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[1]沈海,何春江,羅小兵,等.髖膝聯(lián)合針刺療法對早中期膝骨關(guān)節(jié)炎患者下肢運動功能的影響[J].中醫(yī)正骨,2018,30(12):4-8.
　SHEN Hai,HE Chunjiang,LUO Xiaobing,et al.Effects of hip and knee acupuncture therapy on motor function of lower limbs of patients with early-middle knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(12):4-8.
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髖膝聯(lián)合針刺療法對早中期膝骨關(guān)節(jié)炎患者下肢運動功能的影響()
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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12期
頁碼:
4-8
欄目:
骨科運動康復(fù)
出版日期:
2018-12-20

文章信息/Info

Title:
Effects of hip and knee acupuncture therapy on motor function of lower limbs of patients with early-middle knee osteoarthritis
作者:
沈海1; 何春江2; 羅小兵1; 張純2; 田國剛2; 何栩1
(1.四川省骨科醫(yī)院,四川 成都 610041; 2.成都體育學(xué)院,四川 成都 610041)
Author(s):
SHEN Hai1; HE Chunjiang2; LUO Xiaobing1; ZHANG Chun2; TIAN Guogang2; HE Xu1
1.Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China 2.Chengdu Sport Institute,Chengdu 610041,Sichuan,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  針刺療法;  肌力;  姿勢平衡;  臨床試驗
Keywords:
osteoarthritis; knee;  acupuncture therapy;  muscle strength;  postural balance;  clinical trial
摘要:
目的:觀察髖膝聯(lián)合針刺療法對早中期膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)患者下肢運動功能的影響。方法:將80例符合要求的早中期(Kellgren-Lawrence分級為0級、Ⅰ級、Ⅱ級或Ⅲ級)KOA患者隨機分為2組,每組40例。聯(lián)合針刺組采用髖膝聯(lián)合針刺療法治療,局部針刺組在膝關(guān)節(jié)周圍取穴針刺治療。2組針刺治療均隔天1次,3次為1個療程,間隔2 d后開始下一療程,共治療4個療程。分別于治療前和治療結(jié)束后進行等速肌力測試和單腳站立時間測定。結(jié)果:治療前2組患者的膝關(guān)節(jié)伸直肌力、膝關(guān)節(jié)屈曲肌力、髖關(guān)節(jié)伸直肌力、髖關(guān)節(jié)屈曲肌力、髖關(guān)節(jié)外展肌力、髖關(guān)節(jié)內(nèi)收肌力及單腳站立時間比較,組間差異均無統(tǒng)計學(xué)意義[(1.170±0.456)Nm·kg-1,(1.251±0.415)Nm·kg-1,t=-0.065,P=0.614;(0.637±0.294)Nm·kg-1,(0.793±0.332)Nm·kg-1,t=-0.051,P=0.688;(1.440±0.800)Nm·kg-1,(1.450±0.707)Nm·kg-1,t=-0.034,P=0.729;(1.031±0.462)Nm·kg-1,(1.084±0.331)Nm·kg-1,t=-0.073,P=0.596;(0.829±0.355)Nm·kg-1,(0.858±0.281)Nm·kg-1,t=-0.031,P=0.735;(0.746±0.319)Nm·kg-1,(0.742±0.335)Nm·kg-1,t=0.016,P=0.830;(3.2±0.3)s,(2.9±0.3)s,t=0.409,P=0.224)]。治療結(jié)束后,2組患者的膝關(guān)節(jié)伸直肌力、膝關(guān)節(jié)屈曲肌力、髖關(guān)節(jié)伸直肌力、髖關(guān)節(jié)屈曲肌力、髖關(guān)節(jié)外展肌力、髖關(guān)節(jié)內(nèi)收肌力及單腳站立時間均較治療前增加[聯(lián)合針刺組:t=-2.175,P=0.023; t=-2.492,P=0.003; t=-2.280,P=0.014; t=-2.193,P=0.019; t=-2.457,P=0.006; t=-2.363,P=0.009; t=-4.061,P=0.000。局部針刺組:t=-2.018,P=0.044; t=-2.275,P=0.014; t=-2.110,P=0.027; t=-2.079,P=0.033; t=-2.166,P=0.024; t=-2.254,P=0.015; t=-4.270,P=0.000]; 聯(lián)合針刺組的膝關(guān)節(jié)伸直肌力、膝關(guān)節(jié)屈曲肌力、髖關(guān)節(jié)伸直肌力、髖關(guān)節(jié)屈曲肌力、髖關(guān)節(jié)外展肌力、髖關(guān)節(jié)內(nèi)收肌力及單腳站立時間均大于局部針刺組[(1.559±0.429)Nm·kg-1,(1.357±0.321)Nm·kg-1,t=2.128,P=0.026;(1.087±0.340)Nm·kg-1,(0.912±0.214)Nm·kg-1,t=2.065,P=0.039;(1.926±0.774)Nm·kg-1,(1.631±0.224)Nm·kg-1,t=2.090,P=0.028;(1.431±0.154)Nm·kg-1,(1.212±0.234)Nm·kg-1,t=2.073,P=0.035;(1.274±0.312)Nm·kg-1,(1.001±0.116)Nm·kg-1,t=2.292,P=0.013;(1.231±0.164)Nm·kg-1,(0.967±0.645)Nm·kg-1,t=2.084,P=0.031;(10.5±0.4)s,(7.3±0.2)s,t=2.471,P=0.005]。結(jié)論:髖膝聯(lián)合針刺療法能有效增強早中期KOA患者的患肢肌力和身體平衡協(xié)調(diào)能力,其效果優(yōu)于膝關(guān)節(jié)局部針刺治療。
Abstract:
Objective:To observe the effects of hip and knee acupuncture therapy on motor function of lower limbs of patients with early-middle knee osteoarthritis(KOA).Methods:Eighty patients with early-middle KOA(Kellgren-Lawrence grade 0,Ⅰ,ⅡandⅢ)enrolled in the study were randomly divided into group A and group B,40 cases in each group.The patients in group A were treated with acupuncture therapy at hip and knee,while the patients in group B were treated with acupuncture therapy at acupoints around the knee.The acupuncture therapies were performed in patients of the 2 groups on alternate days for 4 courses of treatment,three times for each course with a 2-day rest-insertion between courses.The isokinetic muscle strength and one-foot standing time were measured before treatment and after the end of the treatment respectively.Results:There was no statistical difference in knee extensor muscle strength,knee flexor muscle strength,hip extensor muscle strength,hip flexor muscle strength,hip abductor muscle strength,hip adductor muscle strength and one-foot standing time between the 2 groups before the treatment(1.170+/-0.456 vs 1.251+/-0.415 Nm/kg,t=-0.065,P=0.614; 0.637+/-0.294 vs 0.793+/-0.332 Nm/kg,t=-0.051,P=0.688; 1.440+/-0.800 vs 1.450+/-0.707 Nm/kg,t=-0.034,P=0.729; 1.031+/-0.462 vs 1.084+/-0.331 Nm/kg,t=-0.073,P=0.596; 0.829+/-0.355 vs 0.858+/-0.281 Nm/kg,t=-0.031,P=0.735; 0.746+/-0.319 vs 0.742+/-0.335 Nm/kg,t=0.016,P=0.830; 3.2+/-0.3 vs 2.9+/-0.3 seconds,t=0.409,P=0.224).The knee extensor muscle strength,knee flexor muscle strength,hip extensor muscle strength,hip flexor muscle strength,hip abductor muscle strength,hip adductor muscle strength and one-foot standing time increased in both of the 2 group after the end of the treatment compared to pre-treatment(Group A:t=-2.175,P=0.023; t=-2.492,P=0.003; t=-2.280,P=0.014; t=-2.193,P=0.019; t=-2.457,P=0.006; t=-2.363,P=0.009; t=-4.061,P=0.000.Group B:t=-2.018,P=0.044; t=-2.275,P=0.014; t=-2.110,P=0.027; t=-2.079,P=0.033; t=-2.166,P=0.024; t=-2.254,P=0.015; t=-4.270,P=0.000).The knee extensor muscle strength,knee flexor muscle strength,hip extensor muscle strength,hip flexor muscle strength,hip abductor muscle strength and hip adductor muscle strength were greater and the one-foot standing time was longer in group A compared to group B(1.559+/-0.429 vs 1.357+/-0.321 Nm/kg,t=2.128,P=0.026; 1.087+/-0.340 vs 0.912+/-0.214 Nm/kg,t=2.065,P=0.039; 1.926+/-0.774 vs 1.631+/-0.224 Nm/kg,t=2.090,P=0.028; 1.431+/-0.154 vs 1.212+/-0.234 Nm/kg,t=2.073,P=0.035; 1.274+/-0.312 vs 1.001+/-0.116 Nm/kg,t=2.292,P=0.013; 1.231+/-0.164 vs 0.967+/-0.645 Nm/kg,t=2.084,P=0.031; 10.5+/-0.4 vs 7.3+/-0.2 seconds,t=2.471,P=0.005).Conclusion:Hip and knee acupuncture therapy can effectively enhance muscle strength of affected limbs and balance and coordination ability of body in patients with early-middle KOA,and its curative effect is better than that of knee local acupuncture therapy.

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備注/Memo

備注/Memo:
基金項目:四川省科技廳科技支撐項目(2014SZ0003-2) 通訊作者:沈海 E-mail:[email protected] (收稿日期:2018-10-16 本文編輯:李曉樂)
更新日期/Last Update: 2019-05-30