三步推拿法联合自拟蒸敷药方对膝骨性关节炎的影响

Effect of Three-steps massage therapy combined with external application of self-made Zhengfu formula on knee osteoarthritis

目的探讨三步推拿法联合自拟蒸敷药方对膝骨性关节炎(KOA)的疗效。方法收集2019年6月至2021年6月在该院就诊的KOA患者120例,按随机数表法分为对照组和观察组,各60例。对照组给予硫酸氨基葡萄糖胶囊(口服,每次2粒,每天3次),观察组在对照组基础上采取三步推拿法联合自拟蒸敷药方,两组疗程都为4周。比较两组治疗前后视觉模拟量表(VAS)、Lysholm量表(LKSS)、中文版健康调查简表(SF-36)评分,血清超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α水平,以及临床疗效。结果与治疗前比较,治疗后两组VAS评分明显降低,LKSS评分明显增加,且观察组VAS评分明显低于对照组,LKSS评分明显高于对照组(P<0.01);与治疗前比较,治疗后两组SF-36量表各维度评分都明显增加,且观察组均明显高于对照组(P<0.01);治疗后观察组总有效率明显高于对照组(95.00%vs.81.67%,P<0.05);与治疗前比较,治疗后两组血清hs-CRP、IL-1β、IL-6、TNF-α水平均明显降低,且观察组均明显低于对照组(P<0.01)。结论在西医常规治疗基础上行三步推拿法联合自拟蒸敷药方治疗KOA的疗效明显,能减轻患者疼痛,改善患者膝关节功能和生活质量,可能与其抑制炎症反应有关。

Objective To investigate the efficacy of Three-steps massage therapy combined with external application of self-made Zhengfu formula on knee osteoarthritis(KOA)patients.Methods A total of 120 KOA patients admitted to this hospital from June 2019 to June 2021 were enrolled and divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The control group was given glucosamine sulfate capsule(oral,2 capsules each time,3 times a day),and the observation group was treated with Three-step massage combined with self-made Zhengfu formula on the basis of the control group.The treatment course for both groups was four weeks.The scores of visual analog scale(VAS),Lysholm scale(LKSS)and Chinese version of 36-Item Short-Form Health Survey((SF-36),serum levels of high sensitivity C-reactive protein(hs-CRP),interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α,and the clinical efficacy were compared between the two groups.Results Compared with before treatment,the VAS scores were significantly decreased,and the LKSS scores were significantly increased in both groups after treatment.The VAS score in the observation group was significantly lower than that in the control group,and the LKSS score was significantly higher than that in the control group(P<0.01).The scores of each dimension of SF-36 scale in both groups were significantly increased after treatment,and the scores in the observation group were significantly higher than those in the control group(P<0.01).After treatment,the total effective rate in the observation group was significantly higher than that in the control group(95.00%vs.81.67%,P<0.05).The serum levels of hs-CRP,IL-1β,IL-6 and TNF-αin the two groupswere significantly decreased after treatment,and the serum levels of these indicators in the observation group were significantly lower than those in the control group(P<0.01).Conclusion Based on the conventional treatment of western medicine,the Three-steps massage therapy combined with external application of self-made Zhengfu formula has obvious curative effect in the treatment of KOA,which can relieve the pain,improve the knee joint function and patients’life quality,and may be related to the inhibition of inflammatory response.