理筋正骨手法联合运动疗法治疗膝骨关节炎30例临床观察

Clinical observation on 30 cases of knee osteoarthritis treated by combination of tendon-regulation and bonesetting manipulation with exercise therapy

目的观察理筋正骨手法联合运动疗法治疗膝骨关节炎的临床疗效。方法将60例膝骨关节炎患者按照随机数字表法分为治疗组和对照组,各30例。对照组给予常规推拿疗法,治疗组给予理筋正骨手法联合运动疗法,2组均1次/d,7 d为1个疗程,共治疗3个疗程。比较2组治疗前后视觉模拟评分法(VAS)评分、压痛值、临床症状评分及2组股四头肌积分肌电值(i EMG)。结果治疗后2组VAS评分明显降低,压痛值明显升高,与同组治疗前比较差异均有统计学意义(P<0.05),且治疗组改善作用明显优于对照组,2组治疗后比较差异均有统计学意义(P<0.05)。治疗后2组除肿胀程度外其他各项临床症状评分均明显升高,与同组治疗前比较差异有统计学意义(P<0.05),且治疗组升高幅度显著大于对照组,2组治疗后比较差异均有统计学意义(P<0.05)。治疗组20 s被动牵伸与20 s主动运动i EMG均明显高于对照组,2组比较差异均有统计学意义(P<0.05)。结论理筋正骨手法联合运动疗法可缓解膝骨关节炎患者疼痛,改善膝关节活动功能,从而提高患者的生活质量。

Objective To observe the clinical efficacy of tendon-regulation and bonesetting manipulation com- bined with exercise therapy on knee osteoarthritis. Methods Sixty patients with knee osteoarthritis, in accordance with the random number table,were divided into treatment group and control group, 30 cases in each one. The con- trol group was treated with routine massage therapy, while the treatment group was treated with the combination of tendon-regulation and bonesetting manipulation with exercise therapy. The 2 groups were both treated for 7 days in a course, 1 time every day. The visual analogue scale （ VAS ） scores, the tenderness value, the clinical symptom scores and iEMG in the quadrieeps femoris of the 2 groups were compared before and after treatment. Results The VAS score of the 2 groups decreased significantly, while the tenderness value of the 2 groups increased significantly after treatment,and statistical significance was found between the same group before and after treatment（P〈0.05）. Moreover, the significant improvement of treatment group was superior to that of control group. The difference be- tween the 2 groups after treatment was significant （P〈0.05）. After treatment, except the swelling degree, the scores of other clinical symptoms increased significantly in the 2 groups, and statistical significance was found between the same group before and after treatment（ P〈0.05 ）. Moreover, the increasing amplitude of the treatment group was sig- nificantly higher than that of the control group, there was statistically significant difference between the 2 groups af- ter treatment （P〈0.05）.The passive stretching for 20 s and active movements for 20 s of treatment group were signif- icantly higher than those of control group. The difference between the 2 groups was statistically significant （P 〈 0.05）. Conclusion Treatment of knee osteoarthritis with the combination of tendon-regulation and bonesetting ma- nipulation and exercise therapy can relieve the pain, improve the joint function and improve the quality life of the patients.