超声引导下股四头肌触发点湿针针刺治疗髌股关节炎疗效的临床研究

Clinical study of ultrasound-guided wet needling at the trigger points of musculus quadriceps femoris in the treatment of patients with patellofemoral osteoarthritis

目的观察超声引导下股四头肌触发点湿针对髌股关节炎(PFOA)的临床疗效。方法收集2019年8月至2020年12月南通市第六人民医院疼痛科收治的PFOA患者50例,按随机数字表法随机分为超声引导下触发点湿针针刺组(WN组,n=25)和口服药物组(OD组,n=25)。WN组每周治疗1次,连续3周为1个疗程;OD组口服塞来昔布200 mg/d,连续3周为1个疗程。分别于治疗前(T0)、1个疗程治疗结束后1个月(T1)及6个月(T2)采用数字等级评价量表(NRS)对患者疼痛程度、膝关节主动活动度(AROM)、Lysholm膝关节评分、健康调查量表(SF-36)评分进行比较。结果两组患者治疗后T1、T2的NRS评分均低于同组T0时(P均<0.01),两组患者T1、T2时AROM、Lysholm评分、SF‐36评分均高于同组T0时(P均<0.01),且各组内T1和T2时NRS、AROM、Lysholm评分、SF‐36评分比较差异均无统计学意义(P均>0.05),WN组T1和T2时的NRS评分均低于OD组(P均<0.05),WN组T1、T2时的AROM、Lysholm评分、SF‐36评分均高于OD组(P均<0.05)。结论超声引导下股四头肌触发点湿针针刺治疗和口服药物均可有效治疗髌股关节炎,湿针针刺对于缓解疼痛、改善膝关节功能、提高患者生活质量的效果更佳。

Objective To observe the clinical effects of ultrasound-guided wet needling at the trigger points of musculus quadriceps femoris in the treatment of patellofemoral osteoarthritis(PFOA).Methods From August 2019 to December 2020,50 patients with PFOA in the Pain Department of Sixth People's Hospital of Nantong City were collected.According to the random number table method,the patients were randomly divided into ultrasound-guided wet needling group(WN group,n=25)and oral medication group(OD group,n=25).The patients was treated once a week for 3 weeks in the WN group or took 200 mg celecoxib orally every day for 3 weeks in the OD group.Numerical rating scale(NRS),active range of motion(AROM),Lysholm knee joint scores and 36-item short-from health survey(SF-36)were compared before the treatment(T0),1 month(T1)and 6 months after the treatment(T2).Results The NRS was lower in T1 and T2 in the two groups than that in T0(all P<0.01).The AROM,Lysholm scores and SF‐36 were all higher in T1 and T2 in the two groups than those in T0(all P<0.01),and there was no significant difference in NRS,AROM,Lysholm scores and SF‐36 in T1 and T2 in each group(all P>0.05).The NRS was lower in T1 and T2 in the WN group than that in the OD group(all P<0.05),and the AROM,Lysholm scores and SF‐36 were higher in T1 and T2 in the WN group than those in the OD group(all P<0.05).Conclusion Ultrasound-guided wet needling at the trigger points of musculus quadriceps femoris is of better effects on relieving pain,improving knee function and heightening patients'quality of life for patients with patellofemoral osteoarthritis.