针刀松解术治疗膝骨关节炎临床研究
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摘要
目的探讨针刀松解术治疗膝骨关节炎(KOA)临床疗效。方法采用随机数字表法将200例KOA患者分为治疗组和对照组各100例。治疗组予针刀松解术,每周1次;对照组予美洛昔康片,每日1次,口服。均连续治疗2周。评价2组临床疗效、膝骨关节炎严重程度指数(ISOA)评分、关节活动度(ROM),观察不良反应。结果治疗组、对照组分别脱落2、1例。治疗组总有效率为98.99%(97/98),对照组为92.93%(92/99),治疗组明显优于对照组(P<0.01)。与本组治疗前比较,2组疼痛、最大步行距离、生活能力评分及ISOA总分明显降低(P<0.05);2组治疗后比较,治疗组疼痛、最大步行距离、日常生活能力评分及ISOA总分明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后ROM明显增加(P<0.05);2组治疗后比较,治疗组ROM明显优于对照组(P<0.05)。治疗组影像学分级Ⅰ、Ⅱ级患者临床疗效明显优于Ⅲ级患者(P<0.05)。2组未见明显不良反应。结论针刀松解术对膝骨关节炎临床疗效显著,对轻中度患者疗效更佳。
Objective To investigate the clinical efficacy of acupotomy surgery in the treatment of knee osteoarthritis(KOA). Methods Totally 200 patients of KOA were divided into treatment group and control group according to random number table method, with 100 cases in each group. The treatment group was treated with acupotomy surgery, once a week. The control group received meloxicam tablets, once a day, orally. The treatment for both groups lasted for two weeks. The clinical efficacy, knee index of severity for osteoarthritis(ISOA) score and joint range of motion(ROM) of both groups were evaluated. Adverse reactions were observed. Results The treatment group lost two cases and the control group lost one case. The total effective rate was 98.99%(97/98) in the treatment group and 92.93%(92/99) in the control group. The treatment group was significantly better than the control group(P<0.01). Compared with before treatment, the pain, maximum walking distance, daily living ability score and ISOA total score of both groups were significantly lower(P<0.05); After treatment, the pain, maximum walking distance, daily living ability score and ISOA score of the treatment group were significantly lower than the control group(P<0.05). Compared with before treatment, the ROM of the two groups increased significantly after treatment(P<0.05); Compared with the control group, the ROM of the treatment group was significantly better than that of the control group(P<0.05). The clinical efficacy of patients with grade Ⅰ and Ⅱ imaging was significantly better than that of patients with grade Ⅲ(P<0.05). No obvious adverse reactions were observed in both groups. Conclusion The treatment of KOA by acupotomy surgery is effective, and has better curative effect for mild and moderate patients.
Objective To investigate the clinical efficacy of acupotomy surgery in the treatment of knee osteoarthritis(KOA). Methods Totally 200 patients of KOA were divided into treatment group and control group according to random number table method, with 100 cases in each group. The treatment group was treated with acupotomy surgery, once a week. The control group received meloxicam tablets, once a day, orally. The treatment for both groups lasted for two weeks. The clinical efficacy, knee index of severity for osteoarthritis(ISOA) score and joint range of motion(ROM) of both groups were evaluated. Adverse reactions were observed. Results The treatment group lost two cases and the control group lost one case. The total effective rate was 98.99%(97/98) in the treatment group and 92.93%(92/99) in the control group. The treatment group was significantly better than the control group(P<0.01). Compared with before treatment, the pain, maximum walking distance, daily living ability score and ISOA total score of both groups were significantly lower(P<0.05); After treatment, the pain, maximum walking distance, daily living ability score and ISOA score of the treatment group were significantly lower than the control group(P<0.05). Compared with before treatment, the ROM of the two groups increased significantly after treatment(P<0.05); Compared with the control group, the ROM of the treatment group was significantly better than that of the control group(P<0.05). The clinical efficacy of patients with grade Ⅰ and Ⅱ imaging was significantly better than that of patients with grade Ⅲ(P<0.05). No obvious adverse reactions were observed in both groups. Conclusion The treatment of KOA by acupotomy surgery is effective, and has better curative effect for mild and moderate patients.
引文
[1]张义,郭长青.针刀治疗软组织疾病的理论依据及其效应[J].中国组织工程研究与临床康复,2010,14(24):4520-4523.
[2]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.
[3]张铁良.临床骨科学[M].3版.北京:人民卫生出版社,2012:856-862.
[4]FAUTRELB,HILLIQUINP,ROZENBERGS,etal.Impactof osteoarthritis:results of a nationwide survey of 10000 patients consulting for OA[J]. Joint Bone Spine,2005,72(3):235-240.
[5]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.
[6]郭长青,温建民,张秀芬,等.针刀松解术对膝骨关节炎局部软组织张力和疼痛的影响[J].中国中医药信息杂志,2012,19(4):15-17.
[7]何新芳,明顺培,俞杰.针刀疗法对膝骨关节炎兔关节软骨凋亡的影响[J].辽宁中医杂志,2016,33(7);894-895.
[8]金晓飞,郭长青,刘福水.针刀治疗膝骨关节炎力学信号传导机制探讨[J].中国中医基础医学杂志,2011,17(12):1363-1364,1370.
[9]嵇波,郭长青,金燕,等.针刀和电针对膝骨关节炎大鼠痛阈和中枢单胺类神经递质的影响[J].中国病理生理杂志,2010,26(6):1091-1095.
[10]郭长青,嵇波,钟鼎文,等.针刀松解术对膝骨关节炎大鼠中枢P物质的影响[J].国际中医中药杂志,2011,33(4):309-312.
[2]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.
[3]张铁良.临床骨科学[M].3版.北京:人民卫生出版社,2012:856-862.
[4]FAUTRELB,HILLIQUINP,ROZENBERGS,etal.Impactof osteoarthritis:results of a nationwide survey of 10000 patients consulting for OA[J]. Joint Bone Spine,2005,72(3):235-240.
[5]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.
[6]郭长青,温建民,张秀芬,等.针刀松解术对膝骨关节炎局部软组织张力和疼痛的影响[J].中国中医药信息杂志,2012,19(4):15-17.
[7]何新芳,明顺培,俞杰.针刀疗法对膝骨关节炎兔关节软骨凋亡的影响[J].辽宁中医杂志,2016,33(7);894-895.
[8]金晓飞,郭长青,刘福水.针刀治疗膝骨关节炎力学信号传导机制探讨[J].中国中医基础医学杂志,2011,17(12):1363-1364,1370.
[9]嵇波,郭长青,金燕,等.针刀和电针对膝骨关节炎大鼠痛阈和中枢单胺类神经递质的影响[J].中国病理生理杂志,2010,26(6):1091-1095.
[10]郭长青,嵇波,钟鼎文,等.针刀松解术对膝骨关节炎大鼠中枢P物质的影响[J].国际中医中药杂志,2011,33(4):309-312.