平乐推按法治疗膝骨关节炎的临床疗效观察

Clinical Observation on Treatment of Knee Osteoarthritis with Pingle Massage

【目的】观察平乐推按法治疗膝骨关节炎(KOA)的临床疗效。【方法】将68例KOA患者随机分为观察组和对照组,每组各34例。观察组采用平乐推按法治疗,对照组采用传统针刺法治疗,每天治疗1次,连续治疗14 d。观察2组患者治疗前、治疗结束后1周、治疗结束后1个月,视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)含量的变化情况,并评价2组患者的临床疗效。【结果】(1)研究过程中,观察组共5例退出,对照组共7例退出。最终观察组29例、对照组27例纳入疗效统计。(2)治疗结束后1周和治疗结束后1个月,2组患者的VAS评分均明显改善,与同组治疗前比较,差异有统计学意义(P<0.05)。治疗结束后1个月,观察组VAS评分明显改善,与同期对照组比较,差异有统计学意义(P<0.05)。(3)治疗结束后1周和治疗结束后1个月,2组患者的WOMAC评分均明显改善,与同组治疗前比较,差异有统计学意义(P<0.05);治疗结束后1周,观察组WOMAC评分明显改善,与同期对照组比较,差异有统计学意义(P<0.05)。(4)治疗结束后1周和治疗结束后1个月,观察组的IL-6、TNF-α含量均较治疗前明显降低,差异有统计学意义(P<0.05),且观察组在降低血清IL-6、TNF-α含量方面均明显优于同期对照组,差异有统计学意义(P<0.05)。治疗结束后1周,对照组的IL-6、TNF-α含量稍有改善,但与同组治疗前比较,差异无统计学意义(P>0.05)。治疗结束后1个月,对照组的IL-6含量稍有改善,但与同组治疗前比较,差异无统计学意义(P>0.05);对照组TNF-α含量明显改善,与同组治疗前比较,差异有统计学意义(P<0.05)。(5)治疗结束后1周,观察组总有效率为82.76%(24/29),对照组为77.78%(21/27)。观察组疗效优于对照组,但差异无统计学意义(P>0.05)。(6)治疗结束后1个月,观察组总有效率为89.66%(26/29),对照组为66.67%(18/27)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】平乐推按法治疗KOA,能减轻患者膝关节疼痛症状,更好地改善患者膝关节的功能,降低炎症反应,疗效显著。

Objective To observe the clinical efficacy of Pingle massage for treatment of knee osteoarthritis(KOA).Methods Sixty-eight KOA patients were randomly divided into observation group and control group,34 cases in each group.The observation group received Pingle massage,and the control group received traditional acupuncture,once every day,the treatment lasting 14 days.The changes in visual analogue scale(VAS)score and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,and contents of serum interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)in the two groups were observed before treatment,one week after treatment and one month after treatment,and the clinical efficacy in the two groups was evaluated.Results(1)During the trial,5 cases from the observation group dropped out,7 cases from the control group.Finally,29 cases in the observation group and 27 cases in the control group were included into statistical analysis.(2)One week after treatment and one month after treatment,the VAS score in the two groups was improved,the difference being significant as compared with that in the same group before treatment(P<0.05).One month after treatment,the VAS score in the observation group was improved,the difference being significant as compared with that in the control group during the same period(P<0.05).(3)One week after treatment and one month after treatment,the WOMAC score in the two groups was improved,the difference being significant as compared with that in the same group before treatment(P<0.05).One month after treatment,the WOMAC score in the observation group was improved,the difference being significant as compared with that in the control group during the same period(P<0.05).(4)One week after treatment and one month after treatment,the contents of IL-6 and TNF-αin the observation group were lowered than those before treatment,the difference being significant(P<0.05),and the decrease of the contents of IL-6 and TNF-αin the observation group was superior to that of the control group during the same period(P<0.05).One week after treatment,the contents of IL-6 and TNF-αin the control group were improved,but the difference being insignificant(P>0.05).One month after treatment,the content of IL-6 in the control group was improved,but the difference being insignificant(P>0.05),while the content of TNF-αin the control group was improved,but the difference being significant(P<0.05).(5)The total effective rate was 82.76%(24/29)in the observation group,and was 77.78%(21/27)in the control group.The curative efficacy of the observation group was superior to that of the control group,but the difference being insignificant(P>0.05).(6)One month after treatment,the total effective rate was 89.66%(26/29)in the observation group,and was 66.67%(18/27)in the control group.The curative efficacy of the observation group was superior to that of the control group(P<0.05).Conclusion Pingle massage has significant therapeutic effect for KOA,and is effective for relieving the symptoms of knee joint pain,improving the function of knee joint,reducing inflammation reaction.