不同深度针刺治疗膝骨关节炎的临床疗效观察

Clinical effects of acupuncture with different needling depths on knee osteoarthritis

目的探讨不同进针深度对针刺治疗膝骨关节炎临床疗效及氧化应激水平的影响。方法将2016年6月至2018年6月于大连市第二人民医院康复科门诊或住院部接受针刺治疗的100例膝骨关节炎患者作为研究对象,按照其初次就诊的顺序排号后随机分为对照组和治疗组,每组50例。对照组采用常规进针的深度进行针刺治疗,治疗组采用深刺、透刺的进针深度进行针刺治疗,每日进行1次针刺治疗,留针30 min左右,6 d为1个疗程,共治疗4个疗程。比较2组视觉模拟评分(VAS)、骨关节炎指数评分(WOMAC)、关节活动度评分(ROM)、膝关节Lysholm评分及其疗效评价,超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GPx)的水平变化。结果 2组治疗前的VAS、WOMAC、ROM、Lysholm评分及SOD、MDA及GPx水平无统计学差异(P>0.05);疗程结束后2组的VAS评分、WOMAC评分及MDA水平较治疗前均有所改善,且治疗组优于对照组(P<0.05);疗程结束后,对照组与观察组的优良率分别为62.0%和90.0%,其差异具有统计学意义(P<0.05)。结论深刺、透刺治疗膝骨关节炎的疗效确切,能够显著地改善患者膝关节的疼痛、活动度和功能,且具有降低氧化应激损伤的作用。

Objective To investigate clinical effects of acupuncture with different needling depths on knee osteoarthritis and oxidative stress level in the treatment of knee osteoarthritis.Methods One hundred patients with knee osteoarthritis who received medical care with acupuncture either in the outpatient department or in the medical wards from June 2016 to June 2018 were recruited as study subjects, and in the order of register number were divided into the control group and the treatment group, each consisting of 50 patients. The control group was treated with acupuncture at routine needling depth, while the treatment group was treated with acupuncture at deep needling and penetrating needling depths. The patients in both groups received acupuncture treatment once a day, one session for about 30 minutes, with a course of 6 days and for a total of 4 courses. Visual analogue score(VAS), osteoarthritis index score(WOMAC), joint mobility score(ROM), and Lysholm score of knee joint and efficacy were evaluated and compared between the 2 groups(excellent, good, fair and poor). Changes in the levels of superoxide dismutase(SOD), malondialdehyde(MDA) and glutathione peroxidase(GPx) were detected for comparison between the 2 groups.Results Before treatment, there were no significant differences in VAS, WOMAC, ROM, Lysholm scores and in the levels of SOD, MAD and GPx, when comparisons were made between the 2 groups(P>0.05). After completion of the treatment courses, the VAS and WOMAC scores, as well as the MAD level in the 2 groups were all improved as compared with those before treatment(P<0.05), and the treatment group was superior to the control group(P<0.05). After treatment, the excellent and good rates of the control group and the observation group were respectively 62.0% and 90.0%. Statistical significance could be seen, when comparisons were made between the 2 groups(P<0.05).Conclusion Deep needling and penetrating needling have definite curative effects on knee osteoarthritis, and could significantly improve pain, mobility and function of knee joint, and at the same time could reduce injury induced by oxidative stress.