学学报,2016,32(2):118-121.
[2]桑久华,史晓.五行健骨操对老年女性膝骨关节炎患者膝关节功能的影响[J].上海中医药大学学报,2015,29(1):41-43.
[3]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[4]李国衡.魏指薪治伤手法与导引[M].上海:上海科学技术出版社,1982:168-170.
[5]王家林,柴春红,许裔敏.推刮手法配合股四头肌功能锻炼治疗退行性膝关节炎的临床疗效观察[J].中国骨伤,2008,21(12):887-889.
[6]缪鸿石.康复医学理论与实践[M].上海:上海科学技术出版社,2000:294-296.
[7]姜林娣.关节炎的生存质量评价[J].中国临床康复,2002,6(1):13-15.
[8]黄洪容.我国社区中老年人膝骨关节炎的发病趋势分析[J].当代医学,2012,18(12):59-60.
[9]闫子贵,马纯青,韩勇,等.人工膝关节表面置换治疗重度骨性关节炎疗效分析[J].中国伤残医学,2013,21(9):3-5.
[10]林勋,陈博,王建平,等.红桂酊涂擦结合推拿手法改善膝骨关节炎疼痛的随机对照临床研究[J].上海中医药大学学报,2016,30(11):38-41.
[11]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.
[12]王济炜,史炜镔,杜宁,等.手法治疗实验性膝骨关节炎的血液动力学研究[J].中国骨伤,1997,10(6):13-15.
[13]杜宁,陆勇,顾翔,等.手法促进膝关节炎软骨修复的核磁共振病例对照研究[J].中国骨伤,2008,21(11):824-827.
[14]张昊,杜宁,任峰,等.手法治疗实验性膝骨关节炎扫描电镜研究[J].中国中医骨伤科杂志,2000,8(2):1-3.
[2]桑久华,史晓.五行健骨操对老年女性膝骨关节炎患者膝关节功能的影响[J].上海中医药大学学报,2015,29(1):41-43.
[3]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[4]李国衡.魏指薪治伤手法与导引[M].上海:上海科学技术出版社,1982:168-170.
[5]王家林,柴春红,许裔敏.推刮手法配合股四头肌功能锻炼治疗退行性膝关节炎的临床疗效观察[J].中国骨伤,2008,21(12):887-889.
[6]缪鸿石.康复医学理论与实践[M].上海:上海科学技术出版社,2000:294-296.
[7]姜林娣.关节炎的生存质量评价[J].中国临床康复,2002,6(1):13-15.
[8]黄洪容.我国社区中老年人膝骨关节炎的发病趋势分析[J].当代医学,2012,18(12):59-60.
[9]闫子贵,马纯青,韩勇,等.人工膝关节表面置换治疗重度骨性关节炎疗效分析[J].中国伤残医学,2013,21(9):3-5.
[10]林勋,陈博,王建平,等.红桂酊涂擦结合推拿手法改善膝骨关节炎疼痛的随机对照临床研究[J].上海中医药大学学报,2016,30(11):38-41.
[11]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.
[12]王济炜,史炜镔,杜宁,等.手法治疗实验性膝骨关节炎的血液动力学研究[J].中国骨伤,1997,10(6):13-15.
[13]杜宁,陆勇,顾翔,等.手法促进膝关节炎软骨修复的核磁共振病例对照研究[J].中国骨伤,2008,21(11):824-827.
[14]张昊,杜宁,任峰,等.手法治疗实验性膝骨关节炎扫描电镜研究[J].中国中医骨伤科杂志,2000,8(2):1-3.