Ju Chang-Jun, Zhou Xin, Dong Cheng-Cheng, Lin Le-Qin, Liu Hai-Ning, Hou Yan
Department of Joint, Wendeng Osteopathic Hospital, Weihai 264400, Shandong Province, China.
Department of Anesthesiology, Wendeng Osteopathic Hospital, Weihai 264400, Shandong Province, China.
Zhongguo Zhen Jiu. 2019 Mar 12;39(3):276-9. doi: 10.13703/j.0255-2930.2019.03.014.
To evaluate the clinical efficacy of warm moxibustion therapy in the recovery of quadriceps muscle strength in patients undergoing total knee arthroplasty (TKA) with analgesia of the femoral nerve block (FNB).
A total of 174 patients with KOA were randomized into a warm moxibustion group and a rehabilitation group, 87 cases in each group. In the warm moxibustion group, warm moxibustion combined with conventional quadriceps strength training were used. In the rehabilitation group, conventional quadriceps strength training was given. The warm moxibustion was applied at Liangqiu (ST 34) and Zusanli (ST 36), the treatment was given twice a day, 7 days for one course, with a total of 2 courses.The quadriceps muscle strength of the two groups was recorded and compared at 24 h before FNB, 24, 48, 72 and 96 h after surgery, and the resting and exercise VAS pain scores were also recorded at the same time point. And the first time for standing up and the first straight raising time in the two groups were compared, and the occurrence of adverse reactions in the two groups were observed.
At 24, 48, 72 and 96 h after FNB, the quadriceps muscle strength in the warm moxibustion group was better than that in the rehabilitation group (<0.05, <0.01). At 72 h and 96 h after FNB, the resting and exercise VAS scores of the warm moxibustion group were lower than those of the rehabilitation group (both <0.001). The average first straight leg raising time in the warm moxibustion group was postoperative (31.03±10.78) h, and the time in the rehabilitation group was postoperative (47.23±15.78) h. The difference was statistically significant (<0.001). The average time of the first time for standing up in the warm moxibustion group was postoperative (25.76±7.00) h, and postoperative (33.12±11.18) h in the rehabilitation group. The difference was also statistically significant (<0.001). No adverse reactions occurred in both groups.
Warm moxibustion combined with conventional quadriceps strength training can improve the symptoms of quadriceps weakness in patients with femoral nerve block after total knee arthroplasty, and accelerate the recovery of joint function, which is superior to conventional quadriceps strength training.
评估温灸疗法对接受股神经阻滞（FNB）镇痛的全膝关节置换术（TKA）患者股四头肌肌力恢复的临床疗效。
将174例膝骨关节炎（KOA）患者随机分为温灸组和康复组，每组87例。温灸组采用温灸结合传统股四头肌力量训练，康复组仅给予传统股四头肌力量训练。温灸选取梁丘（ST 34）和足三里（ST 36），每日治疗2次，7天为1个疗程，共2个疗程。记录两组在FNB前24小时、术后24、48、72和96小时的股四头肌肌力，并进行比较，同时记录同一时间点的静息和运动时视觉模拟评分法（VAS）疼痛评分。比较两组首次站立时间和首次直腿抬高时间，并观察两组不良反应的发生情况。
FNB后24、48、72和96小时，温灸组股四头肌肌力优于康复组（<0.05，<0.01）。FNB后72小时和96小时，温灸组静息和运动时VAS评分低于康复组（均<0.001）。温灸组首次直腿抬高平均时间为术后（31.03±10.78）小时，康复组为术后（47.23±15.78）小时，差异有统计学意义（<0.001）。温灸组首次站立平均时间为术后（25.76±7.00）小时，康复组为术后（33.12±11.18）小时，差异也有统计学意义（<0.001）。两组均未发生不良反应。
温灸结合传统股四头肌力量训练可改善全膝关节置换术后股神经阻滞患者股四头肌无力症状，加速关节功能恢复，优于传统股四头肌力量训练。
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