调和阴阳针刀法治疗膝骨关节炎的临床研究

Clinical Study on Acupotomy Therapy of Harmonizing Yin and Yang for the Treatment of Knee Osteoarthritis

【目的】观察调和阴阳针刀法治疗膝骨关节炎(KOA)的临床疗效。【方法】将88例KOA患者随机分为针刀组和假针刀组,每组各44例。2组患者均给予吲哚美辛巴布膏外贴的常规治疗,在此基础上,针刀组患者给予调和阴阳针刀法治疗,假针刀组患者给予假针刀手法治疗。每周治疗1次,共治疗2周,并于治疗结束后的第3个月随访1次。观察2组患者治疗前、治疗1周后及治疗后3个月随访时西安大略麦克马斯特大学骨关节炎指数(WOMAC)评分和疼痛视觉模拟量表(VAS)评分的变化情况。【结果】(1)治疗1周后和治疗后3个月随访时,2组患者的疼痛VAS评分均较治疗前降低(P<0.05),且针刀组患者在治疗1周后及治疗后3个月随访时的疼痛VAS评分均低于假针刀组,差异均有统计学意义(P<0.01)。(2)治疗1周后和治疗后3个月随访时,2组患者WOMAC量表的疼痛、僵硬和关节功能评分及总评分均较治疗前明显降低(P<0.05),且针刀组患者在治疗1周后和治疗后3个月随访时WOMAC量表的疼痛和关节功能评分及总评分均低于假针刀组,差异均有统计学意义(P<0.05或P<0.01),而2组患者WOMAC量表的僵硬评分比较,差异无统计学意义(P>0.05)。【结论】调和阴阳针刀法治疗KOA患者疗效确切,能明显缓解患者疼痛症状,改善患者膝关节功能,提高患者生活质量。

Objective To observe the clinical efficacy of acupotomy therapy of harmonizing yin and yang for the treatment of knee osteoarthritis(KOA).Methods A total of 88 patients with KOA were randomly divided into the acupotomy group and the sham acupotomy group,44 patients in each group.The patients in both groups were given the conventional treatment of indomethacin ointment applied externally,and additionally,the patients in the acupotomy group were given acupotomy therapy of harmonizing yin and yang,while the patients in the sham acupotomy group were given the sham acupotomy therapy.The treatment for both groups was performed once a week and lasted for 2 weeks.Three months after the completion of treatment,the patients were followed up for one time.The changes in Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores and visual analogue scale(VAS)pain scores in the two groups were observed before treatment,after one week of treatment and at follow-up 3 months after treatment.Results(1)The pain VAS scores of patients in both groups were decreased after one week of treatment and at follow-up 3 months after treatment compared with those before treatment(P<0.05),and the pain VAS scores of patients in the acupotomy group were lower than those in the sham acupotomy group after one week of treatment and at follow-up 3 months after treatment,the differences being statistically significant(P<0.01).(2)The scores of pain,stiffness and joint function of WOMAC scale as well as the total WOMAC scores were significantly decreased in both groups after one week of treatment and at follow-up3 months after treatment compared with those before treatment(P<0.05),and the scores of pain and joint function as well as the total WOMAC scores were lower in the acupotomy group than those in the sham acupotomy group after one week of treatment and at follow-up 3 months after treatment,the differences were statistically significant(P<0.05 or P<0.01).However,there was no significant difference in stiffness scores of WOMAC scale between the two groups(P>0.05).Conclusion The acupotomy therapy of harmonizing yin and yang exerts certain effect in treating KOA patients,which is effective in relieving the pain symptoms of patients,and improving their knee function and quality of life.