针刀松解对膝骨性关节炎足部生物力学及X线表现的影响

Effects of acupotomy on the footplate pressure and X ray manifestations in the treatment of knee osteoarthritis

目的探讨针刀松解对膝骨性关节炎足部生物力学及X线表现的影响。方法选择2005-07至2008-12在我院治疗的58例膝骨性关节炎患者,随机分为针刀观察组和电针对照组各29例,比较两组JOA评分、足部生物力学及X线改变。结果两组治疗前后以及随访时的JOA评分比较具有显著性意义(P<0.01),足底压力分值比较差异有统计学意义(P<0.05),两组间得分差值比较,差异具有统计学意义(P<0.05);观察组在关节间隙变窄、髌骨外移、髌骨高位、关节腔积液方面,治疗后、随访与对照组相比,差异有统计学意义(P<0.05),而在髁间棘骨质增生和软骨下骨硬化方面的发生率无明显差别(P>0.05)。结论针刀疗法可直接松解、剥离压痛部分,将病灶消除,同时具有改变解除关节内外异常应力,促使关节的力学平衡恢复的作用,为临床治疗膝骨性关节炎提供了有效的治疗手段。

Objective To study the effect of acupotomy being used to treat knee osteoarthritis on the footplate pressure and X ray manifestations. Methods 58 patients with knee osteoarthritis treated in this clinic from July 2005 to December 2008 were random- ly divided into observation group and control group. The observation group was treated with acupotomy and the control group treated with electroacupuncture. Their JOA scores, footplate pressure and X ray manifestations were compared. Results After treatment and on revisits, JOA scores showed obvious change. The difference was statistically significant （ P 〈 0.01 ）. Comparison of differential val- ues between the two groups exhibited statistically significant difference （ P 〈 0.05 ）. In the observation group, the joint space neduc- tion, patellar shift, patellar high position, and synovial effusion were ameliorated after treatment, significantly different from those in con- trol group （ P 〈 0.05 ）. However, the formation rate of intercondylar spine hyperosteogeny and subchondral osteosclerosis was not sig- nificantly different （ P 〉 0.05 ）. Conclusions The acupotomy therapy directly relaxes and dissects the tender part, eliminates the fo- cus, simultaneously changes and relieves the unusual stress in the joint, spurs the restoration of jointslnechanical balance, thereby pro- viding an effective treatment method for knee osteoarthritis.