针刺对膝骨关节炎患者膝关节损伤与骨关节炎评分的影响

Effect of acupuncture on knee injury and osteoarthritis outcome score in patients with knee osteoarthritis

目的:验证针刺治疗膝骨关节炎(KOA)的临床疗效。方法:将42例KOA患者随机分为针刺组(21例,脱落1例)和假针刺组(21例,脱落1例)。针刺组从本课题组制定的半标准化针刺方案穴位库中选取5~6个局部穴位(犊鼻、内膝眼、鹤顶、阴陵泉、血海、足三里等)、3~4个远端穴位(风市、外丘、悬钟、足临泣等)进行常规针刺;假针刺组选取非经非穴浅刺,两组均留针30 min,每周治疗3次,共8周。分别于治疗前后及治疗后18周随访时记录两组患者膝关节损伤与骨关节炎评分(KOOS)。结果:与治疗前比较,治疗后及随访时两组患者KOOS 5个维度[疼痛、症状(除疼痛)、日常活动、体育与娱乐功能及生活质量]评分均升高(P<0.05),且针刺组治疗后及随访时疼痛及日常活动评分均高于假针刺组(P<0.05)。结论:针刺可减轻膝骨关节炎患者疼痛症状,提高其日常活动能力。

Objective To verify the clinical effect of acupuncture on knee osteoarthritis(KOA). Methods Forty-two patients with KOA were randomly divided into an acupuncture group(21 cases, 1 case dropped off) and a sham acupuncture group(21 cases, 1 case dropped off). The patients in the acupuncture group were treated with routine acupuncture at 5-6 local acupoints [Dubi(ST 35), Neixiyan(EX-LE 4), Heding(EX-LE 2), Yinlingquan(SP 9), Xuehai(SP 10), Zusanli(ST 36), etc.] and 3-4 distal acupoints [Fengshi(GB 31), Waiqiu(GB 36), Xuanzhong(GB 39), Zulinqi(GB 41), etc.]. The patients in the sham acupuncture group were treated with shallow needling technique at non-acupoint. The needles were retained for 30 min in both groups. All the treatment was given three times a week for 8 weeks. Knee injury and osteoarthritis outcome score(KOOS) were recorded before and after treatment and 18-week follow-up. Results Compared before treatment, the scores of 5 dimensions of KOOS [pain, symptoms(except pain), daily activities, sports and entertainment, and quality of life] were increased after treatment and during follow-up in the two groups(P<0.05), and the scores of pain and daily activities in the acupuncture group were higher than those in the sham acupuncture group(P<0.05). Conclusion Acupuncture can reduce the pain symptoms and improve daily activities in patients with KOA.