超微针刀治疗老年膝骨关节炎临床研究

Clinical Study on Ultramicro Needle-Knife for Senile Knee Osteoarthritis

目的:观察超微针刀治疗老年膝骨关节炎(KOA)的疗效及对膝关节Lysholm评分、炎性因子及生活质量的影响方法:回顾性分析74例老年KOA患者的临床资料,根据资料中的不同治疗方式将其纳入治疗组与对照组。对照组37例给予中药汤剂治疗,治疗组37例在对照组基础上联合超微针刀治疗。分别检测2组治疗前后Lysholm评分、视觉模拟评分法(VAS)评分、西安大略和麦马斯特大学骨关节炎指数(WOMAC)评分、生活质量测评量表(SF-36)评分及白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、前列腺素E2(PGE2)水平的变化;比较2组临床疗效及不良反应发生情况。结果:治疗组总有效率94.59%,高于对照组75.68%(P<0.05)。与同组治疗前比较,治疗后2组VAS评分、WOMAC评分及IL-1、TNF-α、PGE2水平均降低(P<0.05),Lysholm评分、SF-36评分均升高(P<0.05);与对照组治疗后比较,治疗组治疗后VAS评分、WOMAC评分及IL-1、TNF-α、PGE2水平均较低(P<0.05),Lysholm评分、SF-36评分均较高(P<0.05)。2组不良反应比较,差异无统计学意义(P>0.05)。结论:超微针刀治疗老年KOA患者临床疗效显著,可有效缓解患者疼痛,提高膝关节活动度与功能,降低炎症反应,提高生活质量,安全性好。

Objective:To observe the curative effect of ultramicro needle-knife for senile knee osteoarthritis(KOA)and its effect on Lysholm scores of knee,inflammatory factors and quality of life.Methods:A total of 74 cases of senile patients with KOA were given a retrospective analysis on their clinical data,and were divided into the treatment group and the control group according to their treatment methods,37 cases in each group.The control group was treated with Chinese medicine decoction,and the treatment group was additionally treated with ultramicro needle-knife based on the treatment of the control group.Before and after treatment,the changes in scores of Lysholm,Visual Analogue Scale(VAS),Western Ontario and Mcmaster Universities Osteoarthritis Index(WOMAC)and 36-Item Short Form Health Survey(SF-36)as well as levels of interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and prostaglandin E2(PGE2)in the two groups were detected.The clinical effects and the incidences of adverse reactions in the two groups were compared.Results:The total effective rate was 94.59%in the treatment group,higher than that of 75.68%in the control group(P<0.05).After treatment,the scores of VAS and WOMAC as well as the levels of IL-1,TNF-αand PGE2 in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of Lysholm and SF-36 were increased(P<0.05);the scores of VAS and WOMAC as well as the levels of IL-1,TNF-αand PGE2 in the treatment group were lower than those in the control group(P<0.05),and the scores of Lysholm and SF-36 were higher(P<0.05).There was no significant difference being found in the comparison of the adverse reactions between the two groups(P>0.05).Conclusion:Ultramicro needle-knife for senile KOA has a significant clinical effect,and can effectively relieve pain,improve knee joint activity and function,reduce inflammatory responses,and enhance quality of life with good safety.