比较传统经穴、结筋病灶点和激痛点治疗KOA的临床疗效评价研究

Clinical Observation on Treatment of Knee Osteoarthritis by Acupuncturing Trigger Points

目的:比较传统经穴、结筋病灶点和激痛点治疗KOA的临床疗效,讨论治疗KOA最佳治疗方案。方法:将137例患者随机分为3组,经穴组45例用传统经穴治疗,结筋病灶点组46例用结筋病灶点治疗,激痛点组46例用激痛点治疗。3组均用毫针针刺治疗,每日1次,7 d为1个疗程,连续治疗4个疗程。分别在第2疗程后,疗程结束后和随访治疗后4周采用VAS评分法对KOA患者疼痛指数进行评分。结果:治疗结束后,总有效率经穴组51.1%,结筋病灶点组82.6%,激痛点组84.9%,3组比较差异具有统计学意义(P<0.05);结筋病灶点组和激痛点组治疗效果明显优于经穴组,从治疗中、治疗后和随访时3组VAS和WOMAC评分情况比较,其中激痛点组近期疗效更优,结筋病灶点组疗效持久时间更长。结论:结筋病灶点配合激痛点治疗KOA,可以达到近期及远期最佳治疗效果,是治疗本病的一种简便易行、经济实用的有效方法,值得临床推广应用。

Objective：To compare the efficiency of treatment for knee osteoarthritis（KOA）among three aspects,traditional acupoints,focal points,and irritative painful points,then to find out the best therapeutic treatment for KOA. Methods：137 patients were divided into three groups,acupuncture group with 45 patients was treated by acupuncturing traditional acupoints,focal points group with 46 patients was treated by acupuncturing focal points,and irritative painful points group with 46 patients was treated by the treatment on irritative painful points. The instrument used in the three groups was filiform needle. One time daily for 28 days,and 7 days as a course. Then scored the VAS value of three stages,after the second course,after the fourth course,and 4 weeks later after the whole courses. Results：After the treatment,the total effective rate in acupuncture group is 51.1%,that in focal points group is 82.6%,and in the third group it is 84.9%. The comparison of these three groups has statistical significance（P〈0.05）;focal points group and irritative group are superior to the acupuncture group. However,the irritative points group is better in short term effect,the effect in focal points group is longer. Conclusion：Combining focal points with irritative painful points is not only the best way but also the easier and more economic way to treat for KOA,it should be popularized and applied.