针刀疗法治疗Ⅲ和Ⅳ级退行性膝骨关节炎的临床观察

Clinical Observation of the Treatment of Grade Ⅲ and Ⅳ Osteoarthritis of the Knee with Acupotomy

目的探讨针刀疗法治疗Ⅲ和Ⅳ级退行性膝骨关节炎的临床效果。方法选取我院2016年5月至2018年5月收治的80例根据Kellgren-Lawrance的X线分级标准诊断为Ⅲ级、Ⅳ级退行性膝骨关节炎患者作为研究对象,将其按随机数字表法分为观察组40例和对照组40例,观察组实施针刀疗法治疗,对照组实施膝关节炎治疗仪治疗,治疗结束后计算两组患者疗效总有效率,并于术后6个月对患者进行随访观察两组患者VAS评分(疼痛视觉模拟评分法)及Lysholm评分(膝关节功能评分标准)变化。结果观察组患者治疗后临床疗效总有效率为92.50%,明显高于对照组患者的75.00%,P<0.05;术前两组患者VAS评分评分相当,P>0.05。术后6个月随访发现两组患者VAS均有所降低,且观察组VAS评分(1.05±0.87)分,低于对照组的(2.99±0.47)分,P<0.05;两组患者Lysholm评分术前差距不大,P>0.05,术后随着时间延长有不同程度的增高,且6个月后观察组Lysholm评分(94.77±2.38)分明显高于对照组的(85.36±3.29)分,P<0.05。结论针刀疗法治疗Ⅲ和Ⅳ级退行性膝骨关节炎具有良好的临床疗效,在疼痛缓解上优势较为明显,在膝关节功能恢复上具有一定的优势。

Objective To explore the clinical effect of acupotomy for treatment of gradeⅢandⅣdegenerative knee osteoarthritis.Methods Selected from May 2014 to May 2016 treated 80 cases according to K-L X-ray diagnosis classification standard forⅢlevel,levelⅣdegenerative knee osteoarthritis patients as the research object,its according to random number table method can be divided into observation group(n=40)and the control group(n=40),the observation group implementation of needle knife therapy,the control implementation of therapeutic treatment of knee arthritis,calculated two groups of patients after total effective curative effect,The patients were followed up 6 months after operation to observe the changes of VAS score(visual analogue score for pain)and Lysholm score(knee function score)in the two groups.Results The total effective rate of the observation group was 92.50%,significantly higher than the 75.00%of the control group(P<0.05).The VAS scores of the two groups were equal before surgery(P>0.05),and the six months of follow-up after surgery showed that the VAS scores of the two groups were reduced,and the VAS scores of the observation group(1.05±0.87)were lower than those of the control group(2.99±0.47)(P<0.05).Before surgery,there was not much difference in the Lysholm score between the two groups(P>0.05),and the postoperative score increased to different degrees with the extension of time,and the Lysholm score(94.77±2.38)was significantly higher in the observation group than in the control group(85.36±3.29)(P<0.05)six months later.Conclusion Acupotomology has good clinical efficacy in treating gradeⅢandⅣdegenerative knee osteoarthritis,and has unique advantages in pain relief and certain functional recovery of knee joint.