艾灸治疗膝骨性关节炎:随机对照研究

Knee osteoarthritis treated with moxibustion: a randomized controlled trial

目的:观察艾灸对膝骨性关节炎患者疼痛、僵硬、功能障碍等症状的疗效,评价艾灸疗法的有效性和安全性。方法:59例膝骨性关节炎患者随机分为艾灸组(31例)和安慰艾灸组(28例),分别将治疗艾炷和安慰艾炷粘贴在内膝眼、犊鼻、阿是穴处给予艾灸治疗,每次每穴3壮,隔日1次,每周3次,连续治疗6周,统计治疗3周、6周时的疗效,并于治疗结束后6周对患者进行随访。采用骨关节炎调查量表(WOMAC)、46m最快步行时间评价关节功能恢复情况,使用UT-325数字温测仪记录膝关节疼痛最明显的治疗点艾灸前后温度变化。结果:艾灸组治疗3周、6周及随访时WOMAC量表各项评分均明显降低(P<0.05,P<0.01,P<0.001);安慰艾灸组随访时僵硬评分较治疗前降低(P<0.05);治疗6周及随访时,艾灸组较安慰艾灸组疼痛、僵硬、功能障碍评分下降更明显(P<0.01,P<0.05)。艾灸组治疗6周后46m最快步行时间较治疗前明显缩短(P<0.01),而安慰艾灸组治疗后改善不明显(P>0.05),组间比较差异无统计学意义(P>0.05)。艾灸组艾灸后治疗点温度为(49.81±3.10)℃,安慰艾灸组为(40.98±1.67)℃,两组均较治疗前局部皮肤温度明显升高(P<0.001,P<0.01),艾灸组温度升高更明显(P<0.001)。结论:艾灸可明显改善膝骨性关节炎患者疼痛、僵硬、功能障碍等临床症状,是一种安全、有效的治疗方法。

Objective To observe the efficacy of moxibustion on the improvement in pain, stiffness and motor disturbance for the patients with knee ostcoarthritis （OAT and evaluate the effectiveness and safety of moxibustion therapy. Methods Fifty-nine cases of knee OA were randomly divided into a moxibustion group （31 cases） and a placebo moxibuslion group （28 cases）, in which moxa cone and placebo moxa sticker were applied to Neixiyan （EX-LE 4）, Dubi （ST 35） and Ashi points separately, 3 cones on each point in each treatment. The treatment was given once every two days, 3 times per week, continuously for 6 weeks. The follow-up visit was performed in 6 weeks after the end of treatment. The Western Ontario and Mcmaster Universities Osteoarthritis Index （WOMAC） and the time of 46-meter walking at the fastest speed were adopted to evaluate the recovery of joint function. UT-325 digital thermal detector was used to record the temperature change at the most apparent pain points of knee joint before and after moxibustion treatment. Results In moxibustion group, the scores in W（）MAC were reduced apparently in 3 and 6 weeks treatment and during follow-up visit, separately （P〈0.05, P〈0.01, P〈0.001）. In placebo moxibustion group, during follow up visit, the score of stiffness was lower as compared with that before treatment （P〈0.05）. In 6 weeks of treatment and during follow-up visit, the scores of pain, stiffness and motor disturbance in moxibustion group were reduced much more remarkably as compared with placebo moxibustion group （P〈0.01 ,P〈0.05）. In moxibustion group, after treatment for 6 weeks,the time of 46-meter walking at the fastest speed was shorter apparently as compared with that before treatment （P〈0.01）, but there was no apparent improvement after treatment in placebo moxiBustion group （P〉0. 05）. The difference was not significant statistically in group comparison （P〉0. 057. After moxibustion, the temperature at treatment point was （49.81±3. 10）℃ in moxibustion group and was （,10.98± 1. 67）℃ in placebo moxibustion group. The local skin temperature increased apparently as compared with that before treatment in either group （P〈0. 001, P〈0. 01 ）, but the temperature increasing in moxibustion group was mud~ more remarkable （P--CO. 001 ）. Conclusion Moxibustion can obviously improve in the clinical symptoms for the patients with knee osteoarthritis, such as pain, stiffness and motor disturbance. It is a safe and effective therapy.