温针灸联合关节腔注射富含血小板血浆(PRP)治疗膝骨关节炎的疗效分析

Therapeutic Analysis of Warm Needling Moxibustion Combined with Intra-articular Injection of Platelet-rich Plasma(PRP)in the Treatment of Knee Osteoarthritis

目的探讨温针灸联合富含血小板血浆(PRP)治疗膝骨关节炎(KOA)的临床疗效。方法方便选取莒南县中医医院针二科2017年1月—2020年12月收治的140例KOA患者,按治疗方法不同分为治疗组和对照组,各70例。对照组采用关节腔注射PRP治疗,治疗组在对照组基础上加用温针灸治疗,共治疗3周,比较两组临床总有效率、视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)及不良反应。结果治疗后,治疗组临床总有效率92.86%高于对照组81.43%,差异有统计学意义(χ^(2)=4.080,P<0.05);治疗组VAS评分(3.07±0.47)分低于对照组的(4.02±0.60)分,差异有统计学意义(t=10.428,P<0.05);观察组WOMAC评分(25.52±11.58)分低于对照组的(31.09±13.10)分,差异有统计学意义(t=2.665,P<0.05);治疗过程中,治疗组总不良反应率为10.00%,对照组为8.45%,两组比较,差异无统计学意义(χ^(2)=0.085,P>0.05)。结论温针灸联合关节腔注射PRP治疗KOA可提高临床疗效,缓解疼痛,改善症状,安全性高。

Objective To explore the clinical efficacy of warm needle moxibustion combined with platelet-rich plasma(PRP)in the treatment of knee osteoarthritis(KOA).Methods The 140 cases of KOA patients admitted to the Second Department of Acupuncture,Junan County Hospital of Traditional Chinese Medicine from January 2017 to December 2020 were conveniently selected and divided into treatment group and control group,with 70 cases each according to different treatment methods.The control group was treated with PRP injection into the joint cavity,and the treatment group was treated with warm needle moxibustion on the basis of the control group for a total of 3 weeks.The total clinical response rate,visual analog scale(VAS)score,Western Ontario and McMaster University Osteoarthritis Index(WOMAC),and adverse reactions were compared between the two groups.Results After treatment,the total clinical effective rate of the treatment group was 92.86%higher than that of the control group 81.43%,the difference was statistically significant(χ^(2)=4.080,P<0.05).The VAS score of the treatment group(3.07±0.47)points was lower than that of the control group(4.02±0.60)points,and the difference was statistically significant(t=10.428,P<0.05).The WOMAC score(25.52±11.58)points of the observation group was lower than that of the control group(31.09±13.10)points,the difference was statistically significant(t=2.665,P<0.05).During the treatment,the total adverse reaction rate was 10.00%in the treatment group and 8.45%in the control group,compared with the two groups,the difference was not statistically significant(χ^(2)=0.085,P>0.05).Conclusion Warming needle moxibustion combined with intra-articular injection of PRP to treat KOA can improve clinical efficacy,relieve pain,improve symptoms,and have high safety.