逐痰祛瘀固本法联合针刺郑氏经验穴在中老年髌股关节病患者中的应用

Application of Zhutan Quyu Guben Method Combined with Scupuncture at ZHENG’s Experienced Points in Middle-aged and Elderly Patients with Patellofemoral Joint Disease

目的:观察逐痰祛瘀固本法联合针刺郑氏经验穴在中老年髌股关节病患者中的应用效果。方法:前瞻性纳入2018年6月~2019年12月四川省骨科医院收治的60例中老年髌股关节病患者,采用随机数字表法分为两组各30例。对照组采用针刺郑氏经验穴治疗,观察组采用逐痰祛瘀固本法联合针刺郑氏经验穴治疗,均治疗4周,评估两组治疗4周时治疗效果,比较两组治疗前、治疗1周、治疗4周时膝关节功能(膝关节Lysholm评分)及疼痛程度[视觉模拟评分法(VAS)评分],比较两组治疗前及治疗4周时血清指标[前列腺素E2(PGE_(2))、P物质(SP)、5-羟色胺(5-HT)],记录两组治疗期间不良反应。结果:观察组治疗4周时整体治疗效果优于对照组,且治疗总有效率高于对照组(P<0.05);时点与组别交互作用对中老年髌股关节病患者的Lysholm评分、VAS评分影响有统计学意义(P<0.05);进一步经独立效应检验结果显示,治疗前,两组Lysholm、VAS评分相近(P>0.05);治疗1周时、治疗4周时,观察组Lysholm、VAS评分高于对照组(P<0.05);观察组、对照组治疗1周、治疗4周时Lysholm、VAS评分均较治疗前升高(P<0.05);两组治疗4周时PGE_(2)、SP、5-HT水平均较治疗前降低,且观察组低于对照组(P<0.05);两组治疗期间均无不良反应发生。结论:中老年髌股关节病患者采用逐痰祛瘀固本法联合针刺郑氏经验穴治疗疗效确切,可减轻患者疼痛,改善膝关节功能,调节血清相关指标水平,且未出现不良反应,安全性好。

Objective:To observe the application effect of Zhutan Quyu Guben Method combined with acupuncture at ZHENG’s experienced points in middle-aged and elderly patients with patellofemoral joint disease.Methods:60 middle-aged and elderly patients with patellofemoral joint disease admitted to Sichuan Provincial Orthopedic Hospital from June 2018 to December 2019 were prospectively included,a random number table method was used to divide them into two groups with 30 cases in each group.The controlled group was treated with acupuncture at ZHENG’s experienced points,and the observation group was treated with Zhutan Quyu Guben Method combined with acupuncture at ZHENG’s experienced points,both were treated for 4 weeks.The treatment effect of the two groups were evaluated at 4 weeks of treatment,the knee function(Lysholm score of knee joint)and pain degree[visual analogue scale(VAS)score]of the two groups before treatment,1 week and 4 weeks after treatment were compared,the serum indexes[prostaglandin E(PGE_(2)),substance P(SP),5-hydroxytryptamine(5-HT)]were compared between the two groups before treatment and 4 weeks after treatment,the occurrence of adverse reactions during the treatment of the two groups was counted.Results:After 4 weeks of treatment,the overall treatment effect of the observation group was better than that of the controlled group,and the total effective rate was higher than that of the controlled group,there was a statistical significant difference(P<0.05).The interaction between time points and groups had statistical significant effect on Lysholm score and VAS score of middle-aged and elderly patients with patellofemoral joint disease(P<0.05).Furthermore,the results of independent effect test showed that,before treatment,Lysholm and VAS scores of the two groups were similar(P>0.05).The Lysholm and VAS scores of the observation group were higher than those of the controlled group at 1 week and 4 weeks of treatment(P<0.05).The Lysholm and VAS scores of the observation group and the controlled group were increased than those before treatment at 1 week and 4 weeks of treatment(P<0.05).The levels of PGE_(2),SP and 5-HT in the two groups at 4 weeks of treatment were decreased than those before treatment,and the observation group was lower than the controlled group,there was a statistical significant difference(P<0.05).There were no adverse reactions in the two groups during treatment.Conclusion:The treatment of middle-aged and elderly patients with patellofemoral joint disease with Zhutan Quyu Guben Method combined with acupuncture at ZHENG’s experienced point has definite curative effect,which is more conducive to relieve pain,improve knee joint function and regulate serum related indicators,and there are no adverse reactions,with high safety.