推拿联合中药热敷治疗膝骨关节炎临床研究

Clinical Study on Massage Combined with Chinese Medicine Hot Compress for Knee Osteoarthritis

目的:观察推拿联合中药热敷对膝骨关节炎(KOA)患者膝关节功能,膝关节疼痛、肿胀及生活质量的影响。方法:选取117例KOA患者,采用随机数字表法分为研究组59例与对照组58例。对照组给予2%利多卡因与醋酸泼尼松龙封闭治疗,研究组在对照组基础上给予推拿联合中药热敷治疗。2组均治疗3周。比较2组临床疗效及治疗前后膝关节功能、膝关节肿胀度、耐痛阈值及生活质量。结果:研究组总有效率为91.53%,高于对照组的77.59%(P<0.05)。治疗后,2组西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分均较治疗前降低(P<0.05),关节肿胀度均较治疗前缩小(P<0.05),耐痛阈值均较治疗前升高(P<0.05);研究组WOMAC评分低于对照组(P<0.05),关节肿胀度小于对照组(P<0.05),耐痛阈值高于对照组(P<0.05)。治疗后,2组总体健康、生理功能、生理职能、社会功能、情感职能、躯体疼痛、活力、精神健康评分均较治疗前升高(P<0.05),研究组总体健康、生理功能、生理职能、社会功能、躯体疼痛评分均高于对照组(P<0.05)。结论:推拿联合中药热敷治疗KOA疗效较好,能够改善患者的膝关节功能,缓解膝关节疼痛与肿胀,提高其生活质量。

Objective:To observe the effect of massage combined with Chinese medicine hot compress on the knee joint function,pain and swelling of knee joint,and quality of life of patients with knee osteoarthritis(KOA).Methods:A total of 117 cases of KOA patients were selected and divided into the study group and the control group according to the random number table method,with 59 and 58 cases in each group respectively.The control group was given block-therapy with 2%lidocaine hydrochloride and prednisolone acetate,and the study group was given massage combined with Chinese medicine hot compress on the basis of the control group.Both groups were treated for three weeks.The knee joint function,the degree of joint swelling,pain tolerance and quality of life before and after treatment,as well as clinical effects were compared between the two groups.Results:The total effective rate was 91.53% in the study group,higher than that of 77.59% in the control group(P<0.05).After treatment,scores of the Western Ontario and McMaster Universities Arthritis Index(WOMAC) in the two groups were decreased when compared with those before treatment(P<0.05),the degree of joint swelling decreased(P<0.05),and the pain tolerance increased(P<0.05).After treatment,WOMAC score in the study group was lower than that in the control group(P<0.05),the degree of joint swelling smaller(P<0.05),and the pain tolerance higher(P<0.05).After treatment,the scores of general health,physiological function,physical role,social function,emotional function,bodily pain,vitality,and mental health in the two groups were increased when compared with those before treatment(P<0.05),and the general health,physiological functioning,physical role,social functioning,and bodily pain scores in the study group were higher than those in the control group(P<0.05).Conclusion:The therapy of massage combined with Chinese medicine hot compress has a good curative effect in the treatment of KOA,which can improve the knee joint function,relieve joint pain and swelling,and enhance quality of life of patients.