推拿配合常规康复训练对膝骨性关节炎患者膝关节微循环及功能恢复的影响

Effects of Tuina Combined with Conventional Rehabilitation Training on Knee Microcirculation and Function Recovery in Patients with Knee Osteoarthritis

目的评价推拿配合常规康复训练在膝骨性关节炎(knee osteoarthritis,KOA)患者膝关节微循环和关节功能恢复中的应用价值。方法选择2019年4月—2020年11月该院收治的KOA患者87例作为观察对象,按照随机数字表法分为对照组(43例)和观察组(44例)。对照组行常规康复训练,观察组予以推拿配合常规康复训练,治疗1个月后,对比两组临床康复疗效,采用激光散斑成像系统比较两组患者膝关节局部浅表微循环血流灌注量(superficial microcirculatory blood perfusion,SMBP),使用Lysholm评分系统比较两组患者膝关节功能恢复情况,使用西安大略和麦克马斯特大学骨关节炎指数(The Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)比较两组生活质量。结果(1)观察组临床有效率为90.91%(40/44),高于对照组74.42%(32/43),差异有统计学意义(P<0.05)。(2)治疗后观察组患者膝关节各区域SMBP均较对照组增加(P<0.05)。(3)治疗后,两组患者Lysholm评分均较治疗前升高(P<0.05),且观察组患者Lysholm评分均较对照组升高,存在时间和组间效应(P<0.05)。(4)治疗后观察组患者WOMAC评分各维度及总分均较对照组降低(P<0.05)。结论推拿配合常规康复训练有助于改善膝骨性关节炎患者膝关节微循环,改善患者膝关节功能水平,促进患者康复并提高生活质量。

Objective To evaluate the application value of Tuina combined with conventional rehabilitation training on the knee microcirculation and joint function recovery in patients with knee osteoarthritis(KOA).Methods Eighty-seven patients with KOA treated in the hospital between April 2019 and November 2020 were selected as the observation subjects,and were divided into control group(43 cases)and observation group(44 cases)according to the random number table method.The control group received conventional rehabilitation training,and the observation group was given Tuina combined with conventional rehabilitation training.After 1 month of treatment,the clinical rehabilitation efficacy of the two groups was compared.Laser speckle imaging system was used to compare the local superficial microcirculatory blood perfusion(SMBP)of knee joints of the two groups,and Lysholm scoring system was applied to compare the knee function recovery of the two groups of patients,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was adopted to compare the quality of life in the two groups..Results(1)The clinical effective rate(90.91%,40/44)in the observation group was higher than that(74.42%,32/43)in the control group(P<0.05).(2)After treatment,the SMBP in each area of knee joint of the observationgroup was increased compared with that of control group(P<0.05).(3)After treatment,the Lysholm score of the two groupswas higher than that before treatment(P<0.05),and the Lysholm score of the observation group was higher than that of the control group,with time-point effect and between-group effect(P<0.05).(4)After treatment,the scores of dimensions and total score of WOMAC were lower in the observation group than those in the control group(P<0.05).Conclusion Tuina combined with conventional rehabilitation training can help to improve the knee microcirculation and the knee function,promote the rehabilitation and enhance the quality of life of the patients with KOA.