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[1]顧力軍,李文華,張斌,等.鈹針松解和針刀松解治療早中期膝骨關節(jié)炎的短期臨床療效觀察[J].中醫(yī)正骨,2016,28(09):30-34.
　GU Lijun,LI Wenhua,ZHANG Bin,et al.Observation on the short-term clinical curative effect of release with stiletto needle versus knife needle for treatment of early-middle knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(09):30-34.
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鈹針松解和針刀松解治療早中期膝骨關節(jié)炎的短期臨床療效觀察()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年09期
頁碼:
30-34
欄目:
膝骨關節(jié)炎
出版日期:
2016-09-20

文章信息/Info

Title:
Observation on the short-term clinical curative effect of release with stiletto needle versus knife needle for treatment of early-middle knee osteoarthritis
作者:
顧力軍1; 李文華1; 張斌1; 唐燕2; 秦偉凱1; 董福慧1
1.中國中醫(yī)科學院望京醫(yī)院,北京 100102; 2.北京中醫(yī)藥大學,北京 100029
Author(s):
GU Lijun1; LI Wenhua1; ZHANG Bin1; TANG Yan2; QIN Weikai1; DONG Fuhui1
1.Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China2.Beijing University of Traditional Chinese Medicine,Beijing 100029,China
關鍵詞:
骨關節(jié)炎; 膝;  疼痛;  針刺療法;  小刀針;  鈹針;  臨床試驗
Keywords:
osteoarthritis; knee;  pain;  acupuncture therapy;  small knife needle;  stiletto needle;  clinical trial
摘要:
目的:觀察鈹針松解和針刀松解治療早中期膝骨關節(jié)炎(knee osteoarthritis,KOA)的短期臨床療效。方法:將113例早中期KOA患者隨機分為3組,鈹針組38例、針刀組38例、扶他林組37例,分別給予鈹針松解、針刀松解和扶他林乳膠劑涂抹膝關節(jié)疼痛部位,2周為1個療程,共治療1個療程。比較治療前后3組患者的膝關節(jié)軟組織位移值、香蕉面積比值、壓痛值、疼痛視覺模擬量表(visual analogue scale,VAS)評分及日本骨科學會(Japanese orthopaedic association,JOA)KOA療效評分。結果:5例患者失訪,其中鈹針組2例、針刀組2例、扶他林組1例。108例患者完成治療并獲得隨訪,隨訪時間28～35 d,中位數(shù)30 d,均未出現(xiàn)不良反應。治療前3組患者的膝關節(jié)軟組織位移值、香蕉面積比值、壓痛值、VAS評分及JOA評分比較,組間差異均無統(tǒng)計學意義[(5.61±0.50)mm,(5.80±0.65)mm,(5.67±0.68)mm,F=0.877,P=0.419;(72.01±3.23)%,(70.92±3.72)%,(71.48±5.87)%,F=0.546,P=0.581;(27.44±5.19)N,(27.24±7.64)N,(29.50±5.49)N,F=1.532,P=0.221;(4.65±0.71)分,(4.28±0.77)分,(4.36±0.85)分,F=2.283,P=0.107;(72.36±5.00)分,(71.67±3.96)分,(71.81±4.50)分,F=0.239,P=0.788]。治療結束后1個月,3組患者的膝關節(jié)軟組織位移值、香蕉面積比值、壓痛值及VAS評分比較,組間差異均有統(tǒng)計學意義[(7.49±0.52)mm,(6.69±0.68)mm,(6.52±0.74)mm,F=32.280,P=0.000;(58.95±4.50)%,(61.66±4.02)%,(64.24±6.52)%,F=14.095,P=0.001;(46.06±6.76)N,(36.55±8.13)N,(36.46±6.17)N,F=31.015,P=0.000;(0.76±0.62)分,(2.06±0.76)分,(2.64±0.71)分,F=58.117,P=0.000]; JOA評分比較,組間差異無統(tǒng)計學意義[(89.72±8.10)分,(87.50±6.27)分,(85.69±7.67)分,F=3.965,P=0.138]。治療結束后1個月,3組患者的軟組織位移值均較治療前升高(t=-18.395,P=0.000; t=-16.693,P=0.000; t=-11.684,P=0.000),鈹針組的軟組織位移值高于針刀組和扶他林組(P=0.000; P=0.000),針刀組與扶他林組比較差異無統(tǒng)計學意義(P=0.153); 3組患者的香蕉面積比值均較治療前降低(t=23.148,P=0.000; t=21.909,P=0.000; t=-13.081,P=0.000),鈹針組的香蕉面積比值低于扶他林組(P=0.001),鈹針組與針刀組比較差異無統(tǒng)計學意義(P=0.075),針刀組與扶他林組比較差異無統(tǒng)計學意義(P=0.412); 3組患者的壓痛值均較治療前升高(t=-21.091,P=0.000; t=-11.338,P=0.000; t=-10.917,P=0.000),鈹針組的壓痛值高于針刀組和扶他林組(P=0.000; P=0.001),針刀組與扶他林組比較差異無統(tǒng)計學意義(P=0.848); 3組患者的VAS評分均較治療前降低(t=30.138,P=0.000; t=21.622,P=0.000; t=12.552,P=0.000),鈹針組的VAS評分低于針刀組和扶他林組(P=0.000; P=0.000),針刀組的VAS評分低于扶他林組(P=0.012)。結論:鈹針松解、針刀松解及扶他林乳膠劑外用治療早中期KOA的短期臨床綜合療效相當,但鈹針松解能更好地緩解膝關節(jié)疼痛,值得臨床推廣應用。
Abstract:
Objective:To observe the short-term clinical curative effects of release with stiletto needle versus knife needle for treatment of early-middle knee osteoarthritis(KOA).Methods:One hundred and thirteen patients with early-middle KOA enrolled in the study were randomly divided into stiletto needle group(38 cases),knife needle group(38 cases)and voltaren group(37 cases),and were treated with stiletto needle release,knife needle release and votalin emulgel applied to the knee pain sites respectively for one course oftreatment,2 weeks for each course.The displacement values,banana area ratio,tenderness values and pain visual analogue scale(VAS)scores of knee-joint soft tissue and Japanese orthopaedic association(JOA)scores for curative effect evaluation of KOA were compared between the 3 groups before and after the treatment and between pretreatment and posttreatment.Results:Two patients in stiletto needle group,2 patients in knife needle group and 1 patient in voltaren group lost to follow-up.One hundred and eight patients in the 3 groups were followed up for 28-35 days with a median of 30 days,and no adverse reactions were found.There was no statistical difference in the displacement values,banana area ratio,tenderness values and VAS scores of knee-joint soft tissue and JOA scores between the 3 groups before treatment(5.61+/-0.50,5.80+/-0.65,5.67+/-0.68 mm,F=0.877,P=0.419; 72.01+/-3.23,70.92+/-3.72,71.48+/-5.87%,F=0.546,P=0.581; 27.44+/-5.19,27.24+/-7.64,29.50+/-5.49 N,F=1.532,P=0.221; 4.65+/-0.71,4.28+/-0.77,4.36+/-0.85 points,F=2.283,P=0.107; 72.36+/-5.00,71.67+/-3.96,71.81+/-4.50 points,F=0.239,P=0.788).There was statistical difference in the displacement values,banana area ratio,tenderness values and VAS scores of knee-joint soft tissue between the 3 groups at 1 month after the end of the treatment(7.49+/-0.52,6.69+/-0.68,6.52+/-0.74 mm,F=32.280,P=0.000; 58.95+/-4.50,61.66+/-4.02,64.24+/-6.52%,F=14.095,P=0.001; 46.06+/-6.76,36.55+/-8.13,36.46+/-6.17 N,F=31.015,P=0.000; 0.76+/-0.62,2.06+/-0.76,2.64+/-0.71 points,F=58.117,P=0.000).There was no statistical difference in the JOA scores between the 3 groups(89.72+/-8.10,87.50+/-6.27,85.69+/-7.67 points,F=3.965,P=0.138).The displacement values of knee-joint soft tissue increased in the 3 groups at 1 month after the end of treatment compared to pre-treatment(t=-18.395,P=0.000; t=-16.693,P=0.000; t=-11.684,P=0.000).The displacement values of knee-joint soft tissue were higher in stiletto needle group compared to knife needle group and voltaren group(P=0.000; P=0.000)and there was no statistical difference between knife needle group and voltaren group(P=0.153).The banana area ratio decreased in the 3 groups after treament compared to pre-treatment(t=23.148,P=0.000; t=21.909,P=0.000; t=-13.081,P=0.000).The banana area ratio was lower in stiletto needle group compared to voltaren group(P=0.001),and there was no statistical difference in the banana area ratio between stiletto needle group and knife needle group(P=0.075)and between knife needle group and voltaren group(P=0.412).The tenderness values increased in the 3 groups after treatment compared to pre-treatment(t=-21.091,P=0.000; t=-11.338,P=0.000; t=-10.917,P=0.000),and the tenderness values were higher in stiletto needle group compared to knife needle and voltaren group(P=0.000; P=0.001)while there was no statistical difference between knife needle group and voltaren group(P=0.848).The VAS scores decreased in the 3 groups after treatment compared to pre-treatment(t=30.138,P=0.000; t=21.622,P=0.000; t=12.552,P=0.000),and the VAS scores were lower in stiletto needle group compared to knife needle group and voltaren group(P=0.000; P=0.000)and were lower in knife needle group compared to voltaren group(P=0.012).Conclusion:Stiletto needle release,knife needle release and external application of votalin emulgel are similar to each other in the short-term clinical comprehensive curative effects in treatment of early-middle KOA,however,the stiletto needle release can better relieve the knee pain,so it is worthy of popularizing in clinic.

參考文獻/References:

[1] Hochberg MC,Altman RD,Brandt KD,et al.Guidelines for the medical management of osteoarthritis.Part II.Osteoarthritis of the knee[J].Arthritis Rheum,1995,38(11):1541-1546. [2] Kellgren JH,Lawrence JS.Radiological assessment of rheumatoid arthritis[J].Ann Rheum Dis,1957,16(4):485-493. [3] 顧力軍,裘興棟,趙勇,等.鈹針與扶他林乳膠劑治療膝骨關節(jié)炎疼痛的病例對照研究[J].中國骨傷,2012,25(12):1036-1039.[4] 曾貴剛,張秀芬,權伍成,等.針刀松解術對膝骨性關節(jié)炎局部軟組織張力及疼痛的影響[J].中國針灸,2008,28(4):244-247. [5] 顧力軍,董福慧.疼痛客觀化指標在膝骨關節(jié)炎患者膝關節(jié)功能和疼痛評價中的應用[J].中醫(yī)正骨,2013,25(9):22-24. [6] 朱立國,于杰,高景華,等.頸肩部壓痛的測定及其在神經(jīng)根型頸椎病診療過程中的意義[J].頸腰痛雜志,2008,29(1):6-9. [7] Aitken RC.Measurement of feelings using visual analogue scales[J].Proc R Soc Med,1969,62(10):989-993. [8] 蔣協(xié)遠,王大偉.骨科臨床療效評價標準[M].北京:人民衛(wèi)生出版社,2005:203-204. [9] 申延清,劉風霞,曹紅,等.膝骨關節(jié)炎患者的臨床表現(xiàn)及相關影響因素[J].中國組織工程研究與臨床康復,2011,15(9):1643-1646. [10] 中華醫(yī)學會骨科學分會.骨關節(jié)炎診治指南(2007年版)[J].中國臨床醫(yī)生雜志,2008,36(1):28-30. [11] Zacher J,Altman R,Bellamy N,et al.Topical diclofenac and its role in pain and inflammation:an evidence-based review[J].Curr Med Res Opin,2008,24(4):925-950. [12] 郭長青,司同,溫建民,等.針刀松解法改善膝骨關節(jié)炎疼痛癥狀的隨機對照臨床研究[J].天津中醫(yī)藥,2012,29(1):35-38. [13] 趙勇,秦偉凱,顧力軍,等.從經(jīng)筋論治膝骨關節(jié)炎疼痛臨證思維[J].中國中醫(yī)藥信息雜志,2012,19(3):92-93. [14] 董福慧.皮神經(jīng)卡壓綜合征的治療[J].中國骨傷,2003,16(5):308-312. [15] 張芾男,董福慧,張卓男,等.單純減壓對皮神經(jīng)卡壓作用的實驗研究[J].中國骨傷,2007,20(5):289-291.

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備注/Memo

備注/Memo:
2016-04-17收稿 2016-05-25修回
基金項目:中國中醫(yī)科學院基本科研業(yè)務費自主選題項目(ZZ0708084)
董福慧 E-mail:[email protected]

更新日期/Last Update: 1900-01-01