[1]李辉,周承扬,王中华.针刀结合导引治疗膝骨关节炎的临床研究[J].中医正骨,2016,28(04):1-5.
　LI Hui,ZHOU Chengyang,WANG Zhonghua.Clinical study on combination therapy of needle-knife and physical&breathing exercises for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):1-5.
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针刀结合导引治疗膝骨关节炎的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年04期
页码:
1-5
栏目:
临床研究
出版日期:
2016-04-20

文章信息/Info

Title:
Clinical study on combination therapy of needle-knife and physical&breathing exercises for treatment of knee osteoarthritis
作者:
李辉; 周承扬; 王中华
上海市闸北区中心医院,上海 200070
Author(s):
LI Hui; ZHOU Chengyang; WANG Zhonghua
Zhabei District Central Hospital,Shanghai 200070,China
关键词:
骨关节炎; 膝;  小刀针;  导引;  治疗; 临床研究性
Keywords:
osteoarthritis; knee;  small knife needle;  physical&; breathing exercises;  therapies; investigational
摘要:
目的:观察针刀结合导引治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:将符合要求的99例KOA患者随机分为3组,每组33例,分别采用针刀结合导引治疗、单纯针刀治疗和单纯导引治疗。分别于治疗前及治疗2周、4周、8周、16周后,采用视觉模拟评分法(visual analogue score,VAS)评定膝关节疼痛情况,采用西安大略和麦克马斯特大学(Western Ontario and McMaster Universities,WOMAC)评分量表评定膝关节功能。治疗16周后参照《中药新药临床研究指导原则(试行)》中KOA疗效标准及WOMAC评分评定疗效。结果:治疗16周后,每组各有3例脱落。治疗前后不同时间点VAS距离比较,差异有统计学意义,存在时间效应(F=768.009,P=0.001); 3组患者VAS距离比较,总体上组间差异有统计学意义,存在分组效应(F=16.758,P=0.001); 治疗前3组患者VAS距离比较,组间差异无统计学意义[(67.30±4.63)mm,(66.30±3.98)mm,(67.50±3.25)mm; F=0.776,P=0.460]; 治疗2周、4周、8周、16周后,针刀导引组VAS距离小于针刀组、导引组[(49.03±4.01)mm,(49.37±6.32)mm,(55.27±5.69)mm,F=12.518,P=0.001;(43.27±3.60)mm,(44.73±6.99)mm,(50.33±5.16)mm,F=14.167,P=0.001;(38.73±3.93)mm,(41.00±6.14)mm,(45.46±6.25)mm,F=11.434,P=0.001;(33.23±6.51)mm,(36.63±4.61)mm,(41.40±6.66)mm,F=14.009,P=0.001]; 时间因素和分组因素存在交互效应(F=5.220,P=0.001)。治疗前后不同时间点WOMAC评分比较,差异有统计学意义,存在时间效应(F=590.49,P=0.001); 3组患者WOMAC评分比较,总体上组间差异有统计学意义,存在分组效应(F=12.190,P=0.001); 治疗前3组患者WOMAC评分比较,组间差异无统计学意义[(62.17±2.96)分,(61.70±3.22)分,(61.87±4.20)分; F=0.137,P=0.870]; 治疗2周后,针刀导引组WOMAC评分小于导引组[(50.26±5.65)分,(56.53±5.25)分]; 治疗4周、8周、16周后,针刀导引组WOMAC评分小于针刀组、导引组[(41.20±6.96)分,(45.33±7.03)分,(51.86±5.00)分,F=21.153,P=0.001;(35.13±8.43)分,(41.00±8.00)分,(45.40±6.86)分,F=13.108,P=0.001;(27.03±9.90)分,(33.30±9.07)分,(37.03±10.39)分,F=8.236,P=0.001]; 时间因素和分组因素存在交互效应(F=10.000,P=0.001)。治疗16周后,针刀导引组治愈4例、好转24例、未愈2例,针刀组治愈2例、好转18例、未愈10例,导引组治愈1例、好转18例、未愈11例,针刀导引组疗效优于针刀组和导引组(χ2=8.009,P=0.018)。结论:针刀结合导引治疗KOA能够有效缓解膝关节疼痛、恢复膝关节功能,疗效优于单纯针刀或导引,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effects of combination therapy of needle-knife and physical&breathing exercises for treatment of knee osteoarthritis(KOA).Methods:Ninty-nine patients with KOA enrolled in the study were randomly divided into 3 groups,33 cases in each group.The patients were treated with combination therapy of needle-knife and physical&breathing exercises(group A),monotherapy of needle-knife(group B)and monotherapy of physical&breathing exercises(group C)respectively.The knee pains were evaluated by using visual analogue scale(VAS)and the knee joint functions were evaluated by using Western Ontario and McMaster Universities(WOMAC)scoring scale before treatment and at 2,4,8 and 16 weeks after the treatment respectively.The curative effects were evaluated after 16-week treatment according to KOA therapeutic effect standard which was extracted from guiding principles for clinical research on new Chinese medicine(try out) and WOMAC scores.Results:Three patients fell off in each group after 16-week treatment.There was statistical difference in the VAS distance between different timepoints before and after the treatment,in other words,there was time effect(F=768.009,P=0.001).There was statistical difference in the VAS distance between the 3 groups in general,in other words,there was group effect(F=16.758,P=0.001).There was no statistical difference in the VAS distance between the 3 groups before treatment(67.30+/-4.63,66.30+/-3.98,67.50+/-3.25 mm; F=0.776,P=0.460).The VAS distance was shorter in group A compared to group B and group C after 2-,4-,8- and 16-week treatment(49.03+/-4.01,49.37+/-6.32,55.27+/-5.69 mm,F=12.518,P=0.001; 43.27+/-3.60,44.73+/-6.99,50.33+/-5.16 mm,F=14.167,P=0.001; 38.73+/-3.93,41.00+/-6.14,45.46+/-6.25 mm,F=11.434,P=0.001; 33.23+/-6.51,36.63+/-4.61,41.40+/-6.66 mm,F=14.009,P=0.001).There was interaction between time factor and grouping factor(F=5.220,P=0.001).There was statistical difference in the WOMAC scores between different timepoints before and after the treatment,in other words,there was time effect(F=590.49,P=0.001).There was statistical difference in the WOMAC scores between the 3 groups in general,in other words,there was group effect(F=12.190,P=0.001).There was no statistical difference in the WOMAC scores between the 3 groups before treatment(62.17+/-2.96,61.70+/-3.22,61.87+/-4.20 points; F=0.137,P=0.870).The WOMAC scores were lower in group A compared to group C after 2-week treatment(50.26+/-5.65 vs 56.53+/-5.25 points).The WOMAC scores were lower in group A compared to group B and group C after 4-,8- and 16-week treatment(41.20+/-6.96,45.33+/-7.03,51.86+/-5.00 points,F=21.153,P=0.001; 35.13+/-8.43,41.00+/-8.00,45.40+/-6.86 points,F=13.108,P=0.001; 27.03+/-9.90,33.30+/-9.07,37.03+/-10.39 points,F=8.236,P=0.001).There was interaction between time factor and grouping factor(F=10.000,P=0.001).After 16-week treatment,4 patients obtained an excellent result,12 good and 2 poor in group A; 2 patients obtained an excellent result,18 good and 10 poor in group B; and 1 patient obtained an excellent result,18 good and 11 poor in group C.The group A surpassed the group B and group C in the total curative effect(χ2=8.009,P=0.018).Conclusion:The combination therapy of needle-knife and physical&breathing exercises can effectively relieve the knee pain and promote the knee function recovery in the treatment of KOA,and its curative effect is better than that of monotherapy of needle-knife or physical&breathing exercises,so it is worthy of popularizing in clinic.

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备注/Memo

备注/Memo:
基金项目:上海市中医临床重点学科(中医骨伤科学)项目(ZYXK2012018)
更新日期/Last Update: 2016-08-30