基于肌骨超声评价的毫火针治疗寒湿痹阻型膝骨关节炎并发滑膜炎的临床研究

Clinical study on milli-fire needle in treatment of knee osteoarthritis of cold-dampness blockage type complicated with synovitis based on musculoskeletal ultrasound evaluation

目的运用肌骨超声观察并客观评价毫火针治疗寒湿痹阻型膝骨关节炎并发滑膜炎的临床疗效。方法将60例寒湿痹阻型膝骨关节炎并发滑膜炎患者,按随机数字表法分为治疗组和对照组,每组30例。治疗组予毫火针加TDP照射,对照组予单纯针刺加TDP照射,两组疗程均为2周。运用肌骨超声观察膝关节滑膜厚度和关节积液深度,比较疼痛VAS评分、WOMAC评分及膝关节周径的变化情况。结果 (1)治疗前后组内比较,两组滑膜厚度与关节积液深度差异均有统计学意义(P<0.05)。治疗后组间比较,滑膜厚度与关节积液深度差异有统计学意义,治疗组改善明显优于对照组(P<0.05)。(2)治疗前后组内比较,两组疼痛VAS评分与WOMAC评分差异均有统计学意义(P<0.05)。治疗后组间比较,疼痛VAS评分与WOMAC评分差异有统计学意义,治疗组明显低于对照组(P<0.05)。(3)治疗前后组内比较,两组膝关节周径差异均有统计学意义(P<0.05)。治疗后组间比较,膝关节周径差异有统计学意义,治疗组明显小于对照组(P<0.05)。结论与单纯针刺疗法相比,毫火针治疗寒湿痹阻型膝骨关节炎并发滑膜炎的临床疗效更佳,可有效缓解患者的疼痛程度,减轻膝关节肿胀,改善滑膜病变,减少关节积液。

Objective To observe and objectively evaluate the clinical efficacy of milli-fire needle in the treatment of knee osteoarthritis of colddampness blockage type complicated with synovitis by musculoskeletal ultrasound. Methods 60 patients with knee osteoarthritis of cold-dampness blockage type complicated with synovitis were assigned into the treatment group and the control group according to the random number table,30 patients in each group. Patients in the treatment group were treated with milli-fire needle plus TDP irradiation,while those in the control group received simply acupuncture plus TDP irradiation. Patients in both groups were treated for 2 weeks. Synovial thickness and joint effusion depth in the knee joint were observed based on musculoskeletal ultrasound and the changes in VAS pain score,WOMAC score and knee joint circumference were compared. Results(1) There were statistically significant differences in synovial thickness and joint effusion depth in both groups before and after treatment( P<0.05). After treatment,there were statistically significant differences in synovial thickness and joint effusion depth between the groups,and improvement in the treatment group was significantly superior to that in the control group( P<0.05).(2) There were statistically significant differences in VAS pain score and WOMAC score in both groups before and after treatment( P<0.05). After treatment,there were statistically significant differences in VAS pain score and WOMAC score between the groups,and the scores were significantly lower in the treatment group than in the control group( P<0.05).(3) There was statistically significant difference in knee joint circumference in both groups before and after treatment( P<0.05). After treatment,there was statistically significant difference in knee joint circumference between the groups,and the circumference was significantly smaller in the treatment group than in the control group( P<0.05). Conclusion Compared with simply acupuncture,milli-fire needle shows a better clinical efficacy in the treatment of knee osteoarthritis of cold-dampness blockage type complicated by synovitis. It effectively relieves the pain of patients,reduces knee joint swelling,improves synovial lesions,and reduces joint effusion.