热敏灸结合对刺法治疗膝关节骨性关节炎的临床研究

Clinical study of heat sensitive moxibustion combined with relative acupuncture on the treatment of knee osteoarthritis

目的热敏灸对膝关节骨性关节炎有较好的作用,但耗时长而大多只针对局部,对整体调整不足;联合对刺法可以起到更好的互补和协同作用。本研究采用热敏灸结合对刺法以局部与整体相结合,观察其作用是否优于单纯的热敏灸。方法所有的受试者均来源于2014年1月—2015年1月医院门诊,将合格受试的膝关节骨性关节炎患者60例随机分为治疗组和对照组,各30例。对照组采用单纯热敏灸的方法,为在患侧膝周以内外膝眼为主的穴位进行热敏灸。治疗组采用热敏灸加对刺的方法,先采用对刺的针刺法,选取患侧内外膝眼,血海、梁丘,阳陵泉、阴陵泉,太冲、太溪4对穴位,留针30 min。针刺后再进行热敏灸。2组均每周治疗5次,周六和周日休息,观察3周。治疗前后观察疗效和可视疼痛评分(visualanalogscale,VAS)、Lysholm膝关节评分(Lysholm knee score,LKSS)。结果热敏灸结合对刺法总有效率为93.33%,对照组为76.67%。2组疗效比较,经秩和检验,差异有统计学意义(P<0.05)。2组患者治疗后VAS疼痛评分、膝关节功能评分均较治疗前明显改善(P<0.01),2组比较治疗后差异有统计学意义(P<0.05)。结论热敏灸在干预膝关节骨性关节炎、缓解疼痛以及改善功能活动方面都有较好的作用,而热敏灸结合对刺法更可起到协同作用,优于单纯的热敏灸治疗。

Objective Heat sensitive moxibustion on knee osteoarthritis has good effect,but it is time-consuming. There- fore, heat sensitive moxibustion is often operated only for local in patients, without more time for overall adjustment. This study uses heat sensitive moxihustion combined with relative acupuncture in order to treat combination of local and global. The effect will be observed if they are better than only heat sensitive moxibustion. Methods All of the subjects were from outpatient in January,2014 to January,2015. Sixty cases eligible patients with osteoarthritis of the knee were randomly di- vided into treatment group and control group, 30 cases in each group. The control group was treated with the method of simple heat sensitive moxibustion, which was used to heat sensitive moxibustion at inside and outside xiyan points in the a- round the affected side of the knee. The treatment group were treated with heat sensitive moxibustion combined with rela- tive acupuncture, first using of relative acupuncture method, which select four pairs of points such as inside and outside xiyan points,Xuehai and Liangqiu, Yanglingquan and yinlingquan,Taichong and Taixi, retaining needle for 30 min, and then heat sensitive moxibustion. Five times treatment were operated each week, but rest at the weekend, totalled 3 cour- ses. Effect,visual pain score （ visualanalogscale, VAS） and Lysholm knee score （ Lysholm knee score, LKSS） were ob- served before and after treatment. Results The total efficiency of treatment group was 93.33%, but 76.67% in the con- trol group. The difference was statistically significant（ P 〈 0.05 ） using the rank sum test. VAS and Lysholm knee score af- ter treatment were significantly improved compared with before treatment, and it in the treatment group was statistically significant difference with control group （ P 〈 0.05 ）. Conclusion There were good role in effect, relieving pain and im- proving functional activity for heat sensitive moxibustion on the intervention of knee osteoarthritis. But heat sensitive moxi- bustion combined with relative acupuncture has a more synergistic effective than simple heat sensitive moxibustion on the intervention of knee osteoarthritis.