针刀联合塞来昔布治疗膝骨关节炎的临床疗效观察

Clinical Efficacy of Needle-knife Combined with Celecoxib in Treating Knee Osteoarthritis

目的:观察针刀联合塞来昔布治疗膝骨关节炎的临床疗效。方法:选取符合膝骨关节炎纳入标准的患者90例,使用随机数字表法随机分为针刀组、药物组和联合组,每组30例,分别采用针刀治疗、口服塞来昔布治疗和针刀联合塞来昔布治疗,于治疗前、治疗3周和3个月随访时进行疼痛视觉模拟评分(VAS),西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及临床疗效评估。结果:在治疗3周和3个月随访时联合组VAS评分低于其余两组,差异有统计学意义(P<0.05);塞来昔布组在治疗3周时评分低于针刀组,差异有统计学意义(P<0.05),3个月随访时高于针刀组,差异有统计学意义(P<0.05)。WOMAC评分中疼痛评分变化与VAS评分整体变化趋势相同,且差异均有统计学意义(P<0.05);关节僵硬评分中,联合组与针刀组在治疗3周和3个月随访时评分较前均显著下降,差异有统计学意义(P<0.05),且评分低于塞来昔布组,差异有统计学意义(P<0.05);关节功能评分中,联合组在治疗3周和3个月随访时降低最显著,针刀组次之,三组间差异均有统计学意义(P<0.05)。WOMAC评分总分中,联合组在治疗3周和3个月随访时评分显著低于其余两组,差异有统计学意义(P<0.05),且针刀组低于塞来昔布组,差异有统计学意义(P<0.05)。3个月随访时联合组临床疗效优于针刀组和塞来昔布组,差异有统计学意义(P<0.05)。结论:针刀联合塞来昔布治疗膝骨关节炎在短期和远期可明显缓解疼痛、改善关节活动度、促进关节功能恢复,且安全可行,值得临床推广应用。

Objective:To observe the clinical efficacy of needle-knife combined with celecoxib in the treatment of knee osteoarthritis.Methods:Ninety patients with knee osteoarthritis were randomly divided into needle-knife group,drug group and combination group by random number table.Each group had 30 patients who were respectively treated by needle-knife,celecoxib and needle-knife combined with celecoxib.Visual analogue scale(VAS)scores,Western Ontario McMaster University osteoarthritis index(WOMAC)and clinical efficacy were evaluated before treatment,3 weeks after treatment and 3 months follow-up.Results:The VAS scores of the combination group were lower than the other two groups at 3 weeks of treatment and 3 months of follow-up,and the difference was statistically significant(P<0.05).The celecoxib group scores was lower than the needle-knife group at 3 weeks of treatment(P<0.05),and higher than the needle-knife group at 3 months of follow-up(P<0.05).The change of pain score in WOMAC score was the same as the overall change trend of VAS score,and the difference was statistically significant(P<0.05).Among the joint stiffness scores,the combination group and the needle-knife group were significantly lower at3 weeks of treatment and 3 months of follow-up(P<0.05),and the score was lower than the celecoxib group(P<0.05).Among the joint function scores,the combination group was the most significant at 3 weeks of treatment and 3 months of follow-up,followed by the needle-knife group,and the differences between the three groups were statistically significant(P<0.05);Among the total scores of WOMAC scores,the scores of the combination group were significantly lower than those of other groups at 3 weeks of treatment and 3 months of follow-up(P<0.05),and the needle-knife group was lower than the celecoxib group(P<0.05).The clinical efficacy of the combination group was better than that of the needle-knife group and the celecoxib group at the 3 months of follow-up,the difference was statistically significant(P<0.05).Conclusion:Needle-knife combined with celecoxib in the treatment of KOA can significantly relieve pain and improve joint mobility and promote joint function recovery in the short and long term,it is safe,feasible and worthy of clinical promotion.