隔药灸结合电针治疗寒湿型膝骨性关节炎的疗效观察

Clinical Observation on the Therapeutic Effect of Drugs-paste Separated Moxibustion Combined with Electroacupunture for Knee Osteoarthritis Patients of Cold-damp Type

目的:观察隔药灸结合电针对寒湿型膝骨性关节炎的疗效。方法:将124例患者按随机数字表分为隔药灸结合电针组和西药组各62例。隔药灸结合电针组采用神阙穴隔药灸9壮,梁丘、鹤顶、内外膝眼等穴用电针,疏密波,频率4Hz/20Hz,强度1～2mA,电针30min;每日1次,每周治疗5次,治疗4周。西药组口服英太青胶囊,每次50mg,每日2次,4周后统计疗效。结果:隔药灸结合电针组在降低关节疼痛积分、改善膝骨关节病情严重指数方面均优于西药组(P<0.05)。隔药灸结合电针组临床控制8例,显效21例,有效27例,无效6例,总有效率90.3%;西药组临床控制3例,显效16例,有效31例,无效12例,总有效率80.6%。隔药灸结合电针组优于西药组(P<0.05)。治疗后10周随访时隔药灸结合电针组总有效率87.1%(54/62),优于西药组67.7%(42/62,P<0.01)。隔药灸结合电针组较西药组不良反应发生率低(P<0.01)。结论:隔药灸神阙穴配合电针治疗寒湿型膝骨性关节炎的临床疗效佳,且副反应低。

Objective To observe the curative effect of Chinese drugs-paste separated moxibustion combined with electroacupuncture （EA） for knee osteoarthritis （KOA）. Methods A total of 124 cases of KOA patients were randomly and equally divided into moxibustion plus electroacupunture （M ＋ EA） group and medication group by using a random table. Chinese drugs- paste separated moxibustion was applied to Shenque （CV 8） for 9 moxa-cones,combined with EA （4 Hz/20 Hz, 1 - 2 mA） of Liangqiu （ST34）,Heding （EX-LE 2）, Neixiyan （EX-LE 4）, etc. for 30 min, once daily, 5 sessions a week. Patients of medication group were treated by oral administration of Antine Capsule （diclofenac sodium, 50 mg, twice daily）. After 4 weeks of treatment, the therapeutic effect was evaluated. Results Compared with pre-treatment, the knee-joint pain scores and the indexex of severity of osteoarthritis of both M ＋ EA and medication groups decreased significantly after termination of the treatment and 10 weeks after the treatment （ P〈0.01 ）, and those of M ＋ EA group were markedly lower than those of medication group （P〈0.05）. After the treatment,of the two 62 cases in medication and M＋ EA groups,3 （4.8%） and 8 （12.9%） were under control in their symptoms, 16 （25.8%） and 21 （33.9%） had remarkable improvement, 31 （50.0%） and 27 （43.5%） were effective, 12 （19.4%） and 6 （9, 7% ） failed in the treatment,with the effective rates being 80.6% and 90.3% respectively. Ten weeks after the treatment, of the two 62 cases in medication and M＋ EA groups, 1 （1.6%） and 7 （11.3%） were under control, 10 （16. 1%） and 19 （30.6%） had marked improvement, 31 （50.0%） and 28 （45.2%） were effective, 20 （32.3%） and 8 （12.9%） failed in the treatment, with the effective rates being 67.7 % and 87. 1%, respectively. The curative effect of M ＋ EA group was significantly superior to that of medication group （P〈0. 05, P〈0.01 ）. Conclusion Chinese drugs-paste-separated moxibustion combined with EA is effective in the treatment of KOA of cold-damp type.