Zhuang Song-Qiang, Zhuang Kai-Zan, Zhang Lu-Min, Zhang Xi-Long
Department of Orthopedics I, Fenghua People's Hospital, Fenghua 315500, Zhejiang Province, China.
Department of Pharmacy, Fenghua People's Hospital, Fenghua 315500, Zhejiang Province, China.
Zhen Ci Yan Jiu. 2018 May 25;43(5):326-9. doi: 10.13702/j.1000-0607.170371.
To examine the clinical benefits of acupuncture combined with intra-articular injection of sodium hyaluronate for knee osteoarthritis (KOA) patients.
A total of 150 KOA patients were randomized into simple medication and acupuncture plus medication (combined treatment) groups (＝75 in each). For all the patients, intra-articular injection of sodium hyaluronate (2 mL) was performed once a week for 5 weeks, and for patients of the combined treatment group, filiform needles were separately inserted into unilateral or bilateral Zusanli (ST 36), Liangqiu (ST 34), Yanglingquan (GB 34), Yinlingquan (SP 9), Xiyangguan (GB 33), Dubi (ST 35), Neixiyan (EX-LE 4) and Xuehai (SP 10) according to the focus, and manipulated with the uniform reinforcing and reducing technique, followed by retaining the needles for 30 min. The acupuncture treatment was given once every day or every other day, 5 weeks in total. The visual analog scale (VAS) was used to assess the pain severity of knee-joint, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) employed to assess the 1) pain severity during various positions or movements (20 points), 2) severity of joint stiffness (8 points), and 3) difficulty in performing daily functional activities (68 points). The therapeutic effect was evaluated according to the decreased level of WOMAC subscale scores and improvement of daily activities.
After the treatment, the VAS scores of both medication and combined treatment groups were decreased significantly in comparison with their own pre-treatment in each group (<0.05), and that of the combined treatment group was significantly lower than that of the medication group (<0.05). WOMAC and daily activity fin-dings showed that of the two 75 KOA patients in the medication and combined treatment groups, 16 (21.33%) and 32 (42.67%) experienced marked improvement, 46 (61.33%) and 38 (50.67%) were improved, and 13 (17.33%) and 5 (6.67%) ineffective, with the total effective rates being 82.67% and 93.33%, respectively. The therapeutic effect of the combined treatment group was apparently superior to that of the simple medication group (<0.05).
Acupuncture combined with intra-articular injection of sodium hyaluronate is effective in improving KOA patients' pain severity and other symptoms as well as functional activities.
探讨针刺联合关节腔内注射透明质酸钠对膝骨关节炎（KOA）患者的临床疗效。
将150例KOA患者随机分为单纯药物治疗组和针刺加药物治疗（联合治疗）组，每组75例。所有患者均每周进行1次关节腔内注射透明质酸钠（2 mL），共5周。联合治疗组患者根据痛点分别针刺单侧或双侧足三里（ST 36）、梁丘（ST 34）、阳陵泉（GB 34）、阴陵泉（SP 9）、膝阳关（GB 33）、犊鼻（ST 35）、内膝眼（EX-LE 4）和血海（SP 10），采用提插补泻手法行针，留针30分钟。针刺治疗每天或隔天1次，共5周。采用视觉模拟评分法（VAS）评估膝关节疼痛程度，采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估：1）不同体位或运动时的疼痛程度（20分）；2）关节僵硬程度（8分）；以及3）日常功能活动困难程度（68分）。根据WOMAC分量表评分降低水平及日常活动改善情况评估治疗效果。
治疗后，两组患者的VAS评分均较各自治疗前显著降低（<0.05），且联合治疗组显著低于单纯药物治疗组（<0.05）。WOMAC评分及日常活动结果显示，单纯药物治疗组和联合治疗组的75例KOA患者中，分别有16例（21.33%）和32例（42.67%）显著改善，46例（61.33%）和38例（50.67%）改善，13例（17.33%）和5例（6.67%）无效，总有效率分别为82.67%和93.33%。联合治疗组的治疗效果明显优于单纯药物治疗组（<0.05）。
针刺联合关节腔内注射透明质酸钠可有效改善KOA患者的疼痛程度及其他症状，并提高其功能活动能力。
