中医膝关节穴位针刺配合手法对人工膝关节置换术后康复的影响

Effect of TCM Acupuncture on Knee along with Manipulation for Rehabilitation after Knee Replacement Surgeries

目的:探讨人工膝关节置换术后中医穴位针刺配合手法临床效果和安全性。方法:110例患者1∶1随机分为两组,对照组采用常规康复师指导康复结合CPM机械训练,治疗组增加中医膝关节穴位针刺配合手法治疗,比较两组HSS评分、膝关节功能\临床疗效和安全性。结果:治疗1个疗程后,两组HSS评分、最大屈曲度、关节活动度和VAS评分与治疗前相比差异均有统计学意义(P<0.05),且治疗组改善程度高于对照(P<0.05);治疗组总有效率83.64%,对照组总有效率70.91%,两组优良率差异有统计学意义(Ridit z=12.353,P=0.000);两组患者术后均经随访,治疗组并发症发生率1.82%,对照组并发症发生率7.27%,两组发生率比较差异有统计学意义(χ2=24.587,P=0.000)。结论:中医膝关节穴位针刺配合手法对人工膝关节置换术后僵硬、疼痛疗效显著,安全性好,值得临床推广应用。

Objective： To investigate the clinical efficacy and safety of acupuncture along with manipulation on knee after artificial knee replacement surgeries. Methods： One hundred and ten patients were randomized with the proportion of 1： 1 into two groups. Patients in the control group were given conventional rehabilitation guidance and CPM mechanical training,and patients in the observation group received extra acupuncture with manipulation on the knee. HSS score,knee function,clinical efficacy and safety were compared. Results： After one course of treatment,compared with the data before treatment,the HSS score,maximum flexion,range of motion,and VAS scores of both groups were significantly different（ P〈0. 05）,and the degree of improvement in observation group was better（ P〈0. 05）; the total curative rate of the observation group was 83. 64%,and that of the control group was 70. 91%,and the difference of the excellent rates between the two groups was statistically significant（ Ridit z = 12. 353,P = 0. 000）; the follow-up showed that the incidence of complications was 1. 82% in the observation group,and it was 7. 27% in the control group,which showed statistically significant difference（ χ2= 24. 587,P = 0. 000）. Conclusion： Acupuncture along with manipulation on knee treating stiffness and pain after knee replacement surgery has significant effect and safety,and it is worthy of clinical application.