Liu Feng-Wei, Zhao Yuan-Yuan, Ren Fei, Qin Si-He, Liu Li-Chu, Yang Hai-Yun, Zhang Dong-Wei, Feng Feng
Luoyang Orthopedic-Traumatological of Henan Province(Henan Provincial Orthopedic Hospital), Luoyang 471002, Henan, China;
Zhongguo Gu Shang. 2019 May 25;32(5):401-406. doi: 10.3969/j.issn.1003-0034.2019.05.003.
To explore the clinical effect of acupoint puncture combined with Ilizarov technique in the treatment of knee osteoarthritis in the elderly.
From March 2015 to February 2016, 76 patients with primary knee osteoarthritis were treated with tibial osteotomy acupoint puncture grouop and Ilizarov technique anatomical puncture group, including 24 males and 52 females, aged 56 to 75 years old with an average of 61.4 years old, and a course of 3 to 17 years with an average of 5.2 years. Among them, 38 cases were treated with external fixation of acupoint puncture needle and 38 cases were treated with external fixation of anatomical puncture needle. Preoperative full-length X-ray of both lower limbs showed tibial varus deformity, narrowing of medial knee joint space and enlargement of lateral knee joint space. The force line of the affected knee and lower limb was moved inward by body surface measurement, and the KSS knee function score was decreased. Symptoms included medial knee pain, flexion and extension, and conservative treatment for more than 2 years.
The lower limb force lines of both groups were corrected and the osteotomy ends healed well. No nonunion of osteotomy, inadequate correction of lower limbs or recurrence of deformity were found. Seventy-five patients were followed up for 3, 6, 12 and 24 months after operation. There was no significant difference in knee joint mobility between the two groups before operation and on 6, 12, 24 months after operation(=1.346, >0.05). There were significant difference in KSS pain and total score between the two groups at 3 months after operation, acupoint puncture group was better than anatomical puncture group(<0.05); there was no significant difference in KSS score at 12 months after operation(>0.05).
The acupoint puncture group formed a potential acupuncture effect in the acupoint area by continuously tightening the steel needle on Ilizarov ring external fixator during the post-operative adjustment. Within three months after wearing external fixator, the knee pain symptoms of knee osteoarthritis were relieved rapidly, continuously and effectively, which was significantly better than that of the anatomical puncture group.
探讨穴位针刺联合伊利扎洛夫技术治疗老年膝关节骨性关节炎的临床效果。
选取2015年3月至2016年2月收治的76例原发性膝关节骨性关节炎患者，分为穴位针刺组和伊利扎洛夫技术解剖针刺组，其中男24例，女52例，年龄56～75岁，平均61.4岁，病程3～17年，平均5.2年。其中38例采用穴位针刺针外固定治疗，38例采用解剖针刺针外固定治疗。术前双下肢全长X线片显示胫骨内翻畸形，膝关节内侧间隙变窄，外侧间隙增宽。通过体表测量患侧膝关节及下肢力线向内移位，KSS膝关节功能评分降低。症状包括膝关节内侧疼痛、屈伸活动，且保守治疗2年以上。
两组下肢力线均得到矫正，截骨端愈合良好。未发现截骨不愈合、下肢矫正不足或畸形复发。75例患者术后3、6、12和24个月进行随访。两组术前及术后6、12、24个月膝关节活动度比较，差异无统计学意义（=1.346，>0.05）。两组术后3个月KSS疼痛评分及总分比较，差异有统计学意义，穴位针刺组优于解剖针刺组（<0.05）；术后12个月KSS评分差异无统计学意义（>0.05）。
穴位针刺组在术后调整过程中，通过伊利扎洛夫环形外固定器上的钢针持续收紧，在穴位区域形成潜在的针刺效应。佩戴外固定器3个月内，膝关节骨性关节炎的膝关节疼痛症状得到快速、持续、有效的缓解，明显优于解剖针刺组。
