温针灸联合推拿治疗膝关节骨性关节炎的疗效观察

Therapeutic efficacy observation of warm needling moxibustion plus Tuina for knee osteoarthritis

目的观察温针灸联合推拿治疗膝骨关节炎(KOA)的临床疗效。方法将60例KOA患者按照随机数字表法分为观察组和对照组,每组30例。对照组患者给予温针灸治疗;观察组在对照组基础上加用推拿治疗。隔日治疗1次,共治疗10次。治疗前后进行视觉模拟量表(VAS)、西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评分及股四头肌表面肌电信号采集。结果对照组总有效率为76.7%,观察组总有效率为90.0%,组间差异有统计学意义(P<0.05)。两组治疗后WOMAC评分、VAS评分均有改善,股四头肌积分肌电值、中位频率均有提高,组内差异均有统计学意义(P<0.05)。治疗后,观察组VAS及WOMAC评分低于对照组,组间差异有统计学意义(P<0.05);观察组股四头肌功能改善优于对照组,积分肌电值、中位频率显著高于对照组(P<0.05)。结论温针灸联合推拿能有效减轻KOA患者疼痛,改善关节日常活动功能,增强股四头肌表面肌电活动信号。

Objective To observe the clinical efficacy of warm needling moxibustion plus Tuina(Chinese therapeutic massage)for knee osteoarthritis(KOA).Methods A total of 60 patients with KOA were randomized into an observation group and a control group by the random number table,with 30 cases in each group.The control group was treated with warm needling moxibustion,and the observation group was treated with additional Tuina treatment.The treatments were performed once every other day,for a total of 10 times.The visual analog scale(VAS)and Western Ontario and McMaster Universities osteoarthritis index(WOMAC)were scored before and after treatment,and the surface electromyography(sEMG)signals of quadriceps femoris were collected.Results The total effective rate of the control group was 76.7%,and that of the observation group was 90.0%.The difference between the two groups was statistically significant(P<0.05).The WOMAC and VAS scores in both groups after treatment were improved,and the integrated electromyography(iEMG)and median frequency(MF)of quadriceps femoris were increased.The intra-group differences were statistically significant(P<0.05).After treatment,the WOMAC and VAS scores in the observation group were lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05).The improvement of quadriceps femoris function in the observation group was more notable than that in the control group,and the iEMG value and MF were significantly higher than those in the control group(P<0.05).Conclusion Warming needling moxibustion plus Tuina can effectively relieve the pain in patients with KOA,improve their daily activity function,and increase the sEMG signals of the quadriceps femoris.