针推治疗膝关节骨性关节炎随机平行对照研究

Observation on Clinical Effect of Acupuncture and Massage Combined with the Treatment of Knee Osteoarthritis

[目的]观察针推治疗膝关节骨性关节炎疗效。[方法]使用随机平行对照方法,将92例住院患者按就诊顺序号随机分两组。对照组42例推拿,取仰卧位,术者首先采用滚法和揉法放松膝关节周围紧张肌群;按摩阿是穴、足三里、阳陵泉、委中、内犊鼻、外犊鼻,1min/穴;由下向上、由内向外反复推揉髌骨,力度由轻渐重,以局部产生酸、沉、胀感为耐受度;膝关节功能训练,以膝关节为中心,顺时针和逆时针交替运动,120次/min;滚法和揉法放松膝关节周围肌肉。治疗组50例针灸,取穴阴陵泉、阳陵泉、梁丘、血海及内外膝眼,根据中医辨证分型选择配穴,风寒袭络加风市;肝肾亏虚加肝俞、肾俞;淤血阻络加膈俞、三阴交;常规消毒,0.3mm毫针直刺,深度1~1.5寸,平补平泻手法;得气后留针20min,同时使用艾条在穴位对应部位进行熏烧,时间8~12min;推拿治疗同对照组。连续治疗1个月为1疗程。观测临床症状、WOMAC量表评分(疼痛、晨僵、关节功能)、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效39例,有效7例,无效4例,总有效率92.00%;对照组显效27例,有效7例,无效8例,总有效率80.95%;WOMAC量表评分(疼痛、僵硬、关节功能)治疗组疗效优于对照组(P<0.05)。[结论]针推治疗膝关节骨性关节炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of acupuncture on knee osteoarthritis. [Method] 92 patients were randomly divided into two groups according to the order of treatment. The control group of 42 cases of massage, supine position, the first operation using the roll method and kneading method to relax tension around the knee muscles; massage Ashi, Zusanli, Yanglingquan, Weizhong, Dubi, Dubi, 1 min/points; from the bottom up, from the inside to the outside repeatedly rubbing patella, efforts by the light is heavy, in order to locally produce acid, precipitation, swelling and a sense of tolerance; knee joint function training in the knee joint as the center, clockwise and counterclockwise alternating movement, 120/min; the rolling and kneading method to relax muscles around the knee. The treatment group of 50 cases of acupuncture, acupoint yinlingquan, Yanglingquan, Liangqiu, blood and eye of the knee, according to TCM syndrome type selection of acupoints, cold collaterals plus wind; liver and kidney deficiency and liver Yu, Shenshu Geshu; congestion resistance Tongxinluo plus Sanyinjiao; routine disinfection, 0.3mm needle puncture depth. 1 to 1.5 inches, reinforcing reducing techniques; after the gas for 20min, while using moxa smoke in the burning point COlTesponding parts of 8--12min; massage treatment with the control group. Continuous treatment for 1 months for a course of 1. Observation of clinical symptoms, WOMAC score （pain, morning stiffness, joint function）, adverse reaction. Treatment of 1 courses, to determine the efficacy. 39 cases of treatment group [Result] 7 cases were effective, 4 cases ineffective, the total efficiency of 92%; the control group was 27 cases, 7 cases were effective, 8 cases ineffective, the total efficiency of 80.95%; WOMAC score （pain, stiffness, joint function） treatment group than the control group （P〈0.05）. [Conclusion] The therapeutic effect of acupuncture on knee osteoarthritis is satisfactory, no serious adverse reactions, worthy of promotion.