基于平乐正骨“筋滞骨错”理论推拿治疗膝关节骨性关节炎疗效评价

Evaluation on curative effects of tuina in treating knee osteoarthritis based on Pingle bonesetting ‘sinew stagnation and bone dislocation' theory

目的:研究平乐正骨"筋滞骨错"理论指导的推拿治疗膝关节骨性关节炎(KOA)与常规推拿治疗的疗效差异。方法:将60例KOA受试者随机分为对照组(30例)和治疗组(30例)。对照组采用常规的推拿手法,治疗组采用平乐正骨"筋滞骨错"理论指导的推拿手法,每天1次,每个疗程14d,均治疗2个疗程。采用视觉模拟评分量表(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)及临床疗效评价治疗后和6个月随访的疗效。结果:两组患者治疗后及6个月随访的VAS评分、WOMAC评分中疼痛、功能障碍评分及总分均明显优于治疗前(P<0.05),且治疗组优于对照组(P<0.05)。治疗6个月,治疗组总有效率均明显优于对照组(P<0.05)。结论:平乐正骨"筋滞骨错"理论指导下手法治疗KOA的疗效较好,治疗KOA要在整体观的指导下兼顾膝关节和相关的组织。

Objective: To evaluate the effectiveness of tuina based on Pingle bone setting ‘sinew stagnation and bone dislocation' theory, compared with conventional tuina on knee osteoarthritis. Methods: A total of 60 volunteers were randomly divided into conventional tuina group(control group, 30 cases) and Pingle bone setting ‘sinew stagnation and bone dislocation'theory group(treatment group, 30 cases) by using computer-generated random numbers. Participants in treatment group received two courses Pingle ‘sinew stagnation and bone dislocation' tuina manipulation with combination of part and whole. And each patient in control group was given two courses routine tuina method. Every course last 14 days. The clinical assessments included visual analog scale assessing, pain and stiffness, clinical therapeutic effects and WOMAC(Western Ontario and Mc Master university osteoarthritis) index. Baseline, post-treatment, and 6-month follow-up data were collected. Results: Results of both groups showed statistically significant mean differences in visual analogue scale, pain, stiffness, physical function therapy and WOMAC index(P<0.05). The scores of treatment group were better than the control group(P<0.05). Clinical therapeutic effects after 6 months were significantly better than that in the control group(P<0.05). Conclusion: The application of Pingle bone setting ‘sinew stagnation and bone dislocation' tuina therapy combined with part and whole has batter clinical improvement than routine tuina method on knee osteoarthritis. The treatment of knee osteoarthritis should combine part and whole principle based on holism.