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[1]劉偉,顏純淳,于功昌,等.寒濕痹痛方外敷聯(lián)合本體感覺神經(jīng)肌肉促進(jìn)技術(shù)治療老年膝骨關(guān)節(jié)炎寒濕痹阻證的臨床研究[J].中醫(yī)正骨,2025,37(04):41-49,54.
　LIU Wei,YAN Chunchun,YU Gongchang,et al.External application of Hanshi Bitong Fang(寒濕痹痛方)combined with proprioceptive neuromuscular facilitation for treatment of knee osteoarthritis with cold-dampness stagnation syndrome in the aged:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(04):41-49,54.
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寒濕痹痛方外敷聯(lián)合本體感覺神經(jīng)肌肉促進(jìn)技術(shù)治療老年膝骨關(guān)節(jié)炎寒濕痹阻證的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期數(shù):
2025年04期
頁碼:
41-49,54
欄目:
臨床研究
出版日期:
2025-04-20

文章信息/Info

Title:
External application of Hanshi Bitong Fang(寒濕痹痛方)combined with proprioceptive neuromuscular facilitation for treatment of knee osteoarthritis with cold-dampness stagnation syndrome in the aged:a clinical study
作者:
劉偉1; 顏純淳1; 于功昌1; 楊苓2; 翟勁草3; 夏銳3; 馬曉雪3; 師彬1; 孫晉海2
1.山東第一醫(yī)科大學(xué)附屬頸肩腰腿痛醫(yī)院,山東 濟(jì)南 250062; 2.山東大學(xué)體育學(xué)院,山東 濟(jì)南 250061; 3.曲阜師范大學(xué)體育科學(xué)學(xué)院,山東 濟(jì)寧 273100
Author(s):
LIU Wei1; YAN Chunchun1; YU Gongchang1; YANG Ling2; ZHAI Jincao3; XIA Rui3; MA Xiaoxue3; SHI Bin1; SUN Jinhai2
1.Neck-Shoulder and Lumbocrural Pain Hospital Affiliated to Shandong First Medical University,Jinan 250062,Shandong,China 2.School of Physical Education,Shandong University,Jinan 250061,Shandong,China 3.School of Physical Education and Sports Science,Qufu Normal University,Jining 273100,Shandong,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  寒濕痹阻證;  敷貼療法;  寒濕痹痛方;  本體感覺;  神經(jīng)肌肉促進(jìn)技術(shù);  老年人;  隨機(jī)對(duì)照試驗(yàn)專題
Keywords:
osteoarthritis; knee;  cold dampness stagnation syndrome;  plastering therapy;  Hanshi Bitong Fang;  proprioception;  neuromuscular facilitation technique;  aged;  randomized controlled trials as topic
摘要:
目的:觀察寒濕痹痛方外敷聯(lián)合本體感覺神經(jīng)肌肉促進(jìn)技術(shù)(proprioceptive neuromuscular facilitation,PNF)治療老年膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)寒濕痹阻證的臨床療效和安全性。方法:將符合要求的78例老年KOA寒濕痹阻證患者隨機(jī)分為2組,每組39例,分別采用寒濕痹痛方外敷聯(lián)合PNF治療(聯(lián)合PNF組)和單純PNF治療(PNF組)。分別于治療前與治療結(jié)束后,記錄并比較2組患者的西安大略和麥克馬斯特大學(xué)骨關(guān)節(jié)炎指數(shù)(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)疼痛、僵硬和關(guān)節(jié)功能評(píng)分,膝關(guān)節(jié)屈曲與伸展峰值力矩,膝關(guān)節(jié)屈曲角度及下樓梯步態(tài)參數(shù)。觀察并發(fā)癥發(fā)生情況。結(jié)果:①WOMAC評(píng)分。治療結(jié)束后,2組患者WOMAC疼痛評(píng)分、僵硬評(píng)分及關(guān)節(jié)功能評(píng)分均低于治療前(疼痛評(píng)分:t=16.400,P=0.000; t=11.273,P=0.000; 僵硬評(píng)分:t=9.159,P=0.000; t=4.117,P=0.000; 關(guān)節(jié)功能評(píng)分:t=10.076,P=0.000; t=7.392,P=0.000),聯(lián)合PNF組患者WOMAC疼痛評(píng)分、僵硬評(píng)分及關(guān)節(jié)功能評(píng)分均低于PNF組(t=17.577,P=0.000; t=8.354,P=0.000; t=5.753,P=0.000)。②膝關(guān)節(jié)屈曲與伸展峰值力矩。治療結(jié)束后,2組患者膝關(guān)節(jié)屈曲峰值力矩與治療前的差異均無統(tǒng)計(jì)學(xué)意義(t=1.435,P=0.156; t=0.769,P=0.445),2組患者膝關(guān)節(jié)屈曲峰值力矩的差異無統(tǒng)計(jì)學(xué)意義(t=1.229,P=0.224),2組患者膝關(guān)節(jié)伸展峰值力矩均大于治療前(t=7.317,P=0.000; t=3.286,P=0.002),聯(lián)合PNF組患者膝關(guān)節(jié)伸展峰值力矩大于PNF組(t=2.695,P=0.009)。③膝關(guān)節(jié)屈曲角度。治療結(jié)束后,2組患者膝關(guān)節(jié)屈曲角度均大于治療前(t=4.655,P=0.000; t=4.870,P=0.000),2組患者膝關(guān)節(jié)屈曲角度的差異無統(tǒng)計(jì)學(xué)意義(t=1.025,P=0.309)。④下樓梯步態(tài)參數(shù)。治療結(jié)束后,聯(lián)合PNF組患者膝關(guān)節(jié)內(nèi)收峰值力矩小于治療前(t=31.379,P=0.000),PNF組患者膝關(guān)節(jié)內(nèi)收峰值力矩與治療前的差異無統(tǒng)計(jì)學(xué)意義(t=1.493,P=0.140),聯(lián)合PNF組患者膝關(guān)節(jié)內(nèi)收峰值力矩小于PNF組(t=20.033,P=0.000)。治療結(jié)束后,2組患者內(nèi)外和前后方向動(dòng)態(tài)穩(wěn)度值小于治療前(內(nèi)外方向:t=4.994,P=0.000; t=2.402,P=0.019; 前后方向:t=5.700,P=0.000; t=2.101,P=0.040),聯(lián)合PNF組患者內(nèi)外和前后方向動(dòng)態(tài)穩(wěn)度值小于PNF組(t=2.933,P=0.005; t=2.499,P=0.015)。⑤安全性。2組患者均未發(fā)生膝關(guān)節(jié)腫脹、感染、局部皮疹或瘀斑等并發(fā)癥。結(jié)論:寒濕痹痛方外敷聯(lián)合PNF治療KOA寒濕痹阻證,可有效緩解膝關(guān)節(jié)疼痛、僵硬癥狀,增強(qiáng)伸膝肌力,促進(jìn)膝關(guān)節(jié)功能恢復(fù),提高下樓梯時(shí)的步態(tài)穩(wěn)定性,療效優(yōu)于單純采用PNF治療,但二者在膝關(guān)節(jié)屈曲角度改善及安全性方面相當(dāng)。
Abstract:
Objective:To observe the clinical outcomes and safety of external application of Hanshi Bitong Fang(寒濕痹痛方,HSBTF)combined with proprioceptive neuromuscular facilitation(PNF)in treatment of knee osteoarthritis(KOA)with cold-dampness stagnation syndrome in the aged.Methods:Seventy-eight eligible aged KOA patients with cold-dampness stagnation syndrome were enrolled in the study and were randomized into 2 groups,39 ones in each group,and they were treated with external application of HSBTF combined with PNF(combination therapy group)and PNF alone(PNF group),respectively.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores(including pain score,stiffness score,and joint function score),peak torque for knee flexion/extension,knee flexion angle,and down stair gait biomechanical parameters were recorded and compared between the 2 groups before the treatment and after the end of the treatment,respectively,and the complications were observed.Results:①The WOMAC scores.The pain,stiffness,and joint function scores decreased after the end of the treatment compared to pre-treatment in the 2 groups(pain score:t=16.400,P=0.000; t=11.273,P=0.000; stiffness score:t=9.159,P=0.000; t=4.117,P=0.000; joint function score:t=10.076,P=0.000; t=7.392,P=0.000),and the scores were lower in combination therapy group compared to PNF group(t=17.577,P=0.000; t=8.354,P=0.000; t=5.753,P=0.000).②The peak torque for knee flexion/extension.No significant difference was observed in the peak torque for knee flexion between post-treatment and pre-treatment in the 2 groups(t=1.435,P=0.156; t=0.769,P=0.445)and between the 2 groups after the end of the treatment(t=1.229,P=0.224).The peak torque for knee extension increased after the end of the treatment compared to pre-treatment in the 2 groups(t=7.317,P=0.000; t=3.286,P=0.002),with more improvement in combination therapy group(t=2.695,P=0.009).③The knee flexion angle.The knee flexion angle increased after the end of the treatment compared to pre-treatment in the 2 groups(t=4.655,P=0.000; t=4.870,P=0.000),with no significant difference between the 2 groups(t=1.025,P=0.309).④The down stair gait biomechanical parameters.The peak torque for knee adduction shortened after the end of the treatment compared to pre-treatment in the combination therapy group(t=31.379,P=0.000),while,no significant difference was observed in PNF group(t=1.493,P=0.140).The peak torque for knee adduction was smaller in combination therapy group compared to PNF group(t=20.033,P=0.000).The dynamic stability values in the medial-lateral and anterior-posterior directions decreased after the end of the treatment compared to pre-treatment in the 2 groups(medial-lateral direction:t=4.994,P=0.000; t=2.402,P=0.019; anterior-posterior direction:t=5.700,P=0.000; t=2.101,P=0.040),with more decreasement in combination therapy group(t=2.933,P=0.005; t=2.499,P=0.015).⑤Safety.No patients experienced complications such as knee swelling,infection,local rash or ecchymosis in the 2 groups.Conclusion:External application of HSBTF combined with PNF can effectively alleviate the knee pain and stiffness symptoms,enhance knee extension muscle strength,promote knee function recovery,and improve down stair gait stability in treatment of KOA with cold-dampness stagnation syndrome in the aged,and its clinical outcome outperforms that of PNF alone,while,both are comparable in the knee flexion angle improvement and safety.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國家自然科學(xué)基金項(xiàng)目(82374615); 山東省中醫(yī)藥科技項(xiàng)目(2021M149,M-2022253)
通訊作者:孫晉海 E-mail:[email protected]
更新日期/Last Update: 1900-01-01