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[1]張遼,金甬,王煥明,等.“經(jīng)緯辨證”理論指導(dǎo)下針刀配合手法及蚌式開合功能鍛煉治療髕股關(guān)節(jié)外側(cè)高壓綜合征的臨床研究[J].中醫(yī)正骨,2018,30(04):23-27.
　ZHANG Liao,JIN Yong,WANG Huanming,et al.A clinical study of needle-knife therapy under the guidance of Jingwei syndrome differentiation theory combined with manipulation and mussel-style open-close functional exercises for treatment of excessive[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(04):23-27.
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“經(jīng)緯辨證”理論指導(dǎo)下針刀配合手法及蚌式開合功能鍛煉治療髕股關(guān)節(jié)外側(cè)高壓綜合征的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年04期
頁(yè)碼:
23-27
欄目:
臨床研究
出版日期:
2018-04-20

文章信息/Info

Title:
A clinical study of needle-knife therapy under the guidance of Jingwei syndrome differentiation theory combined with manipulation and mussel-style open-close functional exercises for treatment of excessive
作者:
張遼1; 金甬1; 王煥明2; 毛宇芳1; 胡浩1; 許旻鳴1
1.浙江省寧波市中醫(yī)院,浙江 寧波 315010; 2.浙江省中醫(yī)院,浙江 杭州 310006
Author(s):
ZHANG Liao1; JIN Yong1; WANG Huanming2; MAO Yufang1; HU Hao1; XU Minming1
1.Ningbo Hospital of Traditional Chinese Medicine,Ningbo 315010,Zhejiang,China2.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
髕股關(guān)節(jié);  膝關(guān)節(jié);  疼痛;  小刀針;  肌肉骨骼手法;  運(yùn)動(dòng)療法
Keywords:
Keywords patellofemoral joint;  knee joint;  pain;  small knife needle;  musculoskeletal manipulations;  exercise therapy
摘要:
目的:觀察“經(jīng)緯辨證”理論指導(dǎo)下針刀配合手法及蚌式開合功能鍛煉治療髕股關(guān)節(jié)外側(cè)高壓綜合征(excessive lateral pressure syndrome,ELPS)的臨床療效。方法:2015年1月至2017年3月,招募ELPS患者64例,隨機(jī)分為2組,每組32例。觀察組采用“經(jīng)緯辨證”理論指導(dǎo)下針刀配合內(nèi)推髕骨手法及蚌式開合功能鍛煉治療,對(duì)照組采用傳統(tǒng)針刀配合內(nèi)推髕骨手法及直腿抬高功能鍛煉治療。觀察組根據(jù)“經(jīng)緯辨證”理論,以下肢為整體、髕股關(guān)節(jié)為局部,整體與局部相結(jié)合選取進(jìn)針點(diǎn); 對(duì)照組于髕股關(guān)節(jié)局部取點(diǎn)。針刀松解均為每周1次,連續(xù)松解3次為1個(gè)療程; 內(nèi)推髕骨手法每日操作2次,連續(xù)6周為1個(gè)療程; 蚌式開合功能鍛煉及直腿抬高功能鍛煉均為每次5 min,每日2次,連續(xù)鍛煉6周為1個(gè)療程; 均治療1個(gè)療程。分別于治療前及末次隨訪時(shí),采用疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)價(jià)膝部疼痛程度,采用Lysholm膝關(guān)節(jié)功能評(píng)分和Kujala髕股關(guān)節(jié)評(píng)分評(píng)價(jià)膝關(guān)節(jié)及髕股關(guān)節(jié)功能。結(jié)果:所有患者均獲隨訪,隨訪時(shí)間5～8個(gè)月,中位數(shù)6個(gè)月。治療前2組患者的膝部疼痛VAS評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(6.16±0.92)分,(5.97±0.90)分,t=0.825,P=0.412]; 末次隨訪時(shí)2組患者的膝部疼痛VAS評(píng)分均較治療前降低(t=36.704,P=0.000; t=17.647,P=0.000),且觀察組的膝部疼痛VAS評(píng)分低于對(duì)照組[(1.28±0.77)分,(2.91±0.78)分,t=8.393,P=0.000]。治療前2組患者的Lysholm膝關(guān)節(jié)功能評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(59.72±8.55)分,(60.97±8.00)分,t=0.604,P=0.548]; 末次隨訪時(shí)2組患者的Lysholm膝關(guān)節(jié)功能評(píng)分均較治療前增高(t=30.334,P=0.000; t=25.281,P=0.000),且觀察組的Lysholm膝關(guān)節(jié)功能評(píng)分高于對(duì)照組[(90.38±4.56)分,(83.50±5.56)分,t=5.407,P=0.000]。治療前2組患者的Kujala髕股關(guān)節(jié)評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(52.16±8.54)分,(52.41±9.37)分,t=0.112,P=0.912]; 末次隨訪時(shí)2組患者的Kujala髕股關(guān)節(jié)評(píng)分均較治療前增高(t=37.512,P=0.000; t=31.191,P=0.000),且觀察組的Kujala髕股關(guān)節(jié)評(píng)分高于對(duì)照組[(86.38±5.99)分,(82.34±6.45)分,t=2.588,P=0.012]。結(jié)論:“經(jīng)緯辨證”理論指導(dǎo)下針刀配合手法及蚌式開合功能鍛煉治療ELPS,可以減輕膝部疼痛癥狀、促進(jìn)膝關(guān)節(jié)及髕股關(guān)節(jié)功能恢復(fù),且療效優(yōu)于傳統(tǒng)針刀配合手法及直腿抬高功能鍛煉治療。
Abstract:
ABSTRACT Objective:To observe the clinical curative effects of needle-knife therapy under the guidance of Jingwei syndrome differentiation theory combined with manipulation and mussel-style open-close functional exercises for treatment of excessive lateral pressure syndrome(ELPS)of patellofemoral joint.Methods:Sixty-four patients with ELPS of patellofemoral joint were recruited from January 2015 to March 2017,and were randomly divided into observation group and control group,32 patients in each group.The patients in observation group were treated with needle-knife therapy under the guidance of Jingwei syndrome differentiation theory combined with manipulation and mussel-style open-close functional exercises,while the patients in control group were treated with traditional needle-knife therapycombined with patellar inward-pushing manipulation and straight-leg-raise functional exercises.According to the Jingwei syndrome differentiation theory,the needle-insertion points were selected by taking lower extremity as the whole and patellofemoral joint as a part and combining the whole with the part in observation group,while the needle-insertion points were selected at patellofemoral joint in control group.Needle-knife release was performed once a week for consecutive 3 times.The patellar inward-pushing manipulation was performed 2 times a day for consecutive 6 weeks.The mussel-style open-close functional exercises and the straight-leg-raise functional exercises were performed 2 times a day,5 minutes at a time for consecutive 6 weeks.The degree of knee pain,the knee joint function and the patellofemoral joint function were evaluated by using pain visual analogue scale(VAS)scores,Lysholm knee function scores and Kujala patellofemoral joint scores before treatment and at follow-up respectively.Results:All patients in the 2 groups were followed up for 5-8 months with a median of 6 months.There was no statistical difference in knee pain VAS scores between the 2 groups before the treatment(6.16+/-0.92 vs 5.97+/-0.90 points,t=0.825,P=0.412).The knee pain VAS scores were lower at last follow-up compared to pretreatment in the 2 groups(t=36.704,P=0.000; t=17.647,P=0.000)and were lower in observation group compared to control group at last follow-up(1.28+/-0.77 vs 2.91+/-0.78 points,t=8.393,P=0.000).There was no statistical difference in Lysholm knee function scores between the 2 groups before the treatment(59.72+/-8.55 vs 60.97+/-8.00 points,t=0.604,P=0.548).The Lysholm knee function scores were higher at last follow-up compared to pretreatment in the 2 groups(t=30.334,P=0.000; t=25.281,P=0.000)and were higher in observation group compared to control group at last follow-up(90.38+/-4.56 vs 83.50+/-5.56 points,t=5.407,P=0.000).There was no statistical difference in Kujala patellofemoral joint scores between the 2 groups before the treatment(52.16+/-8.54 vs 52.41+/-9.37 points,t=0.112,P=0.912).The Kujala patellofemoral joint scores were higher at last follow-up compared to pretreatment in the 2 groups(t=37.512,P=0.000; t=31.191,P=0.000)and were higher in observation group compared to control group at last follow-up(86.38+/-5.99 vs 82.34+/-6.45 points,t=2.588,P=0.012).Conclusion:The combination therapy of needle-knife therapy under the guidance of Jingwei syndrome differentiation theory and manipulation and mussel-style open-close functional exercises can relieve the knee pain and improve the knee joint function and patellofemoral joint function in the treatment of ELPS,moreover,its curative effect is better than that of traditional needle-knife therapy combined with manipulation and straight-leg-raise functional exercises.

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備注/Memo

備注/Memo:
基金項(xiàng)目:全國(guó)名老中醫(yī)藥專家傳承工作室建設(shè)項(xiàng)目; 浙江省中醫(yī)藥科技計(jì)劃項(xiàng)目(2018ZB119)通訊作者:張遼 E-mail:[email protected]
更新日期/Last Update: 2018-08-24