超声引导下针刀去神经化治疗重度膝骨关节炎的疗效观察

Efficacy of Ultrasound-guided Acupotomy Denervation on Severe Knee Osteoarthritis

目的观察超声引导下针刀去神经化治疗重度膝骨关节炎的临床疗效。方法77例重度膝骨关节炎患者随机分为针刀组38例与封闭组39例。针刀组患者采用超声引导下针刀去神经化治疗,封闭组患者采用封闭治疗。比较治疗前后两组患者视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及健康调查简表(SF-36)评分的变化,判定临床疗效。结果1)VAS评分:针刀组患者治疗后1、4、12周时VAS评分均显著低于治疗前(P<0.01),在12周时评分优于封闭组(P<0.05)。2)WOMAC评分:针刀组患者治疗后1、4、12周时评分均显著低于治疗前(P<0.01),且第4、12周时优于封闭组(P<0.05)。3)SF-36评分:在生理机能(PF)、生理职能(RP)、一般健康(GH)和社会功能(SH)4个维度,两组患者评分在治疗后1、4、12周时均较治疗前升高(P<0.05);在情感职能(RE)和精神健康(MH)方面,针刀组患者在治疗后1、4周时评分升高(P<0.05),在治疗后12周时评分显著增高(P<0.01),且优于封闭组(P<0.05);在躯体疼痛(BP)方面,针刀组患者在治疗后1、4、12周时评分显著均高于治疗前(P<0.01),且优于封闭组(P<0.05);在精力(VT)方面,针刀组患者治疗后1、4、12周时评分增加(P<0.05),同时在4、12周时优于封闭组(P<0.05)。结论超声引导下针刀去神经化治疗可以减轻重度膝骨关节炎患者疼痛症状,改善下肢功能,提高生活质量,具有稳定、良好的治疗效果。

Objective:To observe the clinical efficacy of ultrasound-guided acupotomy denervation in the treatment of severe knee osteoarthritis.Methods:A total of 77 patients with severe knee osteoarthritis were randomly divided into the acupotomy group(n=38)and blocked group(n=39).Patients in the acupotomy group were treated with ultrasound-guided acupotomy denervation,while patients in the blocked group were treated with block therapy.The VAS score,WOMAC score and SF-36 score were compared between the two groups before and after treatment to determine the clinical efficacy.Results:1)VAS score:VAS score in the acupotomy group at 1,4and 12 weeks after treatment was significantly lower than that before treatment(P<0.01),and it was better than that in blocked group at 12 weeks(P<0.05).2)WOMAC score:The score of acupotomy group at 1,4 and 12weeks after treatment was significantly lower than that before treatment(P<0.01),and at 4 and 12 weeks it was better than that of blocked group(P<0.05).3)SF-36 score:in the four dimensions of physiological function(PF),physiological function(RP),general health(GH)and social function(SH),the scores of the two groups at 1,4 and12 weeks after treatment were higher than those before treatment(P<0.05);in terms of emotional functioning(RE)and mental health(MH),the scores of acupotomy group increased at 1 and 4 weeks after treatment(P<0.05),and was significantly increased at 12 weeks after treatment(P<0.01),and were better than those of blocked group(P<0.05);in terms of body pain(BP),the scores of acupotomy group at 1,4 and 12 weeks after treatment were significantly higher than those before treatment(P<0.01),and better than those in blocked group(P<0.05);in terms of energy(VT),the scores of the acupotomy group increased at 1,4 and 12 weeks after treatment(P<0.05),and at 4and 12 weeks after treatment were better than those of blocked group(P<0.05).Conclusion:Ultrasound-guided acupotomy denervation can relieve pain in patients with severe knee osteoarthritis,improve lower limb function,improve their quality of life,and has stable and good therapeutic effect.