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针刺联合膝关节肌肉手法调理治疗膝骨关节炎的临床研究

[Clinical study on the treatment of knee osteoarthritis by acupuncture plus manipulative regulation of knee muscle].

作者信息

Sun Kui, Bao Xue-Mei, Song Yang-Chun, Liu De-Chun

机构信息

Acupuncture-Moxibustion Hospital Affiliated to Anhui College of Traditional Chinese Medicine, Hefei 230061, Anhui, China.

出版信息

Zhongguo Gu Shang. 2010 Dec;23(12):895-8.

PMID:21265192
Abstract

OBJECTIVE

To investigate and research the appraisal scores of the symptoms and physical signs index for the evaluation of the clinical efficacy of acupuncture and manipulative regulation of knee muscle balance for the treatment of knee osteoarthritis, and provide clinical basis for the treatment.

METHODS

From January 2008 to December 2009, 121 patients with knee osteoarthritis were randomly divided into two groups. In the treatment group there were 63 cases of 83 knees including 16 males and 47 females, with an average age of (59.88 +/- 7.97) years; in the control group there were 58 cases of 73 knees including 13 males and 45 females, with an average age of (57.95 +/- 10.37) years. The patients in the treatment group were treated with acupuncture plus manipulative regulation of knee muscle balance, and the patients in the control group were treated with Diclofenac Sodium Sustained Release Tablets. The appraisal scores of the symptoms and physical signs index, numerical rating scale of pain, joint function, joint swelling were evaluated before and after the treatment, as well as 3 months after the treatment. All data were statistical analyzed by package SPSS 10.0.

RESULTS

  1. In the treatment group, before and after treatment the appraisal scores of the symptoms and physical signs index were (39.81 +/- 3.92) and (9.69 +/- 8.08); numerical rating scale of pain were (7.61 +/- 0.97) and (2.17 +/- 2.09); joint function were (1.47 +/- 0.50) and (0.61 +/- 0.58); joint swelling were (1.23 +/- 0.79) and (0.42 +/- 0.52). As well in the control group, above data were (39.89 +/- 3.78), (13.62 +/- 7.83), (7.55 +/- 0.71), (3.34 +/- 2.32), (1.33 +/- 0.47), (0.93 +/- 0.67), an (0.97 +/- 0.88), (0.58 +/- 0.52) respectively. Both group had obvious differences in the appraisal scores of the symptoms and physical signs index, numerical rating scale of pain, joint function, joint swelling between after and before treatment. The comparison between the two groups suggested that after the treatments the treatment group had better therapy effect than those of the control group in the appraisal scores of the symptoms and physical signs index, numerical rating scale of pain, joint function, but both group had no differences in the appraisal scores of joint swelling. 2) After the treatment, 12 patients in the treatment group were clinically cured, 48 had remarkable effects,19 good, and 4 ineffective. As well in the control group, above data were 5, 31, 34 and 3 respectively. Three months after the treatment, above data were 8, 42, 27 and 6 respectively in the treatment group. In the control group, above data were 5, 21, 37 and 10 respectively. The treatment group was superior to the control group after the treatments and 3 months after the treatment.

CONCLUSION

Acupuncture plus manipulative regulation of knee muscle balance can effectively improve the clinical symptoms and knee joint's motor function of patients with knee osteoarthritis, and can avoid the further development of disease. It is a proved effective method for knee osteoarthritis.

摘要

目的

探讨症状体征指数评分法在评估针刺配合手法调整膝关节肌肉平衡治疗膝骨关节炎临床疗效中的应用,为临床治疗提供依据。

方法

选取2008年1月至2009年12月膝骨关节炎患者121例,随机分为两组。治疗组63例83膝,男16例,女47例,平均年龄(59.88±7.97)岁;对照组58例73膝,男13例,女45例,平均年龄(57.95±10.37)岁。治疗组采用针刺配合手法调整膝关节肌肉平衡治疗,对照组采用双氯芬酸钠缓释片治疗。于治疗前、治疗后及治疗后3个月对症状体征指数评分、疼痛数字分级法评分、关节功能、关节肿胀情况进行评估。所有数据采用SPSS 10.0软件进行统计学分析。

结果

1)治疗组治疗前、后症状体征指数评分分别为(39.81±3.92)、(9.69±8.08);疼痛数字分级法评分分别为(7.61±0.97)、(2.17±2.09);关节功能分别为(1.47±0.50)、(0.61±0.58);关节肿胀分别为(1.23±0.79)、(0.42±0.52)。对照组上述数据分别为(39.89±3.78)、(13.62±7.83)、(7.55±0.71)、(3.34±2.32)、(1.33±0.47)、(0.93±0.67)、(0.97±0.88)、(0.58±0.52)。两组治疗前、后症状体征指数评分、疼痛数字分级法评分、关节功能、关节肿胀比较,差异均有统计学意义。两组治疗后比较,治疗组症状体征指数评分、疼痛数字分级法评分、关节功能改善情况优于对照组,关节肿胀评分差异无统计学意义。2)治疗后,治疗组临床治愈12例,显效48例,好转19例,无效4例。对照组分别为5例、31例、34例、3例。治疗后3个月,治疗组分别为8例、42例、27例、6例。对照组分别为5例、21例、37例、10例。治疗组治疗后及治疗后3个月疗效均优于对照组。

结论

针刺配合手法调整膝关节肌肉平衡能有效改善膝骨关节炎患者的临床症状及膝关节运动功能,避免病情进一步发展,是治疗膝骨关节炎的有效方法。

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