Liang Ya-Feng, Li Wen-Xun, Ma Ying, Zhang Bing-Yue, Huang Yi-Ran
School of Acupuncture-moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China.
Zhen Ci Yan Jiu. 2019 Jun 25;44(6):439-42. doi: 10.13702/j.1000-0607.190045.
To compare the clinical efficacy of soft-tissue relaxing needling and electroacupuncture (EA) in the treatment of knee osteoarthritis (KOA), so as to explore a new and more effective therapy for KOA.
Forty patients with KOA who met our diagnostic criteria were randomly and equally divided into acupuncture group and soft-tissue relaxing needling (relaxing-needling) group. EA (20 Hz, a tolerable strength and duration of 20 min) was applied to the unilateral Neixiyan(EX-LE5) and Waixiyan(EX-LE5), and manual acupuncture stimulation was applied to Heding(EX-LE2), Xuehai (SP10), Xiyangguan (GB33), Liangqiu(ST34), Yanglingquan(GB34) and Yinlingquan(SP9) on the affected side by using uniform reinforcing-reducing technique. In the relaxing-needling group, after identifying the tender point and nodule-like or stiff-strip-muscle spot at the affected limb by palpation, we used filiform needles to insert into them, then, made a longitudinal separation or point-like pricking. The visual analog scale (VAS) pain score, knee flexion activity (range of motion, ROM), and the knee osteoarthritis severity (Lequesne index, composed of daily living, walking distance and pain) were measured before and after the treatment. The therapeutic effect was assessed by consulting the Guiding Principles for Researching New Drugs of Traditional Chinese Medicine (2002) and Criteria for Diagnosis and Assessment of Therapeutic Effect of Syndromes or Illnesses of Traditional Chinese Medicine (1994).
After the treatment, the VAS score and Lequesne index were significantly decreased in both acupuncture and relaxing-needling groups (<0.001), and the ROM score was considerably increased in both groups in comparison with their own pre-treatment (<0.001). The difference values of VAS score and Lequesne index between pre- and post-treatment were significantly higher in the relaxing-needling group than in the acupuncture group (<0.05). Of the two 20 cases in the relaxing-needling and acupuncture groups, 8 and 3 experienced a remarkable improvement in their symptoms, 10 and 13 were effective, 2 and 4 failed, with the effective rate being 90.0% and 80.0%, respectively. No significant difference was found between the two groups in the difference value of ROM score and the effective rate (>0.05)．.
Both relaxing-needling and EA therapies are comparable in the therapeutic effect for KOA, and the former is superior to the latter in reducing the joint pain and improving the knee joint locomotor function, thus being worthy of clinical application.
比较软组织松解针刺与电针治疗膝骨关节炎（KOA）的临床疗效，以探索一种新的、更有效的KOA治疗方法。
将40例符合诊断标准的KOA患者随机等分为针刺组和软组织松解针刺（松针）组。电针（20Hz，耐受强度，持续20分钟）应用于单侧内膝眼（EX-LE5）和外膝眼（EX-LE5），患侧的鹤顶（EX-LE2）、血海（SP10）、膝阳关（GB33）、梁丘（ST34）、阳陵泉（GB34）和阴陵泉（SP9）采用提插补泻手法进行手法针刺刺激。在松针组中，通过触诊确定患侧肢体的压痛点和结节样或条索状肌肉点后，用毫针针刺入，然后进行纵向分离或点刺。在治疗前后测量视觉模拟量表（VAS）疼痛评分、膝关节屈曲活动度（活动范围，ROM）以及膝骨关节炎严重程度（Lequesne指数，由日常生活、行走距离和疼痛组成）。根据《中药新药研究指导原则》（2002年）和《中医病证诊断疗效标准》（1994年）评估治疗效果。
治疗后，针刺组和松针组的VAS评分和Lequesne指数均显著降低（<0.001），两组的ROM评分与各自治疗前相比均显著增加（<0.001）。松针组治疗前后VAS评分和Lequesne指数的差值显著高于针刺组（<0.05）。松针组和针刺组的20例患者中，症状显著改善的分别有8例和3例，有效分别为10例和13例，无效分别为2例和4例，有效率分别为90.0%和80.0%。两组ROM评分差值和有效率比较，差异无统计学意义（>0.05）。
松针疗法和电针疗法对KOA的治疗效果相当，前者在减轻关节疼痛和改善膝关节运动功能方面优于后者，值得临床应用。
