关节穴位贴治疗筋脉瘀滞型骨性关节炎的随机对照研究

Randomized Controlled Trial of Articular Point-application for Patients with Osteoarthritis of Sinews Stasis and Stagnation Type

目的评价关节穴位贴治疗筋脉瘀滞型骨性关节炎的临床疗效及安全性。方法 108例筋脉瘀滞型骨性关节炎患者随机分为穴位关节贴组、天和骨通贴膏组、安慰剂敷贴组各36例。各组均予相应穴位敷贴治疗,敷贴时间为(12±2)h,各组均连续用药4周。比较患者治疗前后不同时间视觉模拟疼痛评分(VAS)、局部疼痛压力计分、中医证候评分、疼痛缓解起效时间及不良反应情况,并评价疼痛疗效。结果关节穴位贴组疼痛疗效总有效率为94.44%,优于天和骨通贴膏组74.29%和安慰剂组25.00%(P<0.01)。各组治疗1、2、3、4周VAS评分、中医证候评分均较治疗前明显降低(P<0.05);治疗3周关节穴位贴组、天和骨痛贴膏组VAS评分均明显低于安慰剂组(P<0.05);治疗4周关节穴位贴组VAS评分最低(P<0.05);治疗3、4周时关节穴位贴组、天和骨痛贴膏组中医证候评分均较安慰剂组明显降低(P<0.05)。治疗后关节穴位贴组、天和骨痛贴膏组局部疼痛压力计分分别与安慰剂比较,差异均具有统计学意义(P<0.05)。关节穴位贴组疼痛缓解时间最短(P<0.05)。结论关节穴位贴治疗筋脉瘀滞型骨关节炎疗效确切,能缓解疼痛,起效快,安全性好。

Objective To evaluate the clinical effect and safety of articular point-application for patients with osteoarthritis （OA） of sinews stasis and stagnation type. Methods One hundred and eight patients with OA of sinews stasis and stagnation type were randomized into an articular point-application group, a Tianhe Gutong application （天和骨通贴膏） group, and a placebo application group, with 36 cases in each group. Each group was treated with corre-sponding application for （12±2 ） h daily for 4 weeks. Patients＂ visual analogy score （VAS）, local pain pressure score, Chinese medicine syndrome score, onset time of pain relief and side effect were compared at different time point before and after treatment. The analgesic effect was evaluated. Results The total effective rate in the articular point-application group was 94. 44%, which was superior to 74. 29% in the Tianhe Gutong application group and 25.00% in the placebo group （P 〈0. 01 ）. VAS score and Chinese medicine syndrome score in each group at 1st, 2nd, 3rd and 4th week were lower than those before treatment （P 〈 0. 05 ）. At the 3rd week, VAS score in the artic-ular point-application group and the Tianhe Gutong application group were lower than that in the placebo group （P 〈 0.05）. At the 4th week, VAS score in the articular point-application group was the lowest （P 〈 0. 05 ）. At the 3rd and 4th week, Chinese medicine syndrome score in the articular point-application group and the Tianhe Gutong appli- cation group were lower than that in the placebo group （P 〈 0. 05 ）. There was significant difference in local pain pressure scores between the placebo group and the articular point-application group, and between the placebo group and the Tianhe Gutong application group （ P 〈 0. 05 ）. Onset time of pain relief in the articular point-application group was the shortest （P 〈 0. 05 ）. Conclusion Articular point-application is effective in the treatment of OA of sinews stasis and stagnation type. It could relieve pain and take effect quickly with good safety.