揿针留针疗法联合康复干预治疗中早期膝骨关节炎
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摘要
目的:观察揿针留针疗法联合康复干预措施对中早期膝骨关节炎疗效的影响。方法:将70例患者随机分为观察组和对照组,每组35例。排除脱落病例,最后观察组34例、对照组32例纳入统计。观察组给予揿针埋针联合常规康复干预,埋针穴位为犊鼻、内膝眼、血海、梁丘、阳陵泉、阿是穴,施埋24 h;对照组单纯给予常规康复干预。两组患者于治疗前、初次治疗结束时、治疗1个月后及治疗后3个月随访时采用疼痛视觉模拟评分法(VAS)评判患膝的疼痛程度;同时于治疗前、治疗1个月后采用西安大略和麦克马斯特骨关节炎指数(WOMAC)评定患膝的关节功能,采用主动屈膝关节活动范围(ROM)评定患膝的关节活动度,并评定两组疗效。结果:初次治疗结束时,观察组VAS评分较治疗前及对照组改善明显(均P<0.05),而对照组与治疗前比较,差异无统计学意义(P>0.05)。治疗1个月后,两组VAS评分、WOMAC评分、ROM测定较治疗前均明显改善(均P<0.05),且观察组优于对照组(均P<0.05);观察组总有效率为97.1%(33/34),优于对照组的81.3%(26/32,P<0.05)。随访时,两组患者VAS评分较治疗1个月时稍有上升,但与治疗前比较,差异仍有统计学意义(P<0.05),且观察组仍优于对照组(P<0.05)。结论:揿针留针疗法联合康复干预能有效缓解患膝疼痛以及改善关节功能,揿针留针疗法对中早期膝骨关节炎的康复有趋利作用。
Objective To observe the effect of intradermal needing combined with rehabilitation intervention on middle and early knee osteoarthritis. Methods Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. Excluding the dropping cases, finally, 34 cases in the observation group and 32 cases in the control group were included in the statistics. Intradermal needing combined with rehabilitation intervention were given in the observation group, the intradermal needing was applied at Dubi(ST 35), Neixiyan(EX-LE 8), Xuehai(SP 10),Liangqiu(ST 34), Yanglingquan(GB 34), ashi point, and retained for 24 h; the simple conventional rehabilitation intervention was given in the control group. The visual analogue scale(VAS) was used to evaluate knee pain before treatment, the end of initial treatment, 1 month after treatment, and 3 months after treatment. The Western Ontario and McMaster Osteoarthritis index(WOMAC) was used to assess the joint function of the knee, the active knee flexion range(ROM) was used to assess the joint mobility of the knee before treatment and 1 month after treatment, and the efficacy of the two groups was evaluated. Results At the end of the initial treatment, the VAS score in the observation group were significantly improved as compared with that before treatment and the control groups(P<0.05), but there was no significant difference in the control group compared with that before treatment(P>0.05). After 1 month of treatment, the VAS score,WOMAC score and ROM measurement in the two groups were significantly improved as compared with those before treatment(P<0.05), and the observation group was superior to the control group(P<0.05); the total effective rate in the observation group was 97.1%(33/34), which was better than 81.3%(26/32) in the control group(P<0.05). At the follow-up, the VAS scores in the two groups were slightly higher than those after 1 month of treatment, but the difference was still statistically significant as compared with those before treatment(P<0.05), and the observation group was still superior to the control group(P< 0.05). Conclusion The combination of intradermal needing combined with rehabilitation intervention can effectively alleviate knee pain and improve joint function. It has a beneficial effect on the rehabilitation of middle and early knee osteoarthritis.
Objective To observe the effect of intradermal needing combined with rehabilitation intervention on middle and early knee osteoarthritis. Methods Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. Excluding the dropping cases, finally, 34 cases in the observation group and 32 cases in the control group were included in the statistics. Intradermal needing combined with rehabilitation intervention were given in the observation group, the intradermal needing was applied at Dubi(ST 35), Neixiyan(EX-LE 8), Xuehai(SP 10),Liangqiu(ST 34), Yanglingquan(GB 34), ashi point, and retained for 24 h; the simple conventional rehabilitation intervention was given in the control group. The visual analogue scale(VAS) was used to evaluate knee pain before treatment, the end of initial treatment, 1 month after treatment, and 3 months after treatment. The Western Ontario and McMaster Osteoarthritis index(WOMAC) was used to assess the joint function of the knee, the active knee flexion range(ROM) was used to assess the joint mobility of the knee before treatment and 1 month after treatment, and the efficacy of the two groups was evaluated. Results At the end of the initial treatment, the VAS score in the observation group were significantly improved as compared with that before treatment and the control groups(P<0.05), but there was no significant difference in the control group compared with that before treatment(P>0.05). After 1 month of treatment, the VAS score,WOMAC score and ROM measurement in the two groups were significantly improved as compared with those before treatment(P<0.05), and the observation group was superior to the control group(P<0.05); the total effective rate in the observation group was 97.1%(33/34), which was better than 81.3%(26/32) in the control group(P<0.05). At the follow-up, the VAS scores in the two groups were slightly higher than those after 1 month of treatment, but the difference was still statistically significant as compared with those before treatment(P<0.05), and the observation group was still superior to the control group(P< 0.05). Conclusion The combination of intradermal needing combined with rehabilitation intervention can effectively alleviate knee pain and improve joint function. It has a beneficial effect on the rehabilitation of middle and early knee osteoarthritis.
引文
[1]于晓峰,孙炳龙,毕建飞.关节镜清理术联合中频电药物导入及康复训练治疗膝骨关节炎的疗效观察[J].中华物理医学与康复杂志,2017,39(7):537-539.
[2]陈钢,辜锐鑫,徐丹丹.电针疗法在全膝关节置换术后康复中的应用[J].中国针灸,2012,32(4):309-312.
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[7]张国宁,王友.膝关节评分标准的评估[J].中华外科杂志,2006,44(16):1141-1143.
[8]王安民.康复功能评定学[M].上海:复旦大学出版社,2009:25-51.
[9]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,2002:349.
[10]杨俊兴,袁颖嘉,李田珂,等.等速向心肌力训练对膝关节骨性关节炎患者关节功能水平的影响[J].中国康复医学杂志,2012,27(7):631-634.
[11]万里,赵晓红,朱奕,等.改良关节松动术治疗创伤后膝关节功能障碍的疗效观察[J].中华物理医学与康复杂志,2011,33(6):477-478.
[12]姜屿,姜丽娜,周海涛.磁脉冲热疗联合肌力训练治疗中老年膝骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2013,35(10):783-784.
[13]田小刚,苏旭东.补肝汤配合揿针治疗陈旧性膝关节内侧副韧带损伤41例[J].中医外治杂志,2014,23(5):64.
[2]陈钢,辜锐鑫,徐丹丹.电针疗法在全膝关节置换术后康复中的应用[J].中国针灸,2012,32(4):309-312.
[3]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.
[4]卓大宏.中国康复医学[M].北京:华夏出版社,2003:1205.
[5]何建忠,张健,李钊,等.综合康复联合等速肌力训练对膝关节骨折后功能障碍恢复的影响[J].中华物理医学与康复杂志,2014,36(8):636-638.
[6]蒋协远,王大伟.2010年最新骨科临床疗效评价标准[M].北京:人民卫生出版社,2010:168-169.
[7]张国宁,王友.膝关节评分标准的评估[J].中华外科杂志,2006,44(16):1141-1143.
[8]王安民.康复功能评定学[M].上海:复旦大学出版社,2009:25-51.
[9]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,2002:349.
[10]杨俊兴,袁颖嘉,李田珂,等.等速向心肌力训练对膝关节骨性关节炎患者关节功能水平的影响[J].中国康复医学杂志,2012,27(7):631-634.
[11]万里,赵晓红,朱奕,等.改良关节松动术治疗创伤后膝关节功能障碍的疗效观察[J].中华物理医学与康复杂志,2011,33(6):477-478.
[12]姜屿,姜丽娜,周海涛.磁脉冲热疗联合肌力训练治疗中老年膝骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2013,35(10):783-784.
[13]田小刚,苏旭东.补肝汤配合揿针治疗陈旧性膝关节内侧副韧带损伤41例[J].中医外治杂志,2014,23(5):64.