推拿手法与针灸治疗膝关节骨性关节炎的临床疗效对比研究

Comparative study of the clinical efficacy of manipulation and acupuncture in the treatment of knee osteoarthritis

目的对比推拿手法和针灸疗法治疗膝关节骨性关节炎的临床疗效,为优化本病的非药物治疗方案提供参考。方法选取膝关节骨性关节炎患者120例,随机分为针灸组和推拿组各60例。针灸组采用针灸疗法进行治疗,推拿组采用推拿手法进行治疗。采用WOMAC评分量表在治疗前、治疗2周后以及治疗4周后对两组患者的病情进行评估,并对两组患者治疗前后的临床疗效进行比较。结果治疗2周后,针灸组疼痛得分为(71.52±36.81)分,僵硬得分为(32.94±31.06)分,关节功能得分为(286.33±208.92)分;推拿组疼痛得分为(83.39±42.73)分,僵硬得分为(21.17±36.54)分,关节功能得分为(292.46±213.48)分。两组患者的疼痛和关节功能得分显著低于治疗前(均P<0.05),针灸组僵硬得分和治疗前比较差异无统计学意义(P>0.05),而推拿组僵硬得分显著低于治疗前(P<0.05)。两组患者治疗2周后的疼痛和关节功能得分比较差异无统计学意义(P>0.05),而推拿组僵硬得分显著低于针灸组(P<0.05)。治疗4周后,针灸组疼痛得分为(43.86±35.31)分,僵硬得分为(13.69±12.32)分,关节功能得分为(179.41±165.18)分;推拿组疼痛得分为(51.79±42.68)分,僵硬得分为(11.52±10.74)分,关节功能得分为(195.39±158.92)分。两组患者疼痛、僵硬以及关节功能的得分显著低于治疗2周后(均P<0.05)。两组患者治疗4周后的疼痛、僵硬以及关节功能得分的比较差异无统计学意义(P>0.05)。结论相对于针灸疗法,推拿手法治疗关节僵硬起效更快,两种疗法均可有效缓解膝关节骨性关节炎的病情,长期疗效相当,是治疗本病较为理想的非药物治疗方法。

Objective To compare the clinical efficacy of manipulation and acupuncture therapy in the treatment of knee osteoarthritis, and to provide reference for the optimization of the non-drug treatment scheme of the disease. Methods One hundred and twenty patients with knee osteoarthritis were selected and randomly divided into acupuncture group and manipulation group, with 60 cases in each group. The acupuncture group was treated by acupuncture therapy, and the manipulation group was treated by manipulation. WOMAC scale was used to evaluate the clinical efficacy of the two groups before treatment, 2 weeks and 4 weeks after treatment. Results After 2 weeks＇ treatment, in the acupuncture group, the pain score was （71.52±36.81）, the stiff score was （32.94±31.06）, and the joint function score was （286.33±208.92）. In the manipulation group, the pain score was （83.39±42.73）, the stiff score was （21.17±36.54）, and the joint function score was （292.46±213.48）. The pain score and joint function score of the two groups were significantly lower than those before treatment （P〈0.05）. The difference of the stiff score in the acupuncture group before and after treatment was not statistically significant （P〉0.05）. The stiff score of the manipulation group was significantly lower than that before treatment （P〈0.05）. Two weeks after treatment, the pain score and joint function score showed no statistically significant difference between the two groups （P〉0.05）, but the stiff score of the manipulation group was significantly lower than the acupuncture group （P〈0.05）. Four weeks after treatment, the pain score, stiff score, the joint function score were （43.86±35.31）, （13.69± 12.32）, （179.41 ± 165.18） in the acupuncture group, and （51.79±42.68）, （11.52±10.74）, （195.39±158.92） in the manipulation group, respectively, which were significantly less than the scores 2 weeks after treatment （P〈0.05）. But the differences between the two groups 4 weeks after treatment were not statistically significant （P〉0.05）. Conclusion Compared with the therapy of acupuncture, manipulation treatment for joint stiffness results in faster onset. Two kinds of therapies are all effective for patients with knee ostenarthritis, which are ideal non-drug therapies for the disease.