银质针刀松解导热治疗膝关节骨性关节炎的临床对照研究

A Clinical Randomized Controlled Trial of Silver Acupotomy Relaxing and Heating Therapy in the Treatment of KOA

目的:观察银质针刀与针刀在临床治疗膝关节骨性关节炎诊疗效果的差异性。方法:将膝关节骨性关节炎患者90例,按就诊顺序随机分为银质针刀组和针刀组,每组各45例。银质针刀组采用银质针刀对病变组织切割松解并加温导热;针刀组采用汉章牌Ⅰ型4号针刀行膝关节痛点组织松解术治疗。两组患者均隔7天治疗1次,共治疗3次。观察记录两组患者治疗前、治疗4周后、治疗结束1月后随访时骨性关节炎评分指数(WOMAC)、临床疗效评定及安全性评价。结果:治疗4周后及随访1月后,两组WOMAC量表积分较治疗前有明显改善(P <0. 05),银质针刀组优于针刀组;临床疗效方面,两组治疗4周后,银质针刀组总有效率97. 8%,明显高于针刀组的84. 4%,差异有统计学意义(P <0. 05),银质针刀组疗效优于针刀组;安全性评价方面,银质针刀组明显高于针刀组。治疗后1个月随访,针刀组膝关节功能虽部分患者有所恢复,但仍存在差异(均P <0. 05),银质针刀优于针刀组;两组总有效率比较差异无统计学意义(P> 0. 05)。结论:银质针刀治疗膝关节骨性关节炎有效、安全、不良反应少,疗效优于针刀治疗。

Objective： To observe the difference of clinical efficacy between silver acupotomy and common acupotomy in the treatment of knee osteoarthritis（ KOA）. Methods： 90 KOA patients were randomly divided into the silver acupotomy group（ n = 45） and the common acupotomy group（ n = 45）. The silver acupotomy group used the silver needle knife to debond and heat the pathological tissue. The common acupotomy group used No.4 needle knife to loose the tissue of the knee joint. The two groups were treated once every 7 days for 3 times.WOMAC score,clinical efficacy,and safety evaluation were observed before the treatment,after the treatment,and one month after the treatment. Results： After 4 weeks of treatment and after the one-month follow-up,WOMAC scores were significantly improved compared to those before the treatment in the two groups（ P〈0. 05）; the silver aupotomy group was superior to the common acupotomy group. The total effective rate was97. 8% in the silver acupotomy group after 4 weeks of treatment,which was significantly higher than 84. 4% in the common acupotomy group（ P〈0. 05）. In terms of the safety evaluation,the silver acupotomy group was better than the acupotomy group. During the one-month follow-up,the silver acuptomy group was superior to the common acupotomy group in terms of the functional recovery of knee joint（ P〈0. 05）; however,there was no statistical difference between the two groups in terms of the total effective rate during this peirod of time（ P〈0. 05）. Conclusion： The silver acupotomy is safe and effective for KOA with less adverse reactions,which is superior to the common acupotomy.