[扌衮]法结合坐位调膝法治疗膝骨关节炎的效果

Effect of rolling tuina combined with sitting position knee adjustment method in the treatment of knee osteoarthritis

目的观察[扌衮]法结合坐位调膝法治疗膝骨关节炎(KOA)的临床效果。方法将2017年4月—2018年4月在上海中医药大学附属岳阳中西医结合医院推拿科就诊的60例KOA患者按照随机数字表法分为对照组和治疗组,每组各30例。两组均采用[扌衮]法治疗,治疗组在[扌衮]法基础上结合坐位调膝法。观察两组患者临床疗效和治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表评分和三维步态分析情况。结果两组总有效率比较差异无统计学意义(P>0.05)。治疗5周后,两组患者的WOMAC疼痛、僵硬、日常活动积分和总分均低于治疗前,步长、步幅、步速均增加,双侧支撑相均延长,膝关节最大屈曲角度均增大,差异有统计学意义(P<0.05),且治疗组WOMAC疼痛、日常活动积分和总分均低于对照组,步长、步幅、步速和双侧支撑相均高于对照组,差异有统计学意义(P<0.05)。结论[扌衮]法结合坐位调膝法可以减轻KOA患者疼痛、僵硬等临床症状,改善膝关节功能,提高步行能力,值得临床推广。

Objective To observe the clinical effect of rolling tuina combined with sitting position knee adjustment method in the treatment of knee osteoarthritis(KOA).Methods From April 2017 to April 2018,60 cases of KOA admitted to Department of Tuina in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine were divided into control group and treatment group according to the random number table method,with 30 patients in each group.Both groups were given rolling tuina,and the treatment group was given sitting position knee adjustment method based on rolling tuina.The clinical efficacy and Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores and three dimension gait analysis of two groups before and after treatment were observed.Results There was no significant difference of total effective rate between the two groups(P>0.05).After 5 weeks of treatment,the pain,stiffness,daily activities scores and total scores of WOMAC in the two groups were lower than those before treatment,the step length,stride length,walk velocity all increased,bilateral stance phase was extended,the maximal flexion angle of knee joint increased,the differences were statistically significant(P<0.05).And the pain,daily activities scores and total scores of WOMAC in the treatment group were lower than those of the control group,the step length,stride length,walk velocity and bilateral stance phase were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion The rolling tuina combined with sitting position knee adjustment method can reduce the pain and stiffness symptoms of KOA patients,improve the knee function and walking ability.It is worthy of clinical promotion.