中医药透配合针灸治疗老年性膝关节骨性关节炎临床观察

Observation on treating senile knee osteoarthritis by infiltrating with TCM medicine and acupuncture

目的:探讨中医药透结合针灸治疗老年性膝关节骨性关节炎(Knee Osteoarthritis,KOA)临床观察及功能改善情况。方法:将92例膝关节骨性关节炎患者,随机分为对照组31例,治疗A组31例,治疗B组30例。对照组采用膝关节局部针刺治疗,治疗A组采用局部针刺配合中药药透,治疗B组采用腰膝同时针刺及中药药透,治疗3个疗程及随访一个月后观察疼痛及功能改善情况。结果:治疗结束后,治疗B组疗效明显优于对照组及治疗A组(P<0.05)。治疗B组在主症关节疼痛、活动度及次症局部压痛与治疗A组比较,差异有统计学意义(P<0.05),治疗B组疗效改善优于治疗A组。腰膝同治配合中药药透在第3个疗程治疗后,主症关节疼痛和关节活动度临床疗效显著提高,并且在一个月随访后还体现出较好的远期优势(P<0.01)。结论:老年性膝关节骨性关节炎发病多伴有腰部损伤,采用腰膝同治配合中药药透临床疗效突出,对于缓解老年骨性关节病疼痛症状及提高生活质量有较大帮助,具有简、便、廉的特点,利于社区推广。

Objective:To explore the efficacy of infiltrating with TCM medicine and acupuncture on senile knee osteoarthritis.Methods:92 patients were randomly divided into the control group(31 cases),the treatment group A(31 cases)and the treatment group B(30 cases).The control group was treated by local acupuncture on knee joint,the treatment group A was treated by local acupuncture with infiltrating with TCM medicine,and the treatment group B was treated by acupuncture on lumbar and knee,and infiltrating with TCM medicine.Results:The efficiency in group B was better than control group and group A(P<0.05).There were significant differences between group B and group A in the main joint pain,range of motion and local tenderness of secondary symptoms(P<0.05).The efficiency in group B was better than group A.After the third course of treatment,the main symptoms of joint pain and joint activity were significantly improved,and after a month of follow-up,it also showed a better long-term advantage(P<0.01).Conclusion:The incidence of senile knee osteoarthritis is often accompanied by lumbar injury.The clinical effect of combined treatment of acupuncture on lumbar and knee,and infiltrating with TCM medicine is prominent.It is helpful to relieve the pain symptoms of senile osteoarthritis and improve the quality of life.It is simple,convenient and inexpensive,and conducive to community promotion.