腹针联合中药熏蒸TDP腹部照射治疗膝关节骨性关节炎随机平行对照研究

A Randomized,Parallel Controlled Study of Abdominal Acupuncture combined with Chinese Herbal Fumigation for Treating Knee Osteoarthritis with TDP

[目的]观察腹针联合中药熏蒸TDP腹部照射治疗膝关节骨性关节炎疗效。[方法]使用随机平行对照方法,将120例门诊患者抽签病志号抽签方法简单随机分为两组。对照组60例针灸,膝眼、阳陵泉、阴陵泉、梁丘、膝阳关及阿是穴（一次性针具,规格：0.22×40mm）,常规手法,得气后留针,TDP照射病变部位,留针30min,3次/周。治疗组60例腹针：中脘,关元,患侧滑肉门、患膝外陵,健侧气旁,双侧气穴,患侧下风湿点,双侧大横穴以穴位先后顺序针刺,膝关节内侧痛取下风湿内点;骨质增生双侧外穴;（0.22×40mm,管针）,垂直进针,得气后留针30min;指导膝关节活动,TDP照射腹部;中药熏蒸：自拟熏蒸方（羌活、当归、独活、黄柏、木瓜、威灵仙、红花、牛膝各15g,云参、苍木、没药、乳香各10g,细辛3g,桂枝6g,鸡血藤20g）,倒入熏蒸仪器储药槽沸水至药缸五分之四,1~2次/d;治疗期间做好保暖工作,注意休息,尽量少活动,促进膝关节功能恢复,做好功能锻炼。连续治疗10次为1疗程。观测临床症状、疼痛程度、膝关节运动功能评分、不良反应。连续治疗1疗程（10次）,判定疗效。[结果]治疗组痊愈6例,显效25例,有效24例,无效5例,总有效率91.67%。对照组痊愈2例,显效11例,有效30例,无效17例,总有效率71.67%。治疗组疗效优于对照组（P〈0.05）。疼痛程度、膝关节运动功能评分治疗组优于对照组（P〈0.05）。[结论]腹针联合中药熏蒸TDP腹部照射治疗膝关节骨性关节炎,疗效满意,无严重不良反应,值得推广。

[Objective]To observe the clinical effect of abdominal acupuncture combined with Chinese herbal fumigation with TDP for treating knee osteoarthritis.[Methods]120 patients were randomly divided into two groups by using a randomized,parallel control method.The control group of 60 cases of acupuncture,knee eye,Yanglingquan,Yin Ling Quan,Liangqiu,Xiyangguan and Ashi points（one-off needles,specifications：0.22×40mm） and conventional technique,after the gas needle,TDP irradiation lesion,30 min,3 times/week.The treatment group of 60 cases of abdominal acupuncture：Zhongwan,Guan yuan,suffering from knee and sideslip roumen Ling,the contralateral side gas,bilateral cavitation,ipsilateral lower rheumatism,bilateral large horizontal hole in the sequence of acupuncture points,medial knee pain from rheumatism in point;bone hyperplasia（bilateral lateral hole;0.22×40mm,pin）,vertically into the needle,after the gas needle 30min;guide the knee joint activities,TDP irradiation abdomen;herbal fumigation with fumigation：angelica,notopterygium,Fang（An gelica,phellodendron,papaya,clematis,safflower,radix ginseng,15 g,cloud pale wood,myrrh,frankincense,10 g.Asarum 3G,cinnamon 6G,20g）,caulis spatholobi medicine storage tank into the fumigation instrument to boiling water medicine cylinder 4/5,1-2 /d;during the treatment,do the warm work,pay attention to rest,as little as possible,to promote the functional recovery of knee joint function exercise,do a good job.Continuous treatment for 10 times for 1 courses.Observe clinical symptoms,pain degree,knee joint movement function score,adverse reaction.Continuous treatment of 1 courses（10 times）,determine the efficacy.[Results]6 cases were cured,25 cases markedly effective,24 cases effective,5 cases ineffective,the total effective rate was 91.67%.In the control group,2 cases were cured,11 cases markedly effective,30 cases effective,17 cases ineffective,the total effective rate was 71.67%.The curative effect of the treatment group was better than that of the control group（P〈0.05）.Pain degree,knee joint movement function score in the treatment group was better than the control group（P〈0.05）.[Conclusion]Abdominai acupuncture combined with Chinese herbal fumigation treatment of knee osteoarthritis with TDP exposure,the effect was satisfactory,and no serious adverse reaction,it is worth promoting.