温针灸结合推拿手法治疗寒湿型膝关节骨关节炎的疗效观察

Efficacy of needle warming moxibustion combined with massage manipulation on cold-dampness type of knee osteoarthritis

目的观察温针灸结合推拿手法治疗寒湿型膝关节骨关节炎的疗效。方法桐乡市中医医院、嘉兴市第一医院2017年1月-2018年12月收治的220例寒湿型膝关节骨关节炎患者按随机数字表法分观察组与对照组,每组110例。对照组给予温针灸治疗。观察组在对照组基础上辅以手法推拿,推拿后参照对照组行温针灸治疗。2组均治疗2个疗程。比较2组临床疗效、疼痛程度、膝关节功能、健康调查简易表MOS SF-36评价生活质量,并记录不良反应发生率。结果观察组临床治愈率(34.55%)高于对照组的20.00%(χ^2=5.866,P=0.015);治疗后,2组疼痛分级指数(PRI)、目测类比定级法(VAS)、现有疼痛强度(PPI)评分较治疗前均下降,且观察组低于对照组(t=-6.912、-10.364、-8.975,均P<0.001);而2组膝关节功能各维度评分及总分、生活质量各维度分值较治疗前均上升,且观察组膝关节功能各维度评分及总分(t=5.465、5.059、3.863、6.014、13.852,均P<0.001)、生活质量各维度分值(t=8.777、9.877、2.963、5.553、5.799、2.127、5.714、4.403,均P<0.05)高于对照组。结论较单纯温针灸治疗寒湿型膝关节骨关节炎,结合推拿手法能优化疗效,缓解疼痛、改善膝关节功能及生活质量,且安全性良好,值得临床推广。

Objective To observe the efficacy of needle warming moxibustion combined with massage manipulation on cold-dampness type of knee osteoarthritis. Methods Two hundred and twenty patients with cold-dampness type of knee osteoarthritis admitted to Tongxiang Hospital of Traditional Chinese Medicine and the First Hospital of Jiaxing from January 2017 to December 2018 were divided into observation group and control group by the random number table method, with 110 cases in each group. Both groups were treated with needle warming moxibustion, and observation group was additionally treated with massage manipulation. Both groups were treated for 2 courses. The clinical efficacy, pain degree, knee function and quality of life evaluated with health survey scale MOS SF-36 were compared between the two groups, and the incidence rate of adverse reactions was recorded. Results The clinical cure rate of observation group was significantly higher than that of control group(34.55% vs. 20.00%, χ^2=5.866, P=0.015). After treatment, the scores of pain rating index(PRI), visual analogue scale(VAS) and present pain intensity(PPI) of both groups were decreased, and the scores of observation group were lower than those of control group(t=-6.912,-10.364,-8.975, all P<0.001). The scores of different dimensions and total score of knee function, scores of different dimensions and total score of quality of life of both groups were increased after treatment. Besides, the scores of different dimensions and total score of knee function(t=5.465, 5.059, 3.863, 6.014, 13.852, all P<0.001), scores of different dimensions of quality of life(t=8.777, 9.877, 2.963, 5.553, 5.799, 2.127, 5.714, 4.403, all P<0.05) in observation group were higher than those in control group. Conclusion Compared with simple needle warming moxibustion for cold-dampness type of knee osteoarthritis, combined application of massage manipulation can further optimize clinical efficacy, relieve pain, and improve knee function and quality of life, with safety.