基于“筋柔骨正”推髌伸膝手法治疗早期膝关节骨性关节炎的疗效与机制研究

Clinical Effect and Mechanism of Knee Osteoarthritis in Early Stage Treated by Pushing Patellar and Extending Knee Manipulation Based on “Tendon Flexibility and Bone Upright” Method

目的探讨基于“筋柔骨正”推髌伸膝手法治疗早期膝关节骨性关节炎(KOA)的疗效与机制。方法60例KOA患者随机分为治疗组与对照组,每组30例。治疗组采用“推髌伸膝”手法治疗,对照组采用针刺治疗,均每天治疗1次,每次20 min,14次为1个疗程,共2个疗程。两组均于治疗前后评价临床疗效、下肢力线及股内侧肌、股直肌、股外侧肌、腓肠肌内侧头、腓肠肌外侧头表面张力。结果治疗组总有效率优于对照组(P<0.05);下肢力线与股内侧肌、股直肌、股外侧肌、腓肠肌内侧头、腓肠肌外侧头表面张力比较,治疗组均优于对照组(P<0.05)。结论“推髌伸膝”手法能够改善下肢力线及膝关节软组织表面张力,因此治疗早期膝关节骨性关节炎疗效显著,推广应用价值较高。

Objective To explore the effect and mechanism of patellar stretching manipulation based on“tendon flexibility and bone upright”in the treatment of early knee osteoarthritis.Methods Sixty KOA patients were randomly divided into treatment group and control group,with 30 patients in each group.The treatment group was treated with patellar stretching and knee extension method,while the control group was treated with acupuncture once a day,20 min for each,14 times as a course of treatment,a total of two course of treatment.The clinical efficiency,line of lower limbs and surface tension of vastus medialis,rectus femoris,vastus lateralis,gastrocnemius medial head and gastrocnemius lateral head were used for evaluation before and after treatment in two groups.Results The clinical effect of treatment group was superior to that of the control group(P<0.05).The force line of the lower limbs was compared with the surface tension of the vastus medialis,rectus femoris,vastus lateralis,gastrocnemius medial head and gastrocnemius lateral head.That of the treatment group was superior to that of the control group(P<0.05).Conclusion The manipulation of pushing patellar and extending knee can improve the tension of the lower limbs and the surface of the soft tissue of the knee joint,and so the treatment of early knee osteoarthritis has a significant effect and a high value of popularization and application.