基于“经筋理论”针刀治疗髌骨外侧高压综合征的临床研究

Clinical Study on Acupotomy Based on Musculature Theory for Treating Excessive Lateral Pressure Syndrome

目的:观察针刀治疗髌骨外侧高压综合征的有效性及其特色,为髌骨外侧高压综合征的治疗提供一种可行、有效的方法,并为其"从筋论治"提供临床依据。方法:采用随机对照的设计方案,将2013年2月至2014年2月在中国中医科学院望京医院骨关节三科门诊接受关节腔注射玻璃酸钠治疗的髌骨外侧高压综合征患者作为对照组,接受针刀联合关节腔注射玻璃酸钠治疗的髌骨外侧高压综合征患者作为治疗组。对患者在治疗5周和治疗后6个月的疗效进行随访,以视觉模拟评分量表(VAS疼痛评分)、Lysholm膝关节功能评分作为疗效评价指标,数据统计运用SPSS17.0统计软件,两组间比较计数资料采用χ~2检验,计量资料采用t检验。结果:治疗组治疗5周和治疗后6个月VAS疼痛评分低于对照组,差异有统计学意义(P<0.001)。治疗组治疗5周和治疗后6个月Lysholm总体评分和优良率均高于对照组,并且在膝关节功能各分项评分中,其中不稳定、疼痛、爬楼方面均优于对照组,差异有统计学意义(P<0.05)。结论:基于"经筋理论"的针刀疗法治疗髌骨外侧高压综合征近期疗效肯定,能明显缓解疼痛症状、改善膝关节功能,尤其在纠正膝关节不稳定、缓解疼痛症状、改善爬楼能力方面更有优势。

Objective：To observe the efficiency and characteristics of acupotomy for treating excessive lateral pressure syndrome（ELPS）.In order to offer a feasible and effective treatment for ELPS and provide clinical evidence for treatment based on tendons.Methods：Using randomized and controlled design,the patients of ELPS who receiving intra-articular injections of sodium hyaluronate were divided into control group,and who combined receiving acupotomy and intra-articular injections of sodium hyaluronate were divided into treatment group,from February 2013 to February 2014,at the third department of orthopaedics at the China Academy of Chinese Medical Sciences,Wangjing Hospital.The index of therapeutic effect,such as visual analogue score（VAS）and Lysholm knee score were analyzed with Software SPSS17.0 using X^2 test as count data and t test as measurement data between the two groups,at 5 weeks and 6 months after treatment.Results：The VAS score in treatment group were both significantly lower than the control group at 5 weeks and 6 months after treatment.The total score and excellent rate of Lysholm in the treatment group were higher than those in the control group at 5 weeks and 6 months after treatment,especially on instability,pain,climbing stairs.Conclusion：The acupotomy for treating ELPS based on tendons is effective in the near future,which treatment can relieve pain and improve knee function,particularly in correcting the unstable of knee joint,relieving pain,improving the ability to climb the stairs.