针刺或热敏灸配合玻璃酸钠治疗膝骨关节炎的临床疗效观察

The Clinical Research of Acupuncture or Thermal Moxibustion Combined with Sodium Hyaluronate in the Treatment of Knee Osteoarthritis

目的:探讨治疗膝骨关节炎的最佳方案。方法 :将90例膝骨关节炎患者随机分为针刺加玻璃酸钠组(A组)、热敏灸加玻璃酸钠组(B组)和玻璃酸钠组(C组),每组各30例。A组给予针刺治疗,针后行TDP治疗仪照射,1次/d;1周后再予玻璃酸钠注射液膝关节腔注射治疗,1次/周。B组施以热敏灸,15 min/次,1次/d;1周后再予玻璃酸钠注射液膝关节腔注射治疗,1次/周。C组单纯进行玻璃酸钠注射液膝关节腔内注射,1次/周。结果 :A、B、C三组的临床疗效总有效率分别为86.67%、83.33%和70.00%。A组与B组的总有效率均明显高于C组,P<0.05;A组与B组比较,差异无统计学意义,P>0.05。三组的数字评价量表(NRS)评分值比较,A组与B组在缓解患者疼痛方面优于C组,P<0.05;A组与B组在症状的改善程度方面差异没有统计学意义,P>0.05;2个月后,A组与B组远期疗效优于C组,差异有统计学意义,P<0.05。膝关节功能积分数值显示,三组均能有效的促进膝关节功能的恢复,P<0.05;A组与B组比较没有明显优劣,P>0.05。结论:针刺或热敏灸结合玻璃酸钠注射液膝关节腔注射治疗治疗膝骨关节炎的疗效和远期疗效均优于单一玻璃酸钠注射液膝关节腔注射治疗。

Objective： To explore the best method of treatment of knee osteoarthritis. Methods： 90 patients of knee osteoarthritis were randomly divided into acupuncture plus sodium hyaluronate group （group A）, moxibustion heat plus sodium hyaluronate group （group B）, sodium hyaluronate group （group C）, each group with 30 cases. Group A were given acupuncture point treatment, then given the TDP irradiation treatment, 1 times every day, a week later, given glass acid sodium injection in articular cavity, 1 times every week. Group B were treated with thermal moxibustion, 15 min every time, 1 times every day, a week later, given glass acid sodium injection in articular cavity injection, I times every week. Group C were given glass acid sodium injection in articular cavity only, 1 time every week. Results： The clinical efficacy of group A, group B and group C were 86.67%, 83.33% and 70%. The total effective rate of group A and group B were significantly higher than that of group C, P 〈0.05; the difference between group A and group B was not statistically significant, P〉0.05. In the comparison of digital evaluation table （NRS） score value of three groups, group A and group B is better than that of group C in relieve the pain of the patients, P〈 0.05. The differences in the degree of improvement in symptoms between group A and group B had no statistical significance, P〉0.05; after 2 months, the long-term efficacy of group A and group B were better than that of group C, the difference was statistically significant, P〈0.05. The value of the knee joint function score shows that the three groups can effectively promote the recovery of knee function, P〈0.05; group A and group B had no obvious advantages and disadvantages, P〉0.05. Conclusion： The efficacy and long-term efficacy of acupuncture or thermal moxibustion combined with sodium hyaluronate injection in articular cavity in the treatment of knee osteoarthritis were superior to the single sodium hyaluronate injection in articular cavity.