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[1]林木南,賈良良,許麗梅,等.基于不均勻沉降理論的揉膝推髕點(diǎn)穴法 聯(lián)合口服鹽酸氨基葡萄糖治療早期膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2018,30(09):18-21.
　LIN Munan,JIA Liangliang,XU Limei,et al.A clinical study of rubbing-knee,pushing-patella and pressing-points under the guidance of uneven sagging theory combined with oral application of glucosamine hydrochloride for treatment of early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(09):18-21.
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基于不均勻沉降理論的揉膝推髕點(diǎn)穴法 聯(lián)合口服鹽酸氨基葡萄糖治療早期膝骨關(guān)節(jié)炎()
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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09期
頁碼:
18-21
欄目:
骨關(guān)節(jié)炎
出版日期:
2018-09-20

文章信息/Info

Title:
A clinical study of rubbing-knee,pushing-patella and pressing-points under the guidance of uneven sagging theory combined with oral application of glucosamine hydrochloride for treatment of early knee osteoarthritis
作者:
林木南1; 賈良良2; 許麗梅2; 秦茵1; 李西海3
1.中國人民解放軍南京軍區(qū)福州總醫(yī)院,福建 福州 350025; 2.福建中醫(yī)藥大學(xué),福建 福州 350122; 3.福建省中西醫(yī)結(jié)合老年性疾病重點(diǎn)實(shí)驗(yàn)室,福建 福州 350122
Author(s):
LIN Munan1; JIA Liangliang2; XU Limei2; QIN Yin1; LI Xihai3
1.Fuzhou General Hospital of Nanjing Military District of PLA,Fuzhou 350025,Fujian,China 2.Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian,China 3.Fujian Key Laboratory of Integrated Medicine on Geriatrics,Fuzhou 350122,Fujian,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  穴位按壓;  臨床試驗(yàn)
Keywords:
osteoarthritis; knee;  acupressure;  clinical trial
摘要:
觀察基于不均勻沉降理論的揉膝推髕點(diǎn)穴法聯(lián)合口服鹽酸氨基葡萄糖治療早期膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)的臨床療效和安全性。方法:將符合要求的KOA患者(均為Kellgren-LawrenceⅠ級或Ⅱ級)隨機(jī)分為2組,分別采用揉膝推髕點(diǎn)穴法聯(lián)合口服鹽酸氨基葡萄糖治療(推拿組)和口服鹽酸氨基葡萄糖聯(lián)合外用雙氯芬酸二乙胺乳膠劑治療(藥物組)。揉膝推髕點(diǎn)穴法隔天治療1 次,共治療2周; 鹽酸氨基葡萄糖膠囊口服,每次750 mg,每日2次,服用2周; 雙氯芬酸二乙胺乳膠劑,在痛處涂抹,每日3次,共治療2周。分別于治療前和治療結(jié)束后采用Lysholm膝關(guān)節(jié)評分標(biāo)準(zhǔn)和西安大略和麥克馬斯特大學(xué)(Western Ontario and McMaster Universities,WOMAC)骨關(guān)節(jié)炎指數(shù)量表評價療效,觀察記錄不良反應(yīng)發(fā)生情況。結(jié)果:納入患者共160例(221膝),推拿組80例(111膝)、藥物組80例(110膝)。至試驗(yàn)結(jié)束時,因未按規(guī)定完成治療,推拿組脫落12例(16膝),藥物組脫落15例(21膝)。治療前2組Kellgren-LawrenceⅠ、Ⅱ級患者的Lysholm評分比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.364,P=0.548; t=0.169,P=0.682); 治療結(jié)束后2組Kellgren-LawrenceⅠ、Ⅱ級患者的Lysholm評分均較治療前增高[(59.71±6.41)分,(81.24±6.28)分,t=25.432,P=0.000;(60.54±6.27)分,(77.66±7.04)分,t=25.112,P=0.000;(51.64±6.85)分,(71.07±5.92)分,t=23.778,P=0.000;(52.27±7.21)分,(66.93±7.31)分,t=16.610,P=0.000],推拿組Kellgren-LawrenceⅠ、Ⅱ級患者的評分均高于藥物組(t=6.227,P=0.015; t=7.916,P=0.006)。治療前2組Kellgren-LawrenceⅠ、Ⅱ級患者的WOMAC骨關(guān)節(jié)炎指數(shù)比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.270,P=0.604; t=0.244,P=0.622); 治療結(jié)束后2組Kellgren-LawrenceⅠ、Ⅱ級患者的WOMAC骨關(guān)節(jié)炎指數(shù)均較治療前降低[(10.07±4.46)分,(2.67±2.35)分,t=14.714,P=0.000;(9.56±4.56)分,(3.71±3.53)分,t=11.003,P=0.000;(14.07±4.62)分,(7.44±2.87)分,t=12.141,P=0.000;(13.56±4.86)分,(8.76±3.82)分,t=9.937,P=0.000],推拿組Kellgren-LawrenceⅠ級患者的WOMAC骨關(guān)節(jié)炎指數(shù)低于藥物組(t=10.134,P=0.002),推拿組Kellgren-LawrenceⅡ級患者的WOMAC骨關(guān)節(jié)炎指數(shù)與藥物組比較,差異無統(tǒng)計(jì)學(xué)意義(t=3.275,P=0.074)。2組患者治療期間均未出現(xiàn)不良反應(yīng)。結(jié)論:基于不均勻沉降理論的揉膝推髕點(diǎn)穴法聯(lián)合口服鹽酸氨基葡萄糖,可有效緩解早期KOA患者的臨床癥狀、改善關(guān)節(jié)功能,安全性較高,且療效優(yōu)于口服鹽酸氨基葡萄糖聯(lián)合外用雙氯芬酸二乙胺乳膠劑治療。
Abstract:
To observe the clinical curative effects and safety of rubbing-knee,pushing-patella and pressing-points(RKPPPP)under the guidance of uneven sagging theory combined with oral application of glucosamine hydrochloride for treatment of early knee osteoarthritis(KOA).Methods:The patients with KOA(Kellgren-Lawrence gradeⅠandⅡ)enrolled in the study were randomly divided into 2 groups and were treated with combination therapy of RKPPPP method and oral application of glucosamine hydrochloride(manipulation group)and combination therapy of oral application of glucosamine hydrochloride and external application of diclofenac diethylamine emulgel(drug group)respectively.The RKPPPP method was performed on patients on alternate days for 2 weeks.The glucosamine hydrochloride capsules were taken twice a day for consecutive 2 weeks,750 mg at a time.The diclofenac diethylamine emulgel was applied on pain spots three times a day for consecutive 2 weeks.The curative effects were evaluated by using Lysholm knee scoring standard and Western Ontario and McMaster Universities(WOMAC)osteoarthritis index scale before and after the treatment respectively,and the adverse reactions were observed and recorded.Results:One hundred and sixty patients(221 knees)were enrolled in the study,80 cases(111 knees)in manipulation group and 80 cases(110 knees)in drug group.By the end of the trial,12 patients(16 knees)in manipulation group and 15 patients(21 knees)in drug group dropped out because the treatment were unfinished according to plan.There were no statistical difference in Lysholm scores between the 2 groups before the treatment(t=0.364,P=0.548; t=0.169,P=0.682).The Lysholm scores increased after the end of the treatment compared to pretreatment in the 2 groups(59.71+/-6.41 vs 81.24+/-6.28 points,t=25.432,P=0.000; 60.54+/-6.27 vs 77.66+/-7.04 points,t=25.112,P=0.000; 51.64+/-6.85 vs 71.07+/-5.92 points,t=23.778,P=0.000; 52.27+/-7.21 vs 66.93+/-7.31 points,t=16.610,P=0.000),and were higher in manipulation group compared to drug group(t=6.227,P=0.015; t=7.916,P=0.006).There were no statistical difference in WOMAC osteoarthritis index between the 2 groups before the treatment(t=0.270,P=0.604; t=0.244,P=0.622).The WOMAC osteoarthritis index decreased after the end of the treatment compared to pretreatment in the 2 groups(10.07+/-4.46 vs 2.67+/-2.35 points,t=14.714,P=0.000; 9.56+/-4.56 vs 3.71+/-3.53 points,t=11.003,P=0.000; 14.07+/-4.62 vs 7.44+/-2.87 points,t=12.141,P=0.000; 13.56+/-4.86 vs 8.76+/-3.82 points,t=9.937,P=0.000),and the WOMAC osteoarthritis index of patients with Kellgren-Lawrence gradeⅠKOA was lower in manipulation group compared to drug group(t=10.134,P=0.002),and there was no statistical difference in WOMAC osteoarthritis index of patients with Kellgren-Lawrence gradeⅡKOA between the 2 groups(t=3.275,P=0.074).No adverse reactions were found in the 2 groups during the treatment.Conclusion:The combination therapy of RKPPPP under the guidance of uneven sagging theory and oral application of glucosamine hydrochloride can effectively relieve the clinical symptoms and improve the knee function of patients with early KOA,meanwhile,it has high safty,moreover,its curative effect is better than that of oral application of glucosamine hydrochloride combined with external application of diclofenac diethylamine emulgel.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國家自然科學(xué)基金面上項(xiàng)目(81573998); 福建省科技廳科技平臺建設(shè)項(xiàng)目(2015Y2001); 福建中醫(yī)藥大學(xué)校管課題-重點(diǎn)項(xiàng)目(X2016020-重點(diǎn)); 保健專項(xiàng)科研課題(15BJZ11) 通訊作者:李西海 E-mail:[email protected]
更新日期/Last Update: 2018-09-20