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[1]李輝,周承揚,王中華.針刀結(jié)合導(dǎo)引治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2016,28(04):1-5.
　LI Hui,ZHOU Chengyang,WANG Zhonghua.Clinical study on combination therapy of needle-knife and physical&breathing exercises for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):1-5.
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針刀結(jié)合導(dǎo)引治療膝骨關(guān)節(jié)炎的臨床研究()
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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04期
頁碼:
1-5
欄目:
臨床研究
出版日期:
2016-04-20

文章信息/Info

Title:
Clinical study on combination therapy of needle-knife and physical&breathing exercises for treatment of knee osteoarthritis
作者:
李輝; 周承揚; 王中華
上海市閘北區(qū)中心醫(yī)院,上海 200070
Author(s):
LI Hui; ZHOU Chengyang; WANG Zhonghua
Zhabei District Central Hospital,Shanghai 200070,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  小刀針;  導(dǎo)引;  治療; 臨床研究性
Keywords:
osteoarthritis; knee;  small knife needle;  physical&; breathing exercises;  therapies; investigational
摘要:
目的:觀察針刀結(jié)合導(dǎo)引治療膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)的臨床療效。方法:將符合要求的99例KOA患者隨機分為3組,每組33例,分別采用針刀結(jié)合導(dǎo)引治療、單純針刀治療和單純導(dǎo)引治療。分別于治療前及治療2周、4周、8周、16周后,采用視覺模擬評分法(visual analogue score,VAS)評定膝關(guān)節(jié)疼痛情況,采用西安大略和麥克馬斯特大學(xué)(Western Ontario and McMaster Universities,WOMAC)評分量表評定膝關(guān)節(jié)功能。治療16周后參照《中藥新藥臨床研究指導(dǎo)原則(試行)》中KOA療效標(biāo)準(zhǔn)及WOMAC評分評定療效。結(jié)果:治療16周后,每組各有3例脫落。治療前后不同時間點VAS距離比較,差異有統(tǒng)計學(xué)意義,存在時間效應(yīng)(F=768.009,P=0.001); 3組患者VAS距離比較,總體上組間差異有統(tǒng)計學(xué)意義,存在分組效應(yīng)(F=16.758,P=0.001); 治療前3組患者VAS距離比較,組間差異無統(tǒng)計學(xué)意義[(67.30±4.63)mm,(66.30±3.98)mm,(67.50±3.25)mm; F=0.776,P=0.460]; 治療2周、4周、8周、16周后,針刀導(dǎo)引組VAS距離小于針刀組、導(dǎo)引組[(49.03±4.01)mm,(49.37±6.32)mm,(55.27±5.69)mm,F=12.518,P=0.001;(43.27±3.60)mm,(44.73±6.99)mm,(50.33±5.16)mm,F=14.167,P=0.001;(38.73±3.93)mm,(41.00±6.14)mm,(45.46±6.25)mm,F=11.434,P=0.001;(33.23±6.51)mm,(36.63±4.61)mm,(41.40±6.66)mm,F=14.009,P=0.001]; 時間因素和分組因素存在交互效應(yīng)(F=5.220,P=0.001)。治療前后不同時間點WOMAC評分比較,差異有統(tǒng)計學(xué)意義,存在時間效應(yīng)(F=590.49,P=0.001); 3組患者WOMAC評分比較,總體上組間差異有統(tǒng)計學(xué)意義,存在分組效應(yīng)(F=12.190,P=0.001); 治療前3組患者WOMAC評分比較,組間差異無統(tǒng)計學(xué)意義[(62.17±2.96)分,(61.70±3.22)分,(61.87±4.20)分; F=0.137,P=0.870]; 治療2周后,針刀導(dǎo)引組WOMAC評分小于導(dǎo)引組[(50.26±5.65)分,(56.53±5.25)分]; 治療4周、8周、16周后,針刀導(dǎo)引組WOMAC評分小于針刀組、導(dǎo)引組[(41.20±6.96)分,(45.33±7.03)分,(51.86±5.00)分,F=21.153,P=0.001;(35.13±8.43)分,(41.00±8.00)分,(45.40±6.86)分,F=13.108,P=0.001;(27.03±9.90)分,(33.30±9.07)分,(37.03±10.39)分,F=8.236,P=0.001]; 時間因素和分組因素存在交互效應(yīng)(F=10.000,P=0.001)。治療16周后,針刀導(dǎo)引組治愈4例、好轉(zhuǎn)24例、未愈2例,針刀組治愈2例、好轉(zhuǎn)18例、未愈10例,導(dǎo)引組治愈1例、好轉(zhuǎn)18例、未愈11例,針刀導(dǎo)引組療效優(yōu)于針刀組和導(dǎo)引組(χ2=8.009,P=0.018)。結(jié)論:針刀結(jié)合導(dǎo)引治療KOA能夠有效緩解膝關(guān)節(jié)疼痛、恢復(fù)膝關(guān)節(jié)功能,療效優(yōu)于單純針刀或?qū)б?值得臨床推廣應(yīng)用。
Abstract:
Objective:To observe the clinical curative effects of combination therapy of needle-knife and physical&breathing exercises for treatment of knee osteoarthritis(KOA).Methods:Ninty-nine patients with KOA enrolled in the study were randomly divided into 3 groups,33 cases in each group.The patients were treated with combination therapy of needle-knife and physical&breathing exercises(group A),monotherapy of needle-knife(group B)and monotherapy of physical&breathing exercises(group C)respectively.The knee pains were evaluated by using visual analogue scale(VAS)and the knee joint functions were evaluated by using Western Ontario and McMaster Universities(WOMAC)scoring scale before treatment and at 2,4,8 and 16 weeks after the treatment respectively.The curative effects were evaluated after 16-week treatment according to KOA therapeutic effect standard which was extracted from guiding principles for clinical research on new Chinese medicine(try out) and WOMAC scores.Results:Three patients fell off in each group after 16-week treatment.There was statistical difference in the VAS distance between different timepoints before and after the treatment,in other words,there was time effect(F=768.009,P=0.001).There was statistical difference in the VAS distance between the 3 groups in general,in other words,there was group effect(F=16.758,P=0.001).There was no statistical difference in the VAS distance between the 3 groups before treatment(67.30+/-4.63,66.30+/-3.98,67.50+/-3.25 mm; F=0.776,P=0.460).The VAS distance was shorter in group A compared to group B and group C after 2-,4-,8- and 16-week treatment(49.03+/-4.01,49.37+/-6.32,55.27+/-5.69 mm,F=12.518,P=0.001; 43.27+/-3.60,44.73+/-6.99,50.33+/-5.16 mm,F=14.167,P=0.001; 38.73+/-3.93,41.00+/-6.14,45.46+/-6.25 mm,F=11.434,P=0.001; 33.23+/-6.51,36.63+/-4.61,41.40+/-6.66 mm,F=14.009,P=0.001).There was interaction between time factor and grouping factor(F=5.220,P=0.001).There was statistical difference in the WOMAC scores between different timepoints before and after the treatment,in other words,there was time effect(F=590.49,P=0.001).There was statistical difference in the WOMAC scores between the 3 groups in general,in other words,there was group effect(F=12.190,P=0.001).There was no statistical difference in the WOMAC scores between the 3 groups before treatment(62.17+/-2.96,61.70+/-3.22,61.87+/-4.20 points; F=0.137,P=0.870).The WOMAC scores were lower in group A compared to group C after 2-week treatment(50.26+/-5.65 vs 56.53+/-5.25 points).The WOMAC scores were lower in group A compared to group B and group C after 4-,8- and 16-week treatment(41.20+/-6.96,45.33+/-7.03,51.86+/-5.00 points,F=21.153,P=0.001; 35.13+/-8.43,41.00+/-8.00,45.40+/-6.86 points,F=13.108,P=0.001; 27.03+/-9.90,33.30+/-9.07,37.03+/-10.39 points,F=8.236,P=0.001).There was interaction between time factor and grouping factor(F=10.000,P=0.001).After 16-week treatment,4 patients obtained an excellent result,12 good and 2 poor in group A; 2 patients obtained an excellent result,18 good and 10 poor in group B; and 1 patient obtained an excellent result,18 good and 11 poor in group C.The group A surpassed the group B and group C in the total curative effect(χ2=8.009,P=0.018).Conclusion:The combination therapy of needle-knife and physical&breathing exercises can effectively relieve the knee pain and promote the knee function recovery in the treatment of KOA,and its curative effect is better than that of monotherapy of needle-knife or physical&breathing exercises,so it is worthy of popularizing in clinic.

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備注/Memo

備注/Memo:
基金項目:上海市中醫(yī)臨床重點學(xué)科(中醫(yī)骨傷科學(xué))項目(ZYXK2012018)
更新日期/Last Update: 2016-08-30