三联疗法治疗阳虚寒凝证膝骨性关节炎的临床疗效

目的:评价常规疗法、二联疗法和三联疗法治疗阳虚寒凝证膝骨性关节炎(KOA)的临床疗效。方法:选择90例KOA(阳虚寒凝证)患者,随机分为3组:常规(透明质酸钠关节腔注射)治疗组、二联(针刺+透明质酸钠关节腔注射)治疗组和三联(针刺+威伐光+透明质酸钠关节腔注射)治疗组,每组30例,疗程5周。比较3组治疗5周时的总有效率及治疗5周和治疗后6个月时的WOMAC指数变化。结果:治疗总有效率:三联治疗(93.3%)组优于常规治疗(76.7%)和二联治疗(83.3%)组(P<0.05);常规治疗与二联治疗组比较,差异无统计学意义(P>0.05)。WOMAC指数:治疗5周时,常规治疗(24.44±6.68)分、二联治疗(22.74±7.65)分和三联治疗(16.12±3.93)分,3组治疗前后均有显著疗效(P<0.01),三联治疗组疗效优于常规治疗和二联治疗组(P<0.05),常规治疗与二联治疗组比较差异无统计学意义(P>0.05);治疗后6个月时,三联治疗组(18.35±3.57)分疗效显著优于常规治疗组(46.26±3.95)分和二联治疗组(35.54±4.21)分(P<0.01),二联治疗组疗效优于常规治疗组(P<0.05).结论:应用三联疗法治疗KOA(阳虚寒凝证)的近期(5周)和远期(治疗后6个月)疗效优于常规疗法和二联疗法,可有效改善患者膝关节功能,提高其生活质量,具有临床推广价值。

Objective:To evaluate the clinical efficacy of conventional therapy,two combined therapy and triple therapy in treatment of knee osteoarthritis(KOA)with Yang deficiency and cold congealing.Methods:All 90 cases of KOA(Yang deficiency cold coagulation syndrome)were randomly divided into three groups:conventional treatment group(sodium hyaluronate sodium joint cavity injection),two treatment group(acupuncture+hyaluronate sodium joint injection)and triple therapy group treatment group(acupuncture+WV+hyaluronate sodium joint injection),30 cases each group,the course of five weeks.The total effective rate of the three groups at five weeks and the changes of WOMAC index at five weeks and six months after treatment were compared.Results:The total effective rate of the triple therapy(93.3%)group was superior to the conventional therapy(76.7%)and two group(83.3%)(P<0.05),and the difference was not statistically significant(P>0.05)compared with the two combined treatment group.WOMAC index:five weeks,conventional treatment(24.44+6.68),two combined therapy(22.74+7.65)and triple therapy(16.12+3.93)had significant effects(P<0.01).The curative effects of the triple therapy group was better than the conventional therapy and the two combined treatment group(P<0.05).There was no significant difference between the routine treatment and the two treatment group(P>0.05).At six months after treatment,the curative effect of the triple therapy group(18.35+3.57)was significantly better than the conventional therapy(46.26+3.95)and two combined therapy(35.54+4.21)(P<0.01).The curative effect of the two combined treatment group was better than that of the conventional treatment group(P<0.05).Conclusion:The treatment of KOA(5 weeks)and long term(6 months after treatment)with triple therapy is better than conventional therapy and two combination therapy.It can effectively improved the function of the knee joint and improve the quality of life.It has the value of clinical promotion.