中药穴位注射治疗早中期膝关节骨性关节炎的近期疗效观察及肌力分析

Recent effect and muscle strength analysis in treatment of early and medium stage of knee osteoarthritis by acupoint injection therapy of traditional chinese medicine

目的观察中药穴位注射疗法对早中期膝关节骨性关节炎患者Western Ontario大学和McMaster大学关节炎量表(WOMAC)评分及膝关节屈伸肌力的影响。方法将2015年7月至2017年12月该科收治的80例患者按照随机数字表法分为中药穴位注射组和玻璃酸钠组,每组40例。中药穴位注射组采用膝关节穴位注射舒血宁注射液治疗,玻璃酸钠组采用关节腔注射玻璃酸钠治疗,每组均每周注射1次,5次为1个疗程,同时使用BIODEX System 4等速肌力测试系统测试等速向心/向心模式下的患膝关节屈、伸肌力矩峰值。观察2组治疗前后的WOMAC评分及膝关节屈、伸肌力矩峰值的变化情况。结果 2组治疗疗效比较,差异无统计学意义(P>0.05);2组治疗后的WOMAC评分均较同组治疗前下降,且中药穴位注射组治疗后WOMAC评分较玻璃酸钠组低,差异均有统计学意义(P<0.05);2组治疗后膝关节伸肌力矩峰值较治疗前明显上升,差异均有统计学意义(P<0.05);相同角速度下,中药穴位注射组治疗后伸肌力矩峰值较玻璃酸钠组高,但差异均无统计学意义(P>0.05);在低速角速度(60°/s)下,2组治疗后膝关节屈肌力矩峰值与治疗前比较,差异均有统计学意义(P<0.05);在高速角速度(180°/s)下,2组治疗后膝关节屈肌力矩峰值较治疗前轻微上升,但差异均无统计学意义(P>0.05)。结论中药穴位注射疗法治疗早中期膝关节骨性关节炎的疗效确切,可以减轻疼痛,改善膝关节功能,提高膝关节伸肌肌力,是一种治疗早中期膝关节骨性关节炎的有效方法。

Objective To observe the recent effect of acupoint injection therapy of Traditional Chinese Medicine in treatment of early and mediunl stage of knee osteoarthritis by using WOMAC score and isokinetic concentric dynamometry of knee flexors and extensors. Methods 80 case patients of the hospital fi＇om July 2015 to December were divided into treatment group of 40 cases and control group of 40 cases according to random number table. The treatment group was treated with acupoint injection of Shuxuening injection, and the control group was treated with intra-m＇ticular injection of Sodium Hyaluronate. Each group was injected once a week for a total of 5 times for a comse of treatment. Tested the peak torque of knee flexors and extensors by the BIODEX System 4 before and after treatment at the same time. Observed the change of WOMAC score and the peak torque before and after treatment between two groups. Results Treatment efficacy was no significant difference between two groups （P〉0.05） ; The WOMAC scores of the two group after treatment were decreased obviously, and the treatment group showed a significantly lower scores, the differences were statistically significant （P〈0.05）. The peak torque of knee extensors of the two group after treatment were increased obviously, the differences were statistically significant （P〈0.05）.At the same angu- lar velocity, and the treatment group showed a higher increase, but the differences were not statistically significant （P〈0.05）. Under the low angular velocitg （60~/s） , the two groups after treatment compared with before treatment, knee flexion strength fi＇om peak differences were statistically significant （P〈0.05） ;Under the high angular velocitg（ 180~/s）, the peak torque of knee flexors of the two group after treatment were increased slightly but no significant differences （P〉0.05）. Conclusion The acupoint injection therapy of Traditional Chinese Medicine can relieve pain, and improve knee function and extensor muscle strength,it ＇ s an effective therapy in treatment of early and medium stage of knee osteoarthritis.