针刀治疗膝骨关节炎：一项随机对照试验

[ acupotomy for knee osteoarthritis: a randomized controlled trial].

作者信息

Xu Dang-Han, Lin Yu-Xiang, Wei Jia, Huang Ci-Hui, Li Ming-Hui, Yao Tao-Tao, Hong Xu-Bo, Zhang Ze-Sheng, Zheng Liang

机构信息

Rehabilitaion Center, First Affiliated Hospital of Guangzhou University of CM, Guangzhou 510400, Guangdong Province, China; Rehabilitaion Center, First Clinical Medicine School, Guangzhou University of CM, Guangzhou 510400, Guangdong Province.

Rehabilitaion Center, First Clinical Medicine School, Guangzhou University of CM, Guangzhou 510400, Guangdong Province.

出版信息

Zhongguo Zhen Jiu. 2022 Dec 12;42(12):1351-6. doi: 10.13703/j.0255-2930.20220126-k0002.

DOI:10.13703/j.0255-2930.20220126-k0002

PMID:36484186

Abstract

OBJECTIVE

To observe the clinical efficacy of acupotomy (acupotomy for regulating and harmonizing and ) for knee osteoarthritis (KOA).

METHODS

A total of 88 patients with KOA were randomized into a acupotomy group and a sham-acupotomy group, 44 cases in each group. In the acupotomy group, acupotomy was applied at side (4-5 high stress points i.e. pes anserinus and terminal of popliteus) and side (1-2 high stress points i.e. stimulation point of infrapatellar ligament and suprapatellar bursa) of knee joint. In the sham-acupotomy group, sham-acupotomy was applied at the same points as the acupotomy group. The treatment was given once a week for 2 weeks in the two groups. Before and after treatment, the Western Ontario and McMaster Universities arthritis index (WOMAC) score, visual analogue scale (VAS) score, thickness of medial and lateral collateral ligaments of knee joint, motion range of knee joint and plantar pressure distribution were observed in the two groups. In the follow-up of 3 months after treatment, the WOMAC and VAS scores were recorded in the acupotomy group.

RESULTS

After treatment, the sub item scores (pain, stiffness and function) and total scores of WOMAC and VAS scores were decreased in the both groups (<0.05), pain score, function score and total score of WOMAC and VAS score in the acupotomy group were lower than those in the sham-acupotomy group (<0.05). Before and after treatment, there were no statistical differences in thickness of medial and lateral collateral ligaments of knee joint and motion range of knee joint between the two groups (>0.05). After treatment, the plantar medial pressure was increased while the plantar lateral pressure was decreased (<0.05), and the plantar force line moved medially in the acupotomy group. In the follow-up, the sub item scores and total score of WOMAC and VAS score were lower than those before and after treatment in the acupotomy group (<0.05).

CONCLUSION

acupotomy can improve the clinical symptoms of knee joint in patients with KOA by changing the local biological stress.

摘要

目的

观察针刀（调衡针刀）治疗膝骨关节炎（KOA）的临床疗效。

方法

将88例KOA患者随机分为针刀组和假针刀组，每组44例。针刀组于膝关节患侧（4～5个高应力点，即鹅足和腘肌止点）及健侧（1～2个高应力点，即髌韧带刺激点和髌上囊）施针刀治疗。假针刀组于与针刀组相同的部位行假针刀治疗。两组均每周治疗1次，共治疗2周。观察两组治疗前后西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟评分法（VAS）评分、膝关节内外侧副韧带厚度、膝关节活动度及足底压力分布情况。治疗后随访3个月，记录针刀组的WOMAC和VAS评分。

结果

治疗后，两组WOMAC及VAS评分的各分项评分（疼痛、僵硬及功能）及总分均降低（P<0.05），针刀组WOMAC及VAS评分的疼痛评分、功能评分及总分均低于假针刀组（P<0.05）。治疗前后，两组膝关节内外侧副韧带厚度及膝关节活动度比较，差异无统计学意义（P>0.05）。治疗后，针刀组足底内侧压力升高，足底外侧压力降低（P<0.05），足底力线向内侧移动。随访时，针刀组WOMAC及VAS评分的各分项评分及总分均低于治疗前后（P<0.05）。