[1]刘伟,颜纯淳,于功昌,等.寒湿痹痛方外敷联合本体感觉神经肌肉促进技术治疗老年膝骨关节炎寒湿痹阻证的临床研究[J].中医正骨,2025,37(04):41-49,54.
　LIU Wei,YAN Chunchun,YU Gongchang,et al.External application of Hanshi Bitong Fang(寒湿痹痛方)combined with proprioceptive neuromuscular facilitation for treatment of knee osteoarthritis with cold-dampness stagnation syndrome in the aged:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(04):41-49,54.
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寒湿痹痛方外敷联合本体感觉神经肌肉促进技术治疗老年膝骨关节炎寒湿痹阻证的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年04期
页码:
41-49,54
栏目:
临床研究
出版日期:
2025-04-20

文章信息/Info

Title:
External application of Hanshi Bitong Fang(寒湿痹痛方)combined with proprioceptive neuromuscular facilitation for treatment of knee osteoarthritis with cold-dampness stagnation syndrome in the aged:a clinical study
作者:
刘伟1; 颜纯淳1; 于功昌1; 杨苓2; 翟劲草3; 夏锐3; 马晓雪3; 师彬1; 孙晋海2
1.山东第一医科大学附属颈肩腰腿痛医院,山东 济南 250062; 2.山东大学体育学院,山东 济南 250061; 3.曲阜师范大学体育科学学院,山东 济宁 273100
Author(s):
LIU Wei1; YAN Chunchun1; YU Gongchang1; YANG Ling2; ZHAI Jincao3; XIA Rui3; MA Xiaoxue3; SHI Bin1; SUN Jinhai2
1.Neck-Shoulder and Lumbocrural Pain Hospital Affiliated to Shandong First Medical University,Jinan 250062,Shandong,China 2.School of Physical Education,Shandong University,Jinan 250061,Shandong,China 3.School of Physical Education and Sports Science,Qufu Normal University,Jining 273100,Shandong,China
关键词:
骨关节炎; 膝;  寒湿痹阻证;  敷贴疗法;  寒湿痹痛方;  本体感觉;  神经肌肉促进技术;  老年人;  随机对照试验专题
Keywords:
osteoarthritis; knee;  cold dampness stagnation syndrome;  plastering therapy;  Hanshi Bitong Fang;  proprioception;  neuromuscular facilitation technique;  aged;  randomized controlled trials as topic
摘要:
目的:观察寒湿痹痛方外敷联合本体感觉神经肌肉促进技术(proprioceptive neuromuscular facilitation,PNF)治疗老年膝骨关节炎(knee osteoarthritis,KOA)寒湿痹阻证的临床疗效和安全性。方法:将符合要求的78例老年KOA寒湿痹阻证患者随机分为2组,每组39例,分别采用寒湿痹痛方外敷联合PNF治疗(联合PNF组)和单纯PNF治疗(PNF组)。分别于治疗前与治疗结束后,记录并比较2组患者的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)疼痛、僵硬和关节功能评分,膝关节屈曲与伸展峰值力矩,膝关节屈曲角度及下楼梯步态参数。观察并发症发生情况。结果:①WOMAC评分。治疗结束后,2组患者WOMAC疼痛评分、僵硬评分及关节功能评分均低于治疗前(疼痛评分:t=16.400,P=0.000; t=11.273,P=0.000; 僵硬评分:t=9.159,P=0.000; t=4.117,P=0.000; 关节功能评分:t=10.076,P=0.000; t=7.392,P=0.000),联合PNF组患者WOMAC疼痛评分、僵硬评分及关节功能评分均低于PNF组(t=17.577,P=0.000; t=8.354,P=0.000; t=5.753,P=0.000)。②膝关节屈曲与伸展峰值力矩。治疗结束后,2组患者膝关节屈曲峰值力矩与治疗前的差异均无统计学意义(t=1.435,P=0.156; t=0.769,P=0.445),2组患者膝关节屈曲峰值力矩的差异无统计学意义(t=1.229,P=0.224),2组患者膝关节伸展峰值力矩均大于治疗前(t=7.317,P=0.000; t=3.286,P=0.002),联合PNF组患者膝关节伸展峰值力矩大于PNF组(t=2.695,P=0.009)。③膝关节屈曲角度。治疗结束后,2组患者膝关节屈曲角度均大于治疗前(t=4.655,P=0.000; t=4.870,P=0.000),2组患者膝关节屈曲角度的差异无统计学意义(t=1.025,P=0.309)。④下楼梯步态参数。治疗结束后,联合PNF组患者膝关节内收峰值力矩小于治疗前(t=31.379,P=0.000),PNF组患者膝关节内收峰值力矩与治疗前的差异无统计学意义(t=1.493,P=0.140),联合PNF组患者膝关节内收峰值力矩小于PNF组(t=20.033,P=0.000)。治疗结束后,2组患者内外和前后方向动态稳度值小于治疗前(内外方向:t=4.994,P=0.000; t=2.402,P=0.019; 前后方向:t=5.700,P=0.000; t=2.101,P=0.040),联合PNF组患者内外和前后方向动态稳度值小于PNF组(t=2.933,P=0.005; t=2.499,P=0.015)。⑤安全性。2组患者均未发生膝关节肿胀、感染、局部皮疹或瘀斑等并发症。结论:寒湿痹痛方外敷联合PNF治疗KOA寒湿痹阻证,可有效缓解膝关节疼痛、僵硬症状,增强伸膝肌力,促进膝关节功能恢复,提高下楼梯时的步态稳定性,疗效优于单纯采用PNF治疗,但二者在膝关节屈曲角度改善及安全性方面相当。
Abstract:
Objective:To observe the clinical outcomes and safety of external application of Hanshi Bitong Fang(寒湿痹痛方,HSBTF)combined with proprioceptive neuromuscular facilitation(PNF)in treatment of knee osteoarthritis(KOA)with cold-dampness stagnation syndrome in the aged.Methods:Seventy-eight eligible aged KOA patients with cold-dampness stagnation syndrome were enrolled in the study and were randomized into 2 groups,39 ones in each group,and they were treated with external application of HSBTF combined with PNF(combination therapy group)and PNF alone(PNF group),respectively.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores(including pain score,stiffness score,and joint function score),peak torque for knee flexion/extension,knee flexion angle,and down stair gait biomechanical parameters were recorded and compared between the 2 groups before the treatment and after the end of the treatment,respectively,and the complications were observed.Results:①The WOMAC scores.The pain,stiffness,and joint function scores decreased after the end of the treatment compared to pre-treatment in the 2 groups(pain score:t=16.400,P=0.000; t=11.273,P=0.000; stiffness score:t=9.159,P=0.000; t=4.117,P=0.000; joint function score:t=10.076,P=0.000; t=7.392,P=0.000),and the scores were lower in combination therapy group compared to PNF group(t=17.577,P=0.000; t=8.354,P=0.000; t=5.753,P=0.000).②The peak torque for knee flexion/extension.No significant difference was observed in the peak torque for knee flexion between post-treatment and pre-treatment in the 2 groups(t=1.435,P=0.156; t=0.769,P=0.445)and between the 2 groups after the end of the treatment(t=1.229,P=0.224).The peak torque for knee extension increased after the end of the treatment compared to pre-treatment in the 2 groups(t=7.317,P=0.000; t=3.286,P=0.002),with more improvement in combination therapy group(t=2.695,P=0.009).③The knee flexion angle.The knee flexion angle increased after the end of the treatment compared to pre-treatment in the 2 groups(t=4.655,P=0.000; t=4.870,P=0.000),with no significant difference between the 2 groups(t=1.025,P=0.309).④The down stair gait biomechanical parameters.The peak torque for knee adduction shortened after the end of the treatment compared to pre-treatment in the combination therapy group(t=31.379,P=0.000),while,no significant difference was observed in PNF group(t=1.493,P=0.140).The peak torque for knee adduction was smaller in combination therapy group compared to PNF group(t=20.033,P=0.000).The dynamic stability values in the medial-lateral and anterior-posterior directions decreased after the end of the treatment compared to pre-treatment in the 2 groups(medial-lateral direction:t=4.994,P=0.000; t=2.402,P=0.019; anterior-posterior direction:t=5.700,P=0.000; t=2.101,P=0.040),with more decreasement in combination therapy group(t=2.933,P=0.005; t=2.499,P=0.015).⑤Safety.No patients experienced complications such as knee swelling,infection,local rash or ecchymosis in the 2 groups.Conclusion:External application of HSBTF combined with PNF can effectively alleviate the knee pain and stiffness symptoms,enhance knee extension muscle strength,promote knee function recovery,and improve down stair gait stability in treatment of KOA with cold-dampness stagnation syndrome in the aged,and its clinical outcome outperforms that of PNF alone,while,both are comparable in the knee flexion angle improvement and safety.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82374615); 山东省中医药科技项目(2021M149,M-2022253)
通讯作者:孙晋海 E-mail:sunjinhai@126.com
更新日期/Last Update: 1900-01-01