[1]陈长贤,仲卫红,赖传仕,等.针刀松解术联合南少林站桩功锻炼治疗早期膝骨关节炎的临床研究[J].中医正骨,2022,34(02):19-23.
 CHEN Changxian,ZHONG Weihong,LAI Chuanshi,et al.A clinical study of needle-knife release combined with southern Shaolin standing stake exercises for treatment of early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):19-23.
点击复制

针刀松解术联合南少林站桩功锻炼治疗早期膝骨关节炎的临床研究()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年02期
页码:
19-23
栏目:
临床研究
出版日期:
2022-02-20

文章信息/Info

Title:
A clinical study of needle-knife release combined with southern Shaolin standing stake exercises for treatment of early knee osteoarthritis
作者:
陈长贤1仲卫红2赖传仕1翁文水1林思雄1杨原芳1唐桂东1廖伟东1李培潮1刘有限1许中源1
1.泉州市正骨医院,福建 泉州 362000; 2.福建中医药大学附属康复医院,福建 福州 350003
Author(s):
CHEN Changxian1ZHONG Weihong2LAI Chuanshi1WENG Wenshui1LIN Sixiong1YANG Yuanfang1TANG Guidong1LIAO Weidong1LI Peichao1LIU Youxian1XU Zhongyuan1
1.Quanzhou Orthopedic-Traumatological Hospital,Quanzhou 362000,Fujian,China 2.Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350003,Fujian,China
关键词:
骨关节炎 髌股关节 针刀疗法 站桩功 临床试验
Keywords:
osteoarthritisknee patellofemoral joint acupotomy therapy standing stake exercise clinical trial
摘要:
目的:观察针刀松解术联合南少林站桩功锻炼治疗早期膝骨关节炎的临床疗效。方法:将60例早期膝骨关节炎患者随机分为2组,每组30例。南少林站桩功组采用针刀松解术联合南少林站桩功锻炼治疗,股四头肌锻炼组采用针刀松解术联合股四头肌肌力锻炼治疗。针刀松解术每周治疗1次,共治疗2次; 针刀松解术后第2天分别开始南少林站桩功锻炼和股四头肌肌力锻炼,连续锻炼2周。分别于治疗前、治疗结束后,采用膝部疼痛视觉模拟量表(visual analogue scale,VAS)评价患膝疼痛程度,采用西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分评价患膝功能,并于治疗结束后按照自拟标准评价总体疗效。结果:①膝部疼痛VAS评分。治疗前2组患者的膝部疼痛VAS评分比较,差异无统计学意义[(4.54±1.03)分,(4.64±1.22)分,t=0.759,P=0.451]; 治疗结束后南少林站桩功组的膝部疼痛VAS评分低于股四头肌锻炼组[(1.75±0.77)分,(2.35±1.31)分,t=-5.976,P=0.000],2组患者的膝部疼痛VAS评分均较治疗前降低(t=13.360,P=0.000; t=6.020,P=0.000)。②WOMAC评分。治疗前2组患者的WOMAC评分比较,差异无统计学意义[(25.42±5.63)分,(25.56±5.29)分,t=-0.686,P=0.493]; 治疗结束后南少林站桩功组的WOMAC评分低于股四头肌锻炼组[(13.28±5.40)分,(16.75±4.33)分,t=-0.725,P=0.000],2组患者的WOMAC评分均较治疗前降低(t=-23.456,P=0.000; t=-23.745,P=0.000)。③总体疗效。治疗结束后,南少林站桩功组治愈9例、显效14例、有效5例、无效2例,股四头肌锻炼组治愈2例、显效5例、有效17例、无效6例; 南少林站桩功组的总体疗效优于股四头肌锻炼组( R^-南少林站桩功组=22.28,R^-股四头肌锻炼组=38.72,Z=-3.819,P=0.000)。结论:针刀松解术联合南少林站桩功锻炼治疗早期膝骨关节炎,可以有效减轻膝关节疼痛,改善膝关节功能,总体疗效优于针刀松解术联合股四头肌肌力锻炼。
Abstract:
Objective:To observe the clinical outcome of needle-knife release combined with southern Shaolin standing stake exercises for treatment of early knee osteoarthritis(KOA).Methods:Sixty patients with early KOA were enrolled in the study and were randomly divided into group A and group B,30 cases in each group.The patients in group A were treated with needle-knife release and southern Shaolin standing stake exercises,while the ones in group B with needle-knife release and quadriceps femoris muscle strength exercises.The needle-knife release was performed once a week for consecutive 2 times,followed by 2-week southern Shaolin standing stake exercises and quadriceps femoris muscle strength exercises respectively on day 2 after the needle-knife release.The knee pain degree and knee function were evaluated by using knee pain visual analogue scale(VAS)and Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score before the treatment and after the end of the treatment respectively,and the total outcome were evaluated according to the self-made evaluation standards after the end of the treatment.Results:①There was no statistical difference in knee pain VAS score between the 2 groups before the treatment(4.54±1.03 vs 4.64±1.22 points,t=0.759,P=0.451).The knee pain VAS score was lower in group A compared to group B after the end of the treatment(1.75±0.77 vs 2.35±1.31 points,t=-5.976,P=0.000),and it decreased in the 2 groups after the end of the treatment compared to pre-treatment(t=13.360,P=0.000; t=6.020,P=0.000).②There was no statistical difference in WOMAC score between the 2 groups before the treatment(25.42±5.63 vs 25.56±5.29 points,t=-0.686,P=0.493).The WOMAC score was lower in group A compared to group B after the end of the treatment(13.28±5.40 vs 16.75±4.33 points,t=-0.725,P=0.000),and it decreased in the 2 groups after the end of the treatment compared to pre-treatment(t=-23.456,P=0.000; t=-23.745,P=0.000).③After the end of the treatment,9 patients were cured,14 good,5 fair and 2 poor in group A; while 2 ones were cured,5 good,17 fair and 6 poor in group B.The total outcome was better in group A compared to group B(R^-group A=22.28,R^-group B=38.72,Z=-3.819,P=0.000).Conclusion:Needle-knife release combined with southern Shaolin standing stake exercises can effectively relieve knee pain and improve knee function in treatment of early KOA,and its total outcome is better than that of needle-knife release combined with quadriceps femoris muscle strength exercises.

参考文献/References:

[1] 王欢,孙贺,张耀南,等.中国40岁以上人群原发性膝骨关节炎各间室患病状况调查[J].中华骨与关节外科杂志,2019,12(7):528-532.
[2] SINUSAS K.Osteoarthritis:diagnosis and treatment[J].Am Fam Physician,2012,86(10):893.
[3] 沈佳韵,邢华,龚利,等.髌股关节紊乱对膝骨关节炎影响的研究进展[J].中医正骨,2021,33(3):53-55.
[4] 王存有,李建伟,要晓鑫,等.髌股关节不稳的诊疗进展[J].中国医药导刊,2021,23(5):332-336.
[5] 褚东晓,王大伟,苏虔,等.早期膝骨关节炎治疗的研究进展[J].风湿病与关节炎,2018,7(1):72-76.
[6] 中华中医药学会骨伤科分会膝痹病(膝骨关节炎)临床诊疗指南制定工作组.中医骨伤科临床诊疗指南·膝痹病(膝骨关节炎)[J].康复学报,2019,29(3):1-7.
[7] 中国中医药研究促进会骨伤科分会.膝骨关节炎中医诊疗指南(2020年版)[J].中医正骨,2020,32(10):1-14.
[8] 王和鸣,王诗忠.图解南少林理筋整脊康复疗法[M].北京:人民卫生出版社,2011:5-10.
[9] FERREIRA C D B,DIBAI-FILHOA V,ALMEIDA D O D S,et al.Structural validity of the Brazilian version of the Western Ontario and McMaster Universities osteoarthritis index among patients with knee osteoarthritis[J].Sao Paulo med J,2020,138(5):400-406.
[10] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:31.
[11] XIE Y,ZHANG C,JIANG W,et al.Quadriceps combined with hip abductor strengthening versus quadriceps strengthening in treating knee osteoarthritis:a study protocol for a randomized controlled trial[J].BMC Musculoskelet Disord,2018,19(1):147.
[12] 中华医学会骨科分会关节外科学组,吴阶平医学基金会骨科学专家委员会.膝骨关节炎阶梯治疗专家共识(2018年版)[J].中华关节外科杂志(电子版),2019,13(1):124-130.
[13] 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.
[14] DING Y,WANGY X,SHI X,et al.Effect of ultrasound-guided acupotomy vs electro acupuncture on knee osteoarthritis:a randomized controlled study[J].J Tradit Chin Med,2016,36(4):450-455.
[15] 章奇,闫丽超,郎伯旭.针刺配合微针刀治疗膝骨关节炎[J].中医正骨,2019,31(5):44-46.
[16] 赵明雷,白跃宏,张颖,等.小针刀配合运动疗法治疗膝骨关节炎:随机对照3个月随访[J].中国组织工程研究,2016,20(7):1057-1064.
[17] 梁楚西.针刀干预对KOA兔韧带胶原相关因子及软骨细胞凋亡因子基因、蛋白表达的影响[D].北京:北京中医药大学,2015.
[18] 郭长青,张丽萍.针刀干预对膝骨关节炎兔髌韧带拉伸、蠕变及应力松弛等生物力学特性的影响[J].中国科学:生命科学,2016,46(8):976-982.
[19] 陈国键,朱江龙,丰哲,等.运动疗法在膝骨关节炎治疗中的应用[J].中医正骨,2019,31(3):38-41.
[20] 李紫梦,靳英辉,刘佳,等.八段锦对膝骨性关节炎患者干预效果的Meta分析[J].中华现代护理杂志,2020,26(4):480-486.
[21] 汤丽珠,李长辉,张坤木,等.推拿结合等速训练配合五禽戏治疗膝骨关节炎的临床疗效观察[J].湖南中医药大学学报,2019,39(7):879-884.
[22] VASSÃO P G,PARISI J,PENHA T F C,et al.Association of photobiomodulation therapy(PBMT)and exercises programs in pain and functional capacity of patients with knee osteoarthritis(KOA):a systematic review of randomized trials[J].Lasers Med Sci,2021,36(7):1341-1353.
[23] HU X,LAI Z,WANG L.Effects of Taichi exercise on knee and ankle proprioception among individuals with knee osteoarthritis[J].Res Sports Med,2020,28(2):268-278.
[24] 涂平,廖远朋.五禽戏和站桩练习对女性KOA患者伸、屈膝力量及WOMAC评分的影响[J].成都体育学院学报,2014,40(6):68-71.

相似文献/References:

[1]孟维娜,明立功,王新德,等.关节镜下清理联合腓骨近1/3段截骨治疗膝骨关节炎[J].中医正骨,2015,27(11):40.
[2]明立功,孟维娜,王新德,等.腓骨近端截骨治疗内侧间室膝骨关节炎的近期疗效观察[J].中医正骨,2015,27(10):25.
[3]张杰,王人彦,张玉柱.膝骨关节炎的治疗进展[J].中医正骨,2015,27(10):68.
[4]梁朝,蔡静怡,闫立,等.针刀疗法改善膝骨关节炎早期疼痛症状的疗效评价[J].中医正骨,2015,27(09):9.
 LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):9.
[5]王建武,党建军,李强,等.四联疗法治疗膝骨关节炎[J].中医正骨,2015,27(08):44.
[6]刘红娟,郭会利,郭树农.云克联合中药治疗膝骨关节炎的护理[J].中医正骨,2015,27(08):75.
[7]陈卫衡.探索建立系统的膝骨关节炎中医临床科研范式 和理论体系[J].中医正骨,2015,27(07):1.
[8]郑春松,叶蕻芝,李西海,等.透骨消痛胶囊中补肾柔肝药和活血祛风药治疗 骨关节炎作用方式的计算机模拟比较[J].中医正骨,2015,27(07):6.
 ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Comparison of the mode of action of Bushen Rougan(补肾柔肝)drugs versus Huoxue Qufeng(活血祛风)drugs contained in Tougu Xiaotong Jiaonang(透骨消痛胶囊)for the treatment of osteoarthritis:A computer simulation study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):6.
[9]帅波,沈霖,杨艳萍,等.加味青娥丸治疗膝骨关节炎的作用机制研究[J].中医正骨,2015,27(07):15.
 SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):15.
[10]梅其杰,袁长深,段戡,等.壮药骨痹方烫熨联合运动疗法治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):27.
 MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):27.

备注/Memo

备注/Memo:
基金项目:国家中医药管理局中医药循证能力建设项目(2019XZZX-GK001)
通讯作者:仲卫红 E-mail:zwh7118@126.com
更新日期/Last Update: 2022-02-20