“筋穴”导气针法联合电针治疗早、中期膝骨关节炎临床疗效观察

Observation of clinical therapeutic effect of qi-guiding acupuncture method at“tendon acupoint”combined with electro-acupuncture in the treatment of early and middle knee osteoarthritis

目的:观察“筋穴”导气针法结合电针对肝肾亏虚型早、中期膝骨关节炎(KOA)的临床疗效。方法:收集2018年6月1日至2019年1月30日就诊于上海市徐汇区长桥街道社区卫生服务中心的肝肾亏虚型KOA患者40例,随机分为治疗组和对照组各20例。治疗组采用“筋穴”导气针法结合电针,对照组采用针刺假穴法结合电针。两组留针时间为20 min,隔日1次,10次为1个疗程,共2个疗程。比较治疗前、治疗后45 d及治疗后6个月的骨性关节炎指数(WOMAC)评分,并用8公尺行走试验及5次坐立试验评价膝关节运动功能。结果:两组治疗后45 d的WOMAC评分均下降(P均<0.01),膝部疼痛评分、进行日常活动评分的组间差异有统计学意义(P<0.01)。治疗后45 d治疗组的8公尺行走试验及5次坐立试验所用时间均较治疗前缩短(P均<0.01),而对照组仅5次坐立试验所用时间缩短(P<0.01)。6个月随访,两组间WOMAC评分差异有统计学意义(P均<0.01);两组5次坐立试验所用时间与治疗后45 d比较均有下降(P<0.01),且组间差异有统计学意义(P<0.05)。结论:“筋穴”导气针法结合电针治疗肝肾亏虚型早、中期KOA,患者WOMAC评分、膝关节运动功能均有明显改善。

Objective:To observe the clinical effect of qi-guiding acupuncture method at“tendon acupoint”combined with electro-acupuncture in the treatment of knee osteoarthritis(KOA)in early and middle stage of deficiency of liver and kidney.Methods:From June 1,2018 to January 30,2019,40 KOA patients with deficiency of liver and kidney were collected from Changqiao Community Health Service Center of Xuhui District,Shanghai,and randomly divided into a treatment group and a control group with 20 cases in each group.The treatment group was treated with qi-guiding acupuncture method at“tendon acupoint”combined with electro-acupuncture,and the control group was treated with acupuncture at false points combined with electro-acupuncture.The needle retention time of the two groups was 20 minutes,once every other day,10 times as a course of treatment,and a total of 2 courses.The WOMAC scores were compared between the two groups before treatment,after treatment of 45 days,and after 6 months of follow-up,and the movement function of knee joints was evaluated by 8-meter walking test and 5-time sit-to-stand test.Results:After 45-day treatment,WOMAC scores all decreased in two groups(all P<0.01),the difference of the knee pain score and daily activity score was statistically significant between the two groups(P<0.01).The time for the 8-meter walking test and the 5-time sit-to-stand test in the treatment group at 45 days after treatment was shorter than before treatment(all P<0.01),and the control group only shortened the time taken for 5-time sit-to-stand test(P<0.01).After 6 months of follow-up,the difference of WOMAC score between the two groups was statistically significant(P<0.01);the time taken for the 5-time sit-to-stand test in both groups decreased compared with that 45 days after treatment(P<0.01),and the difference between the groups was statistically significant(P<0.05).Conclusion:In the treatment of KOA at the early and middle stage of deficiency of liver and kidney with qi-guiding acupuncture method at“tendon acupoint”combined with electro-acupuncture,the WOMAC score and knee joint motor function of the patients are significantly improved.