体外冲击波针灸治疗膝骨性关节炎的疗效观察

Observation on the Clinical Effect of Extracorporeal Shock Wave Acupuncture in the Treatment of Knee Osteoarthritis

目的观察体外冲击波针灸(extracorporeal shock wave acupuncture,ESWA)治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法将80例膝关节骨性关节炎患者随机分为冲击波针灸(经络穴位+痛点)治疗组40例,冲击波(痛点)对照组40例,治疗组采用冲击波针灸治疗方法刺激足阳明胃经、足太阴脾经、足少阳胆经,肾俞、委中、环跳、关元、血海、梁丘、膝阳关、膝眼、阳陵泉及阿是穴;对照组采用冲击波刺激痛点阿是穴;均隔2日治疗1次,共治疗5次。根据视觉模拟评分法(Visual Analogue Score,VAS)观察两组治疗前后患膝关节的疼痛症状改善情况,通过Lysholm评分标准对治疗前后的膝关节功能进行综合评价。结果治疗后两组患膝的疼痛和活动功能均较治疗前明显改善(P<0.05),2周治疗后及治疗后4周、12周随访,治疗组的VAS评分指数低于对照组(P<0.05),Lysholm膝关节评分高于对照组(P<0.05)。结论体外冲击波针灸治疗能够有效的减轻KOA患者的疼痛,明显改善关节功能,是一种疗效显著、安全、临床应用易于推广的治疗方法。

Objective To observe the clinical effect of extracorporeal shock wave acupuncture（ ESWA） in the treatment of knee osteoarthritis（ KOA）. Methods 75 cases of patients with KOA were randomly divided into shock wave acupuncture treatment（ Meridians points and pain spot） group of 38 cases and shock waves（ pain point） control group of 37 cases. The treatment group was treated by shock wave acupuncture method to stimulate the meridian of yangming foot,foot lunar spleen,foot shaoyang gallbladder meridian,Shenshu（ BL23）,Weizhong（ BL40）,Huantiao（ GB30）,Guanyuan（ RN4）,Xuehai（ SP10）,Liangqiu（ ST34）,Xiyangguan（ GB33）,Xiyan（ EX-LE5）,Yanglingquan（ GB34） and Ashi points. The control group used shock wave to stimulate Ashi points. Every 2 days,the two groups were treated 1 time for 5 times. According to the method of visual analogue scale（ VAS）,the two groups of patients with knee joint pain symptoms were observed before and after treatment,by the Lysholm knee scoring criteria,knee joint function recovery before and after the treatment was comprehensively evaluated. Results After treatment,knee pain and function activities of the two groups were significantly improved（ P〈0. 05）. 2 weeks after treatment and following-up 4,12 weeks after treatment,the VAS score index of the treatment group was lower than that of the control group（ P〈0. 05）,and Lysholm knee score of the treatment group was higher than that of the control group（ P〈0.05）. Conclusion ESWA therapy can effectively relieve the pain of patients with KOA,and significantly improve the joint function. It is a kind of therapy with obvious curative effect,safety and clinical application of easy promotion.