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干针治疗膝关节骨关节炎患者的潜在和活跃肌筋膜触发点与口服双氯芬酸的随机对照试验。

Dry needling on latent and active myofascial trigger points versus oral diclofenac in patients with knee osteoarthritis: a randomized controlled trial.

机构信息

Department of Pain Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China.

Department of Treatment, Yang Zhi Affiliated Rehabilition Hospital of Tongji, Shanghai, China.

出版信息

BMC Musculoskelet Disord. 2023 Jan 18;24(1):36. doi: 10.1186/s12891-022-06116-9.

Abstract

BACKGROUND

Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA.

METHODS

This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up.

RESULTS

A total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG.

CONCLUSIONS

Dry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months.

TRIAL REGISTRATION

Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) in 17/11/2017 with the following code: ChiCTR-INR-17013432.

摘要

背景

膝关节相关肌肉中的潜伏性和活动性肌筋膜触发点(MTrP)可能在膝骨关节炎(KOA)患者的疼痛管理中发挥关键作用。本研究旨在探讨干针治疗对 KOA 患者疼痛强度、残疾和关节活动度(ROM)的影响。

方法

这是一项为期 6 周治疗和 6 个月随访的随机、单盲、临床试验。共有 98 名符合入选标准的患者被随机分配至干针治疗潜伏性和活动性肌筋膜触发点(MTrP)加拉伸组或口服双氯芬酸钠加拉伸组。在治疗前后和 6 个月随访时,采用数字疼痛评分量表(NPRS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)和 ROM 进行统计学分析。

结果

共有 42 名干针组(DNG)和 35 名双氯芬酸钠组(DG)患者完成了研究,两组一般资料无统计学差异。治疗后,两组膝关节疼痛、功能和 ROM 均有较好的疗效,但 DNG 组疗效明显优于 DG 组。特别是在 6 个月随访时,DNG 组的结果明显优于 DG 组。

结论

干针治疗潜伏性和活动性 MTrP 结合拉伸以及口服双氯芬酸钠结合拉伸可有效缓解 KOA 引起的疼痛、改善功能和恢复膝关节 ROM。然而,至少在 6 个月内,干针和拉伸的效果优于口服双氯芬酸钠和拉伸。

试验注册

2017 年 11 月 17 日在中国临床试验注册中心(www.chictr.org.cn)注册,注册号:ChiCTR-INR-17013432。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31ae/9847151/f0dd02b9ee4c/12891_2022_6116_Fig1_HTML.jpg

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