石氏针刺疗法配合口服益肾蠲痹丸治疗膝骨关节炎

Combination therapy of Shi's acupuncture therapy and oral application of Yishen Juanbi Wan(益肾蠲痹丸)for the treatment of knee osteoarthritis

目的:观察石氏针刺疗法配合口服益肾蠲痹丸治疗膝骨关节炎的临床疗效和安全性。方法:将120例膝骨关节炎患者随机分为2组,每组60例,分别采用石氏针刺疗法配合口服益肾蠲痹丸和传统针刺疗法治疗。于治疗前和治疗3周后,分别记录并比较2组患者膝关节疼痛视觉模拟评分(vsual analogue score,VAS)及西安大略和麦克马斯特大学(Western Ontario and Mc Master Universities,WOMAC)量表积分;并在治疗期间观察有无与治疗相关的不良反应。结果:治疗3周后,3例患者脱落,其中石氏针刺疗法配合口服益肾蠲痹丸组脱落1例,传统针刺疗法组脱落2例。治疗前2组患者膝关节疼痛VAS评分及WOMAC量表积分比较,差异均无统计学意义[(7.14±1.14)分,(7.20±1.15)分,t=-0.180,P=0.858;(57.26±8.49)分,(56.36±8.76)分,t=0.404,P=0.688]。治疗3周后,2组患者膝关节疼痛VAS评分[(2.90±1.47)分,(3.83±1.51)分]及WOMAC量表积分[(25.69±5.31)分,(34.90±4.75)分]均较治疗前下降(t=11.559,P=0.000;t=9.505,P=0.000;t=13.319,P=0.000;t=9.627,P=0.000);2组患者膝关节疼痛VAS评分下降幅度比较,差异无统计学意义[(4.18±1.95)分,(3.34±1.89)分,t=1.537,P=0.121];石氏针刺疗法配合口服益肾蠲痹丸组膝关节WOMAC量表积分下降幅度大于传统针刺疗法组[(31.65±12.79)分,(21.86±12.22)分,t=2.830,P=0.006]。2组患者在治疗期间均未出现不良反应。结论:采用石氏针刺疗法配合口服益肾蠲痹丸和传统针刺疗法治疗KOA,均能缓解膝关节疼痛,不良反应小;但在改善膝关节功能方面,石氏针刺配合口服益肾蠲痹丸优于传统针刺疗法,值得临床推广应用。

Objective：To observe the clinical curative effect and safety of Shi’s acupuncture therapy combined with oral application of Yishen Juanbi Wan（益肾蠲痹丸,YSJBW）for the treatment of knee osteoarthritis（KOA）.Methods：One hundred and twenty patients with KOA were randomly divided into 2 groups,60 cases in each group.The patients were treated with Shi’s acupuncture therapy combined with oral application of YSJBW（group A）and traditional acupuncture therapy（group B）respectively.The vsual analogue scores（VAS）and West-ern Ontario and McMaster Universities（WOMAC）scores were recorded and compared between the 2 groups before the treatment and after 3 -week treatment respectively.The treatment -related adverse reactions were observed during the treatment.Results：Three patients（1 case in group A and 2 cases in group B）dropped out after 3 -week treatment.There was no statistical difference in knee pain VAS scores and WOMAC scores between the 2 groups before the treatment（7.14 ＋/-1.14 vs 7.20 ＋/-1.15 points,t =-0.180,P =0.858;57.26 ＋/-8.49 vs 56.36 ＋/-8.76 points,t =0.404,P =0.688）.The knee pain VAS scores（2.90 ＋/-1.47,3.83 ＋/-1.51 points）and WOMAC scores（25.69 ＋/-5.31,34.90 ＋/-4.75 points）decreased in the 2 groups after 3 -week treatment（t =11.559,P =0.000;t =9.505,P =0.000;t =13.319,P =0.000;t =9.627,P =0.000）.There was no statistical difference in the descent degree of knee pain VAS scoresbetween the 2 groups（4.18 ＋/-1.95 vs 3.34 ＋/-1.89 points,t =1.537,P =0.121）,while the knee -joint WOMAC scores decreased more significantly in group A compared to group B（31.65 ＋/-12.79 vs 21.86 ＋/-12.22 points,t =2.830,P =0.006）.No adverse reac-tions were found in the 2 groups during the treatment period.Conclusion：Either Shi’s acupuncture therapy combined with oral application of YSJBW or the traditional acupuncture therapy can relieve knee pain with less adverse reactions in the treatment of KOA.However,the former surpasses the latter in improving knee function,so it is worthy of popularizing in clinic.