针刺配合复方青藤碱注射液穴位注射治疗膝关节骨性关节炎的临床观察

Clinical Observation on Acupuncture Combined with Compound- sinomenine Injection for Knee- osteoarthritis

目的:观察针刺配合复方青藤碱注射液治疗膝关节骨性关节炎的临床效果并对疗效进行评价。方法:将86例膝骨关节炎患者随机分成针刺穴位注射组及针刺西药组。针刺穴位注射组采用电针疗法,穴取血海、梁丘、犊鼻、内膝眼、阳陵泉、阴陵泉、阿是穴,在电针治疗后在犊鼻、内膝眼、阿是穴用复方青藤碱注射液给予穴位注射,电针每日1次,6次为一疗程,疗程间休息1天,共治疗2个疗程。第一疗程穴位注射每天1次,第二疗程穴位注射隔日1次。针刺西药组电针治疗同治疗组,并给予双氯芬酸钠口服,每天1次,每次75 mg,7天为一疗程,共服用2个疗程。以总有效率、WOMAC量表评分为观察指标,在治疗2周后、治疗后2周、治疗后1个月、治疗后3个月随访时进行疗效评估。结果:治疗2周后,两组疗效及WOMAC量表各项评分差异有统计学意义(P<0.05),针刺西药组疗效及关节功能优于针刺穴注组;安全性评价无明显差异(P>0.05);治疗后2周,两组疗效及WOMAC量表各项评分差异无统计学意义(P>0.05),针刺穴位注射组疗效及关节功能与针刺西药组相同;治疗后1个月、治疗后3个月随访时,两组疗效及WOMAC量表各项评分差异有统计学意义(P<0.01,P<0.05),针刺穴位注射组疗效及关节功能优于针刺西药组。结论:针刺配合复方青藤碱注射液穴位注射治疗膝关节骨性关节炎安全、有效,即时效果不如针刺西药组明显,但远期疗效明显优于针刺西药组。

Objective： To observe the clinical effect of acupuncture combined with compound-sinomenine injection in the treatment of knee-osteoarthritis and to evaluate the therapeutic effect. Methods： 86 cases of patients with knee-osteoarthritis were randomly divided into acupuncture-acupoint injection group and acupuncture-medicine group. In acupuncture-acupoint injection group,electro-acupuncture was used,selecting points of Xuehai,Liangqiu,Dubi,Neixiyan,Yanglingquan,Yinlingquan and Ashi points,following treatment of acupoint injection of compound-sinomenine in Dubi,Neixiyan and Ashi points. The treatment was taken once a day,6 times as a course of treatment,one day to have a rest between treatments and two courses of treatment totally,during which acupoint injection was taken once a day in the first course while once every other day in the second course. In acupuncture-medicine group,the same electroacupuncture therepy as acupuncture-acupoint injection group was taken,and at the same time,it was treated with Diclofenac sodium orally,each 75 mg,once a day,7 days as a course of treatment,and two courses totally. Thereafter,the total effective rate and WOMAC score were observed and evaluated respectively after two courses of treatment,two weeks after the treatment,one month after the treatment and three months after the treatment. Results： After treatment of two weeks,the clinical effect and WOMAC score in two groups were statistically significant（ P〈0. 05）. The clinical effect and joint function of acupuncture-medicine group were better than those of acupuncture-acupoint injection group,while there was no significant difference in the safety evaluation（ P〈0. 05）. Two weeks after the treatment,the efficacy and WOMAC score in two groups were without statistical significance（ P〈0. 05）,as well as the clinical effect and joint function. One month and three months after treatment,there was a statistical significance（ P〈0. 01,P〈0. 05） in clinical effect and WOMAC score between acupuncture-acupoint injection group and acupuncture-medicine group,between which the previous group was better both in clinical effect and joint function. Conclusion： Acupuncture combined with acupoint injection of compound-sinomenine for treating knee-osteoarthritis is safe and effective. Even though immediate effect is not as good as acupuncture-medicine group,the long-term curative effect is obviously superior.