温针灸结合康复训练治疗膝骨关节炎远期疗效观察

Observation on the long-term efficacy of knee osteoarthritis treated with warm needling and rehabi-litation training

目的:观察温针灸结合康复训练治疗地震后板房区膝骨关节炎远期疗效及安全性。方法:将88例膝骨性关节炎患者随机分为温针组和针刺组,每组44例。温针组采用温针灸法,穴取内膝眼、犊鼻,配合康复训练治疗;针刺组取穴及康复训练同温针组,只针刺,不施灸。观察治疗20次后及随访1个月、2个月的临床疗效。结果:温针组总有效率为100.0%(41/41),明显优于针刺组的85.4%(35/41,P<0.05);两组症状积分、疼痛及膝关节功能评分在治疗20次后均显著改善(均P<0.05),温针组在症状及疼痛改善方面明显优于针刺组(均P<0.05),且在随访2个月内仍保持较好的疗效,与针刺组比较差异有统计学意义(均P<0.05);但两组膝关节功能评分差异无统计学意义(均P>0.05)。结论:温针灸结合康复训练治疗地震后板房区膝骨关节炎远期疗效优于针刺配合康复训练,具有较好的安全性。

Objective To observe the long-term efficacy and safety of warm needling therapy combined with rehabilitation training in the treatment of knee osteoarthritis （KOA） for the patients living in simple room after earthquake. Methods Eighty-eight cases of KOA were randomized into a warm needling group and an acupuncture group, 44 cases in each one. In the warm needling group, the warm needling therapy was applied at Neixiyan （EX- LE 4） and Dubi （ST 35）, in combination with rehabilitation training. In the acupuncture group, the same rehabili- tation training was received, and the same acupoints were selected as the warm needling group, but only stimulated with acupuncture without moxibustion applied. The clinical efficacy was observed after 20 treatments and in 1-2 months of follow-up. Results The total effective rate was 100. 0% （41/41） in the warm needling group, which was apparently superior to 85.4% （35/41） in the acupuncture group （P^0.05）. The symptom integral, pain and knee joint function score were all improved significantly after 20 treatments in both groups （all P〈O. 05）. The improvements in symptoms and pain in the warm needling group were superior apparently to the acupuncture group （all P^0.05）. The efficacy remained well within 2 months follow-up （all P^0.05）. But the difference in knee joint function score was not statistically significant between the two groups （all P^0.05）. Conclusion The combined therapy of warm needling and rehabilitation training achieves the superior efficacy and good safety in the treatment of KOA as compared with the combined therapy of simple acupuncture and rehabilitation training for the patients living in simple room after earthquake.