基于肌骨超声技术评价循经筋阿是穴治疗膝骨性关节炎的临床疗效

Evaluation of clinical efficacy of Ashi acupoint along meridians in the treatment of knee osteoarthritis based on musculoskeletal ultrasonography

目的评价基于肌骨超声技术对针刺循经筋阿是穴治疗膝骨性关节炎的临床疗效。方法选取2015年12月~2018年12月治疗的膝骨性关节炎患者153例,随机分为传统经穴组(经穴组:采用毫针针刺穴位治疗)、循经筋阿是穴组(经筋辨证组:通过经筋辨证后,采用膝部规律性阿是穴位进行针刺治疗)、经穴结合循经筋阿是穴组(结合组:以上两种方法结合)各51例,观察各组治疗前后VAS变化,比较治疗效果以及结筋病灶点周围肌骨的超声检查结果。结果经穴组的VAS改善与经筋辨证组、结合组比较,差异均具有统计学意义(P<0.05);而经筋辨证组与结合组比较,差异无明显统计学意义(P>0.05)。3组患者的治疗有效率比较,结合组最高,其次为经筋辨证组,经穴组最低,组间比较差异均有明显统计学意义(P<0.05)。治疗后,超声检查显示3组患者各观察点的病变范围与治疗前比较均有明显统计学差异(P<0.05),其中以经穴组的病变范围最高,其次为经筋辨证组,结合组最低,组间比较差异均有统计学意义(P<0.05)。结论针刺循经筋阿是穴结合经穴治疗膝骨性关节炎具有较好的效果,基于肌骨超声技术对膝骨性关节炎的效果评价具有较高的应用价值。

Objective To evaluate the clinical effect of acupuncture at Ashi acupointpoint along meridians on knee osteoarthritis by using musculoskeletal ultrasound technology. Methods 153 patients with knee osteoarthritis treated from December 2015 to December 2018 were selected and randomly divided into traditional meridian point group(meridian point group:acupuncture with filiform needle),meridian tendon Ashi acupoint group(meridian tendon dialectical group:acupuncture with knee regular Ashi acupoin position after meridian tendon dialectical),meridian point combined with meridian tendon Ashi acupoin group(combination group:combination of the above two methods),with 51 cases each.The changes of VAS,therapeutic effect and ultrasonic examination results of musculoskeletal around the focal point of tendon junction were observed and compared before and after treatment in each group. Results The VAS improvement of meridian point group was significantly different from that of meridian tendon dialectical group and combination group(P<0.05),while there was no significant difference between meridian tendon dialectical group and combination group(P>0.05).Compared with the treatment efficiency of the three groups,the combined group has the highest treatment efficiency,followed by the meridian tendon dialectical group,and the meridian acupoint group has the lowest treatment efficiency.there are significant statistical differences between the groups(P<0.05). After treatment,ultrasonic examination showed that the lesion range of each observation point of the three groups of patients was significantly different from that before treatment(P<0.05).The lesion range of meridian point group was the highest,followed by meridian tendon dialectical group. the combined group was the lowest,and the difference between the groups was statistically significant(P<0.05). Conclusion Acupuncture at Ashi acupoin along meridian sinews combined with meridian points has a good effect in treating knee osteoarthritis patients,and the application of musculoskeletal ultrasound technology to evaluate this effect has a high value.