内热针联合推拿对膝骨性关节炎患者疼痛及关节功能的影响

Effect of Internal Heated Needle Combined with Tuina on Pain and Joint Function in the Treatment of KOA

目的:探讨内热针联合推拿对膝骨性关节炎患者疼痛及关节功能的影响。方法:选取我院收治的70例膝骨性关节炎患者,随机分为对照组和观察组,各35例。对照组给予双氯芬酸钠缓释片治疗,观察组在对照组的基础上给予内热针联合推拿治疗,两组患者进行6周的治疗。采用视觉模拟评分量表(VAS)及膝关节功能(Lysholm)量表评估两组患者治疗前及治疗1、3、6周后关节疼痛及膝关节功能情况;检测治疗前、治疗6周后患者血清炎性因子水平变化;统计两组治疗6周后临床疗效。结果:与治疗前比较,治疗1~6周后两组关节VAS评分均呈逐渐降低趋势(P<0.01),且治疗1、3、6周后观察组均显著低于对照组(P<0.05或P<0.01);与治疗前比较,治疗1~6周后两组Lysholm评分均呈逐渐升高趋势(P<0.01),且治疗1、3、6周后观察组均显著高于对照组(P<0.01);与治疗前比较,治疗6周后两组血清TNF-α、IL-6、IL-1β、hs-CRP水平显著降低(P<0.01),且观察组显著低于对照组(P<0.01);治疗6周后观察组临床总有效率为97.14%,显著高于对照组的62.86%(P<0.01)。结论:内热针联合推拿可显著缓解膝骨性关节炎患者疼痛症状,抑制炎性反应,恢复关节功能,且疗效优于单纯西药治疗。

Objective:To explore the effect of internal heated needle combined with tuina on pain and joint function in the treatment of knee osteoarthritis(KOA). Methods:70 cases of KOA were randomly divided into the control group( n =35) and the observation group( n =35).The control group was treated with Diclofenac Sodium Sustained Release Tablets;on which basis,the observation group was also treated with internal heated needle combined with tuina.The two groups were treated continuously for six weeks.The joint pain and knee function before the treatment,1w,3w,6w after the treatment were evaluated according to the visual analogue scale(VAS) and the knee function(Lysholm) scale in the two groups.The serum inflammatory factors changes before and 6w after the treatment were detected in the two groups.The clinical curative effect was observed after six weeks of the treatment. Results:VAS scores of the joint decreased gradually during the six weeks of the treatement in the two groups( P <0.01);of which the observation group was significantly lower than the control group after 1w,3w and 6w of the treatment( P <0.05,P <0.01).The Lysholm scores increased gradually during the six weeks of the treatment( P <0.01);of which the observation group was significantly higher than the control group after 1w,3w and 6w of the treatment( P <0.01).The serum levels of TNF-α,IL-6,IL-1β and hs-CRP significantly decreased in the two groups( P <0.01),of which the observation group was lower than the control group( P <0.01).The clinical total effective rate was 97.14% in the observation group,which was significantly higher than 62.86% in the control group after six weeks of the treatment( P <0.01). Conclusion:Internal heated needle combined with tuina can significantly alleviate the joint pain,inhibit inflammatory response,and restore joint function in the KOA patients.The efficacy is superior to single western medication.