枢筋理论指导下针刀治疗早、中期膝骨关节炎的临床疗效

Clinical efficacy of acupotomy following the instruction of Shujin theory in early or middle stage knee osteoarthritis

目的观察枢经理论及“痛则不松,松则不痛”的经筋治疗理念指导下的针刀疗法对缓解早、中期膝骨关节炎(KOA)患者疼痛、关节僵硬症状及改善关节功能的临床疗效。方法选择80例早、中期KOA患者,随机分为治疗组和对照组,各40例,两组均采用针刀治疗。治疗组操作部位为局部病灶阳性点+枢筋辨证取穴;对照组操作部位为局部病灶阳性点。两组均为每5 d治疗1次,15 d为1疗程,共治疗2个疗程。治疗前、治疗15 d后及治疗2个疗程(30 d)后,评价两组骨关节炎指数(WOMAC)评分及步态分析。结果治疗15 d及治疗30 d后,两组患者的WOMAC指数评分、步态分析中的各项指标均明显改善,且治疗组优于对照组(均P<0.05)。2个疗程治疗结束后治疗组总有效率为92.50%,对照组总有效率为75.00%,治疗组总有效率明显优于对照组(P<0.05)。结论基于枢经理论及“痛则不松,松则不痛”的经筋治疗理念指导的针刀疗法可较好地减轻早、中期KOA患者的疼痛和关节僵硬症状,同时有助于关节功能的改善。

Objective To observe the clinical efficacy of acupotomy therapy,following the instruction of Shujin theory and the Jingjin therapy concept,“pain is because of non-relaxation,conversely,relaxation can relieve pain”,in alleviating pain and joint stiffness and improving joint function in patients with early or middle stage knee osteoarthritis(KOA).Methods A total of 80 patients with early or middle stage KOA were selected and randomly divided into treatment group or control group,with 40 cases in each group.Both groups were treated with acupotomy.The operation sites of the treatment group were the positive spot of local lesion+the dialectical point selected by Shujin,while the operation sites of the control group were the positive spots of local lesion.The two groups were treated once every 5 days for 2 treatment courses,with 15 days as a course.The Western Ontario and McMaster University Osteoarthritis Index(WOMAC)score and gait analysis were evaluated before treatment,15 days and 2 treatment courses(30 days)after treatment.Results After 15 days and 30 days of treatment,the WOMAC scores and various indexes of gait analysis in both groups were significantly improved,and the changes of the treatment group were superior to those of the control group(all P<0.05).After 2 courses of treatment,the total effective rate in the treatment group was significantly superior to that in the control group(92.50%vs.75.00%,P<0.05).Conclusion Based on the Shujin theory and the concept of Jingjin therapy,“pain is because of non-relaxation,conversely,relaxation can relieve pain”,acupotomy therapy can relieve pain and joint stiffness in patients with early or middle stage KOA;meanwhile,it is conducive to improving joint function.