毫火针针刺高应力点治疗髌骨软化症疗效观察

Efficacy observation on chrondromalacia patellae treated with fire needling technique at high stress points

目的：比较毫火针针刺高应力点与常规穴针刺治疗髌骨软化症的临床疗效差异，为针刺治疗髌骨软化症提供更佳的方法。方法：将60例患者随机分为毫火针组（28例）与常规针刺组（32例）。毫火针组按症状、触诊、影像学表现三步定位法，选取高应力点5～6个，予毫火针针刺治疗，隔天治疗1次，5次为一疗程，治疗1个疗程；常规针刺组常规针刺犊鼻、膝关、阳陵泉、阴陵泉、足三里等穴，每天治疗1次，5次为一疗程，治疗1个疗程。观察两组治疗前后Lysholm膝关节功能评分、视觉模拟量表（VsA）疼痛评分和患膝髌骨倾斜角（PTA）、外侧髌股角（LPA）变化及治疗后临床疗效。结果：两组治疗后：Lysholm膝关节功能评分、VSA疼痛评分、PTA与LPA角度均较治疗前明显改善（均P〈0．01），毫火针组治疗后Lysholm膝关节功能评分、VSA疼痛评分、PTA与LPA角度较常规针刺组改善更明显（均P〈0．05）；毫火针组有效率为92．9％（26／28），优于常规针刺组的87．5％（28／32，P〈0．01）。结论：毫火针针刺高应力点治疗髌骨软化症患者能较好改善髌骨软化症临床症状并恢复髌骨生物力学结构。

Objective To compare the clinical efficacy differences between fire needling technique of filiform needle at high stress points and regular acupuncture on chrondromalacia patellae so as to provide the better therapy for the treatment of this disease. Methods Sixty cases of chrondromalacia patellae were randomized into a fire needling group （28 cases） and a routine acupuncture group （32 cases）. In the fire needling group, 5 to 6 high stress points were localized according to the symptoms, palpation and imaging condition and were stimulated with fire needling technique of filiform needle. The treatment was given once every two days, 5 treatments made one session. In the routine acupuncture group, the regular acupuncture was applied at Dubi （ST 35）, Xiguan （LR 7）, Yanglingquan （GB 34）, Yinlingquan （SP 9）, Zusanli （ST 36）. etc. The treatment was given once every day, 5 treatments made one session. Lysholm score, VSA score, patella title angle （PTA） and lateral patella angle （LPA） of the affected knees before and after treatment, as well as the clinical efficacy after treatment were ob- served in the two groups. Results After treatment. Lysholm score, VSA score. PTA and LPA were all improved apparently in the two groups （all P〈0. 01）. After the treatments, the improvements in Lysholm score, VSA score, PTA and LPA in the fire needling group were more obvious than those in the routine acupuncture group （all P〈0.05）. The effective rate was 92.9% （26/28） in the fire needling group, better than 87.5%（28/32） in the routine acupuncture group（P〈0.01）. Conclusion The fire needling technique of filiform needle at the high stress points relieves the clinical symptoms of chrondromalacia patellae and recovers the biodynamical structure of patellae.