腰膝协同中医外治技术治疗膝骨关节炎的临床疗效

Clinical effect of traditional Chinese medicine external application technology of waist and knee in treating knee osteoarthritis

目的观察腰膝协同中医外治技术治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法纳入60例KOA病人,随机分为腰膝协同用药组、腰部用药组、膝部用药组并给予相应治疗。采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、VAS评价3组关节疼痛、肿胀、功能障碍的改善情况,并进行比较。结果3组治疗后WOMAC各项评分及VAS评分均较治疗前下降(P<0.05);治疗2周后,腰膝协同用药组WOMAC疼痛评分、活动功能评分及VAS评分明显低于腰部用药组及膝部用药组(P<0.05),在僵硬评分上低于腰部用药组(P<0.05);治疗第4周时,膝部用药组及腰膝协同用药组WOMAC疼痛评分、活动功能评分及VAS评分均低于腰部用药组(P<0.05);治疗6、8周及随访1个月时,3组WOMAC、VAS评分差异均无统计学意义(P>0.05)。腰膝协同用药组治疗显效率为57.9%,膝部用药组为45.0%,腰部用药组为20.0%,腰膝协同用药组显效率明显高于腰部用药组(P<0.05)。结论“易层”贴敷安全性良好,单纯腰部用药、单纯膝部用药、腰膝协同用药均能缓解KOA病人的疼痛感,提高病人的生活质量,其中腰膝协同用药效果更佳且在改善疼痛及关节活动功能方面起效时间更短。

Objective To observe the clinical efficacy of knee osteoarthritis(KOA)by using the traditional Chinese medicine external application technology of waist and knee.Methods A total of 60 KOA cases,in accordance with the inclusion criteria,were randomly divided into the waist and knee co-medication group,the waist medication group,the knee medication group,according to the different medication sites of Layers Adjusting External Application(LAEA).The improvement of the symptoms such as joint pain,swelling and dysfunction in the three groups were observed and compared.Results After treatment,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores and Visual Analogue Scale(VAS)scores of the three groups were all decreased(P<0.05).After two weeks of treatment,the pain,physical function scores of WOMAC and VAS scores in waist and knee co-medication group were significantly lower than those in the other two groups(P<0.05).WOMAC pain score,WOMAC physical function score and VAS score in co-medication group and knee medication group were significantly lower than those in waist medication group after four weeks of treatment(P<0.05).After 6 weeks,8 weeks of therapy and 1 month of follow up,there were no significant differences in WOMAC scores and VAS scores among the three groups(P>0.05).At the end of the treatment,the efficiency of the waist and knee co-medication group was 57.9%,compared with 45.0%and 20.0%in knee medication group and waist medication group(P<0.05).Conclusions LAEA is safe and effective to improve the KOA patients’joint pain and life of quality,whether applying LAEA to waist,knee or both waist and knee.Nevertheless applying LAEA to both waist and knee can achieve better efficacy and shows significant advantage in early onset.