针灸疗法和双氯芬酸钠乳胶剂治疗老年膝骨性关节炎的对比研究

Therapy Comparison of Acupuncture and Diclofenac Sodium in the Treatment of Senile Knee Osteoarthritis

目的:对比评价针灸疗法和双氯芬酸钠乳胶剂治疗老年膝骨性关节炎的临床疗效。方法:制订膝骨性关节炎的纳入标准,收集2014年2月至2015年9月新泾镇社区卫生服务中心管辖范围内的老年膝骨关节炎患者200例,随机分为两组,西医组100例在患肢疼痛处及周围皮肤上外涂双氯芬酸钠乳胶剂,针灸组100例采用针灸疗法治疗。两组疗程均是1个月。测量治疗前及治疗后1个月WOMAC量表、麦吉尔疼痛问卷SF-MPQ得分,比较中医症候疗效及不良反应发生率。结果:WOMAC量表评定显示,两组组内比较治疗后各项得分均低于治疗前(P<0.05)。但组间比较结果显示,针灸组在关节僵硬、日常关节活动、社会功能以及情绪状态这些方面的得分均明显低于西医组(P<0.05)。麦吉尔疼痛问卷SF-MPQ得分显示,治疗后针灸组的分数显著低于西医组(P<0.05)。中医症候综合疗效评估显示,针灸组的总有效率为90%,明显高于西医组的51%(P<0.05)。不良反应发生率两组相比,差异虽无统计学意义(P>0.05),但针灸组的不良反应发生率明显低于西医组。结论:针灸治疗老年膝骨性关节炎痛苦小,疗效好,副作用少,是一种简单、安全、有效的治疗方式,值得在社区推广应用。

Objective：To compare clinical effects of acupuncture and Diclofenac sodium in the treatment of senile knee osteoarthritis.Methods：200 senile patients with knee osteoarthritis were randomly divided into the western medicine group and the acupuncture and moxibustion group,with 100 cases in each group.Emulsion of Diclofenac sodium was applied around the pain area in the western medicine group.The treatment course was one month for both groups.WOMAC scale and the score of Mcgill pain questionnaire（SF-MPQ） before treatment and one month after treatment,TCM clinical effect,and adverse reaction rate were compared between the two groups.Results：Scores of WOMAC scale after treatment were lower than those before treatment in the same group（P〈0.05）.Scores of joint stiffness,joint activities,social functions,and emotional status of the acupuncture and moxibustion group were significantly lower than those of the western medicine group（P〈0.05）;SF-MPQ score of the acupuncture and moxibustion group was significantly lower than that of the western medicine group after treatment（P〈0.05）.The total effective rate of the acupuncture and moxibustion group was90%,which was significantly higher than 51% of the western medicine group（P〈0.05）;although there was no statistically significant difference in terms of the incidence of adverse reactions between the two groups（P〈0.05）,the incidence of adverse reactions of the acupuncture group was lower than that of the western medicine group.Conclusion：Acupuncture and moxibustion is an effective and safe therapy for senile knee osteoarthritis,with little pain trouble and less side effects,which is worthy of promotion and application in the community.