点穴拨筋干预膝骨关节炎滑膜液渗出的临床观察

Clinical Observation on Effect of Acupoint Pressing and Tendon Pulling on Synovial Exudation of Knee Arthritis

目的:观察点穴拨筋干预膝骨关节炎滑膜液渗出体积的疗效观察。方法:根据本次研究的标准筛选入组70例,随机分为观察组35例给予点穴拨筋,对照组35例给予扶他林外用,两组每周治疗2次,10次为1个疗程。观察治疗前后两组患者髌上区、中央部、股骨后隐窝区、腓下隐窝区渗出滑膜液体积、体积评分的变化和安大略省西部与麦克马斯特大学骨关节炎指数评分(WOMAC)总分与亚域中疼痛、僵硬、活动困难评分的变化。结果:观察膝骨关节炎髌上区(t=2.010,P=0.048)、中央部(t=2.612,P=0.011)、股骨后隐窝区(t=2.174,P=0.033)、腓下隐窝区渗出体积(t=0.984,P=0.328)、滑膜液体积评分的变化(t=2.128,P=0.037)和WOMAC评分总分(t=3.856,P<0.01)与亚域中疼痛程度(t=4.297,P<0.01)、僵硬程度(t=4.095,P<0.01)、活动困难程度评分(t=3.024,P<0.01),除腓下隐窝区治疗后两组差异无统计学意义(P>0.05),其余各项指标差异均有统计学意义(P<0.05),观察组明显优于对照组。结论:中医点穴拨筋手法治疗膝骨关节炎滑膜液渗出疗效较好。

Objective:To observe the effect of acupoint pressing and tendon pulling on synovial exudation volume of knee arthritis. Methods:According to the criteria of this study,70 cases were randomly divided into experimental group(35 cases) and control group(35 cases). The experimental group was given acupoints and tendons,and the contral group was given votalin for external use. The two groups were treated twice a week,10 times as a course of treatment. Before and after treatment,the changes of exudation volume and synovial exudation volume scores in suprapatellar area,central area,posterior femoral recess area,inferior fibular recess area,and the changes of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) total score and sub-domain pain,stiffness and difficulty in movement scores were observed. Results:The changes of exudation volume in suprapatellar area(t=2.010,P=0.048),central part(t=2.612,P=0.011),posterior femoral recess area(t=2.174,P=0.033),and in inferior fibular recess area(t=0.984,P=0.328),synovial exudation volume score(t=2.128,P=0.037),total WOMAC score(t=3.856,P<0.01),sub-domain pain(t=4.297,P<0.01),stiffness(t=4.095,P<0.01) and the changes of dyskinesia score(t=3.024,P<0.01) in the two groups were observed before and after treatment. Except for the exudation volume in inferior fibular recess area after treatment(P>0.05). The other indexes observed showed statistical significance between both groups(P<0.05). The experimental group was significantly better than the control group on the clinical effect. Conclusion:Acupoint pressing and tendon pulling of traditional Chinese medicine massage is effective in treating synovial exudation in patients with knee arthritis.