温针对骨关节病证分型的疗效观察

Effective observation on treating different syndromes of osteoarthritis by warm acupuncture

目的:观察温针治疗骨关节病的临床疗效及对中医不同辨证分型的疗效比较。方法:将中医辨证为寒湿阻络、痰瘀痹阻、肝肾亏虚的180例骨关节病患者(包括颈椎病、腰间盘突出证、骨性膝关节炎)随机分为治疗组(温针组)90例和对照组(毫针组)90例进行对比,观察两组的临床疗效及治疗前后症状、体征的改善情况,并对两组不同证型的疗效进行观察。结果:治疗组和对照组总有效率比较有显著性差异(P<0.01),治疗组明显优于对照组;两组治疗前后症状、体征改变比较均有显著性差异(P<0.01或P<0.05),且治疗组明显优于对照组;两组对辨证同证型疗效比较,治疗组3种证型均明显优于对照组,差异显著(P<0.01或P<0.05),而同组各证型疗效比较,治疗组对寒湿阻络型疗效最优,但同组的3种证型比较,疗效差异无统计学意义。结论:温针灸有明显祛寒除湿、祛瘀消肿、通经补虚作用,对骨关节相关疾病中医辨证寒湿阻络、痰瘀痹阻及肝肾亏虚型均有很好的治疗效果,尤其对寒湿阻络型疗效最优。

Objective:To observe and compare the clinical effect of warm acupuncture on different syndromes of osteoarthritis.Methods:180 patients with osteoarthritis(including cervical spondylosis,Lumbar disc herniation,osteoarthritis of the knee)were differentiated as the Hanshi Zuluo type(寒湿阻络型),Tanyu Bizu type(痰瘀痹阻型)and Ganshen Kuixu type(肝肾亏虚型),and were randomly divided into the treatment group(needle group)and control group(filiform group),90 cases in each.The total efficacy,the improvement of symptoms and physical signs after treatment in two groups and the effect of different syndromes were observed.Results:The total efficiency in the treatment group was better than that in control group,with a significant difference(P<0.01).The improvement of symptoms and physical signs after treatment in the treatment group were significantly better than those in control group,with significant differences(P<0.01 or P<0.05).The clinical efficacy of the three syndromes in the treatment group were significantly better than those in the control group,with significant differences(P<0.01 or P<0.05).The best clinical efficacy of three syndromes in the treatment group was the Hanshi Zuluo type,without statistical difference.Conclusion:Warm acupuncture on the osteoarthritis showed good effects on Quhan Chushi(祛寒除湿),Quyu Xiaozhong(祛瘀消肿),and Tongjing Buxu(通经补虚),especially on the Hanshi Zuluo type.