“形气辨证”推拿治疗膝骨关节炎临床观察

Clinical Observation of Tuina Manipulation of "Syndrome Differentiation of Physical Form and Qi" in Treating KOA

目的:观察"形气辨证"推拿法对形体肥胖超重人群中膝骨关节炎的患者临床疗效。方法:将符合纳入标准的60名患者,随机均分到治疗组和对照组中。治疗组口服洛索洛芬钠片同时,加用"形气辨证"推拿手法治疗;对照组予洛索洛芬钠片口服治疗,治疗2周,每周仅推拿6次,共治疗12次。记录治疗前后WOMAC评分、HAQ评分、VAS评分,测定治疗前后外周血中瘦素、脂联素、IL-6、TNF-α水平,并进行两组内部及两组之间对比。结果:两组KOA患者治疗后,治疗组总有效率为83.33%(25/30),对照组总有效率为56.67%(17/30),两组间临床疗效比较差异显著(P=0.019);两组WOMAC、HAQ、VAS评分数值均有不同程度下降,与治疗前对比,具有统计学意义(P<0.05),两组之间治疗后WOMAC、HAQ、VAS评分比较治疗组明显优于对照组(P<0.05);两组患者治疗后血清瘦素、IL-6、TNF-α水平均有不同程度下降,血清脂联素水平均有上升,与治疗前对比,具有统计学意义(P<0.05);两组之间治疗后比较,血清瘦素、脂联素、IL-6、TNF-α水平呈显著差异(P<0.05),治疗组明显优于对照组。结论:"形气辨证"推拿法通过对人体形与气的调整,干预肥胖因素对膝关节的不利影响,进而有效改善超重膝骨关节炎患者各临床症状,调节血清中相关脂肪细胞因子及炎症细胞因子水平,提高患者的生活质量,值得临证参考应用。

Objective: To observe the clinical effect of Tuina manipulation of "syndrome differentiation of physical form and Qi" on knee osteoarthritis(KOA) in obese and overweight people. Methods: 60 patients who met the inclusion criteria were randomly divided into the treatment group and the control group. The control group was treated with Loxoprofen Sodium Tablet;on which basis, the treatment group was also treated with Tuina manipulation of "syndrome differentiation of physical form and Qi". The WOMAC scores, HAQ scores and VAS scores were recorded before and after the treatment, also the levels of leptin, adiponectin, IL-6 and TNF-α in peripheral blood were measured before and after the treatment in the two groups. Results: After the treatment, the total effective rate of the treatment group was 83.33%(25/30), which was significantly higher than 56.67%(17/30) of the control group(P<0.05). The scores of WOMAC, HAQ and VAS decreased in varying degrees after the treatment compared to those before the treatment in the two groups(P<0.05);of which the decreases were more significant in the treatment group(P<0.05). The serum levels of leptin, IL-6 and TNF-α were decreased to varying degrees and the serum level of adiponectin was increased after the treatment compared to those before the treatment in the two groups(P<0.05);of which the improvements were more significant in the treatment group(P<0.05). Conclusion: Through the adjustment of physical form and Qi, the Tuina manipulation of "syndrome differentiation of physical form and Qi" can intervene the adverse effects of obesity on knee joint, thus to effectively improve the clinical symptoms of overweight patients with KOA, regulate the serum levels of adipocytokines and inflammatory cytokines, and improve the life quality of the patients, which is worthy of clinical promotion.