针刀+玻璃酸钠关节腔注射联合物理疗法治疗膝关节骨关节炎随机平行对照研究

Randomized Controlled Trial of Acupuncture and Sodium Hyaluronate Intra-articular Injection combined with Physiotherapy in the Treatment of Knee Osteoarthritis

[目的]观察针刀＋玻璃酸钠关节腔注射联合物理疗法治疗膝关节骨关节炎疗效。[方法]使用随机平行对照方法,将95例住院患者按就诊顺序编号简单随机分为两组。对照组34例脉冲磁疗,20min/次,1次/d;短波电局泥,15min/次,1次/d;低频磁疗,15min/次,1次/d。治疗组61例针刀闭合型松解术,选取膝关节周围4-5个压痛点,皮下局麻,针刀加压皮肤进针,做纵疏、横剥;关节腔内注射玻璃酸钠2m L/次,1次/周;物理治疗同对照组。连续治疗1周为1疗程。观测临床症状、膝关节功能、不良反应。连续治疗5疗程,判定疗效。[结果]治疗组临床治愈35例,显效9例,有效13例,无效4例,总有效率93.44%。对照组临床治愈12例,显效6例,有效7例,无效9例,总有效率73.53%。治疗组疗效优于对照组（P〈0.05）。[结论]针刀＋玻璃酸钠关节腔注射联合物理疗法治疗膝关节骨关节炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the acupuncture ＋ intra-articular injection combined with physical therapy for knee osteoarthritis. [Methods] 95 patients were randomly divided into two groups according to the order of treatment. The control group （34 cases） pulse magnetic field, 20 min/time, 1 times/d; shortwave Bureau mud, 15 minutes per time, 1 times/d; low frequency magnetic therapy, 15 minutes per time, ltimes/d. Intraarticular injection of glass acid sodium 2ml/time, 1 time/week; physical therapy with the control group and treatment group （n=61） the needle knife closed type neurolysis, around the knee joint selection 4-5 tenderness point, after disinfection, subcutaneous local anesthesia, knife pressure skin needling, longitudinal drainage, strip transverse. Continuous treatment for 1 weeks for 1 courses. Observation of clinical symptoms and adverse reactions. Continuous treatment for 5 courses of treatment, to determine efficacy. [Results] In the treatment group, 35 cases were cured, 9 cases were markedly effective, 13 cases were effective, 4 cases were ineffective, the total effective rate was 93.44%. In the control group, 12 cases were cured, 6 eases were markedly effective, 7 cases were effective, 9 cases were ineffective, the total effective rate was 73.53%. The curative effect of the treatment group was better than that of the control group （P〈0.05）. [Conclusion] Knife＋articular cavity injection combined with physical treatment of osteoarthritis of the knee, and the results were satisfactory. No serious adverse reactions, worthy of promotion.