[1]吴晓飒,李春峰,刘巍,等.浮针疗法联合推髌手法治疗髌骨软化症的临床研究[J].中医正骨,2025,37(01):51-57.
　WU Xiaosa,LI Chunfeng,LIU Wei,et al.A clinical study of fu's acupuncture therapy combined with patella-pushing manipulation for treatment of chondromalacia patellae[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(01):51-57.
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浮针疗法联合推髌手法治疗髌骨软化症的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年01期
页码:
51-57
栏目:
临床研究
出版日期:
2025-01-20

文章信息/Info

Title:
A clinical study of fu's acupuncture therapy combined with patella-pushing manipulation for treatment of chondromalacia patellae
作者:
吴晓飒1; 李春峰2; 刘巍2; 龙大伟2; 吴新州2
1.安徽中医药大学第一临床医学院,安徽 合肥 230031; 2.太和县中医院,安徽 太和 236607
Author(s):
WU Xiaosa1; LI Chunfeng2; LIU Wei2; LONG Dawei2; WU Xinzhou2
1.The First Clinical Medical College of Anhui University of Chinese Medicine,Hefei 230031,Anhui,China 2.Taihe Hospital of Traditional Chinese Medicine,Taihe 236607,Anhui,China
关键词:
髌骨软骨软化;  浮针疗法;  推拿疗法
Keywords:
chondromalacia patellae;  Fu's acupuncture therapy;  Tui Na therapy
摘要:
目的:探讨浮针疗法联合推髌手法治疗髌骨软化症的临床疗效和安全性。方法:将96例髌骨软化症患者随机分为浮针联合手法组、浮针组、手法组和口服西药组,每组24例,分别采用浮针疗法联合推髌手法、浮针疗法、推髌手法、口服盐酸氨基葡萄糖片治疗。浮针疗法每隔2 d治疗1次,推髌手法每日早晚各治疗1次,口服盐酸氨基葡萄糖片每日2次,均连续治疗14 d。分别于治疗前和治疗结束后,采用Lysholm膝关节评分评价膝关节功能,采用Kujala髌股关节评分评价髌股关节功能和症状严重程度,采用视觉模拟量表(visual analogue scale,VAS)评分评价膝部疼痛程度。治疗结束后3个月,按照《中医病证诊断疗效标准》中髌骨软化症疗效评定标准评价综合疗效。治疗及随访过程中观察患者的不良反应发生情况。结果:①Lysholm膝关节评分。治疗结束后,4组患者的Lysholm膝关节评分均较治疗前增高(t=18.620,P=0.000; t=7.378,P=0.000; t=12.658,P=0.000; t=11.028,P=0.000)。浮针联合手法组的Lysholm膝关节评分高于浮针组、手法组、口服西药组(P=0.000,P=0.000,P=0.000)。浮针组、手法组、口服西药组的Lysholm膝关节评分比较,组间差异均无统计学意义(P=0.210,P=0.793,P=0.187)。②Kujala髌股关节评分。治疗结束后,4组患者的Kujala髌股关节评分均较治疗前增高(t=10.883,P=0.000; t=13.091,P=0.000; t=13.038,P=0.000; t=11.412,P=0.000)。浮针联合手法组的Kujala髌股关节评分高于浮针组、手法组、口服西药组(P=0.000,P=0.000,P=0.000)。浮针组、手法组、口服西药组的Kujala髌股关节评分比较,组间差异均无统计学意义(P=0.547,P=0.320,P=0.096)。③膝部疼痛VAS评分。治疗结束后,4组患者的膝部疼痛VAS评分均较治疗前降低(t=7.245,P=0.000; t=3.675,P=0.001; t=5.150,P=0.000; t=3.129,P=0.003)。浮针联合手法组的膝部疼痛VAS评分低于浮针组、口服西药组(P=0.022,P=0.001),与手法组比较差异无统计学意义(P=0.164)。浮针组、手法组、口服西药组的膝部疼痛VAS评分比较,组间差异均无统计学意义(P=0.441,P=0.241,P=0.061)。④综合疗效。治疗结束后3个月,4组患者的综合疗效比较,差异无统计学意义(χ2=5.935,P=0.115)。⑤安全性。4组患者中,浮针联合手法组和浮针组各有1例患者在治疗过程中出现晕针现象,其他患者在整个治疗过程中均未出现不良反应。4组患者不良反应发生率比较,差异无统计学意义(P=1.000)。结论:浮针疗法联合推髌手法与单独使用浮针疗法、推髌手法和口服盐酸氨基葡萄糖片治疗髌骨软化症,均可缓解膝部疼痛、减轻髌股关节症状和改善膝关节功能; 其中浮针疗法联合推髌手法在缓解膝部疼痛方面的疗效优于单独使用浮针疗法和口服盐酸氨基葡萄糖片,与单独使用推髌手法相当,且该疗法在减轻髌股关节症状和改善膝关节功能方面的疗效优于其他3种疗法,但是这4种疗法的综合疗效和安全性相当。
Abstract:
Objective:To explore the clinical outcomes and safety of fu's acupuncture therapy combined with patella-pushing manipulation for treatment of chondromalacia patellae(CMP).Methods:Ninety-six CMP patients were randomized into 4 groups,with 24 ones in each group,and they were treated with fu's acupuncture therapy combined with patella-pushing manipulation(combination therapy group),fu's acupuncture therapy(fu's acupuncture group),patella-pushing manipulation(manipulation group),and oral application of glucosamine hydrochloride tablets(western medicine(WM)group),respectively.The fu's acupuncture therapy was performed once every 2 days for consecutive 14 days; the patella-pushing manipulation was conducted once in the morning and evening,respectively,for consecutive 14 days; and the glucosamine hydrochloride tablets was taken twice a day,1 tablet at a time for consecutive 14 days.Before the treatment and after the end of the treatment,the knee function was assessed by using the Lysholm knee score,the patellofemoral function and the severity of the symptoms were evaluated by employing the Kujala patellofemoral score,and the knee pain degree was evaluated by using the visual analogue scale(VAS)score.Three months after the end of treatment,the total clinical outcomes were evaluated according to the therapeutic effect evaluation standard of CMP which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes,and the adverse reactions were observed during the treatment and follow-up period.Results:①The Lysholm knee score.The Lysholm knee score increased after the end of the treatment compared to pretreatment in the 4 groups(t=18.620,P=0.000; t=7.378,P=0.000; t=12.658,P=0.000; t=11.028,P=0.000),and it was higher in combination therapy group compared to fu's acupuncture group,manipulation group,and WM group(P=0.000,P=0.000,P=0.000),while,there was no significant difference among fu's acupuncture group,manipulation group,and WM group(P=0.210,P=0.793,P=0.187).②The Kujala patellofemoral score.The Kujala patellofemoral score increased after the end of the treatment compared to pretreatment in the 4 groups(t=10.883,P=0.000; t=13.091,P=0.000; t=13.038,P=0.000; t=11.412,P=0.000),and it was higher in combination therapy group compared to fu's acupuncture group,manipulation group,and WM group(P=0.000,P=0.000,P=0.000),while,there was no significant difference among fu's acupuncture group,manipulation group,and WM group(P=0.547,P=0.320,P=0.096).③The knee pain VAS score.The knee pain VAS score decreased after the end of the treatment compared to pretreatment in the 4 groups(t=7.245,P=0.000; t=3.675,P=0.001; t=5.150,P=0.000; t=3.129,P=0.003),and it was lower in combination therapy group compared to fu's acupuncture group and WM group(P=0.022,P=0.001),while there was no significant difference between combination therapy group and manipulation group(P=0.164); furthermore,the differences were not significant among fu's acupuncture group,manipulation group,and WM group(P=0.441,P=0.241,P=0.061).④The total clinical outcomes.Three months after the end of treatment,the difference was not significant in the total clinical outcomes among the 4 groups(χ2=5.935,P=0.115).⑤The safety.Among the 4 groups,1 patient each in the combination therapy group and fu's acupuncture group experienced fainting during the acupuncture treatment process,apart from that,no adverse reactions occurred in the other patients throughout the entire treatment.There was no statistical difference in the incidence of adverse reactions among the 4 groups(P=1.000).Conclusion:Combination of fu's acupuncture therapy with patella-pushing manipulation,or exclusive use of fu's acupuncture therapy,patella-pushing manipulation,and oral application of glucosamine hydrochloride tablets all can relieve knee pain,alleviate patellofemoral symptoms and improve knee function in the treatment of CMP.Among the 4 therapies,the fu's acupuncture therapy combined with patella-pushing manipulation is superior to fu's acupuncture therapy or oral application of glucosamine hydrochloride tablets alone,but,comparable to patella-pushing manipulation alone in alleviating knee pain,while,it outperformes the other 3 therapies in alleviating patellofemoral symptoms and improving knee function.However,the 4 therapies are similar to each other in the total clinical outcomes and safety in treatment of CMP.

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备注/Memo

备注/Memo:
基金项目:安徽中医药大学科研基金项目(2023LCTH25)
通讯作者:李春峰 E-mail:1i13866260309@qq.com
更新日期/Last Update: 1900-01-01