“温通针法”治疗膝关节骨性关节炎:随机对照研究

“Warming-promotion acupuncture”on knee osteoarthritis:a randomized controlled trial

目的:观察"温通针法"、平补平泻法及穴位注射治疗膝关节骨性关节炎的临床疗效差异。方法:将90例膝关节骨性关节炎患者随机分为A组(温通针法治疗组)、B组(平补平泻治疗组)和C组(玻璃酸钠治疗组),每组30例。A组和B组均取血海、鹤顶、梁丘、内膝眼、犊鼻、膝中、阳陵泉、阴陵泉、足三里,并进行辨证加减配穴,A组行温通针法;B组行平补平泻针法;C组取内膝眼、犊鼻、膝中任何一个穴位注射玻璃酸钠。A组、B组均每天治疗1次,10d为一疗程;C组5d注射1次,2次为一疗程。以上3组疗程间隔2d,治疗3个疗程后观察3组治疗前后症状、体征积分及临床疗效。结果:A组较B组和C组患者的症状、体征积分降低更明显(均P<0.05);A组的总有效率为100.00%(30/30),优于B组的90.00%(27/30)(P<0.05)和C组的73.33%(22/30,P<0.01)。结论:温通针法治疗膝关节骨性关节炎的临床疗效优于平补平泻针法和玻璃酸钠穴位注射,其疗效肯定。

Objective To observe the clinical efficacy differences between warming-promotion acupuncture,mild reinforcing-reducing acupuncture and acupoint injection for knee osteoarthritis（KOA）.Methods Ninety cases of KOA were randomly assigned into a warming-promotion acupuncture group（group A）,a mild reinforcingreducing acupuncture group（group B）and a sodium hyaluronate group（group C）,30 cases in each one.Patients in the group A and group B were treated at Xuehai（SP 10）,Heding（EX-LE 2）,Liangqiu（ST 34）,Neixiyan（EX-LE 4）,Dubi（ST 35）,Xizhong（Extra）,Yanglingquan（GB 34）,Yinlingquan（SP 9）,Zusanli（ST 36）,and acupoints could be added or reduced based on syndrome differentiation;warming-promotion acupuncture was applied in the group A and mild reinforcing-reducing method was applied in the group B.Patients in the group C were treated with injection of sodium hyaluronate at any of Neixiyan（EX-LE 4）,Dubi（ST 35）or Xizhong（Extra）.Treatment was given once a day for group A and group B,and ten days were taken as one course;the injection was given every 5days,and 2times were taken as one course.There was an interval of 2days between courses in the three groups.After three courses,the symptom and sign score and clinical efficacy were observed in the three groups.Results Compared with the group B and group C,the symptom and sign score was significantly reduced after treatment in the group A（all P〈0.05）.The total effective rate was 100.00%（30/30）in the group A,which was superior to 90.00%（27/30）in the group B（P〈0.05）and 73.33%（22/30）in the group C（P〈0.01）.Conclusion The clinical efficacy of warming-promotion acupuncture on KOA is obviously superior to the mild reinforcing-reducing acupuncture and injection of sodium hyaluronate,indicating its positive efficacy.