基于肌骨超声量化评价“飞龙在天”针法治疗膝关节骨性关节炎滑膜病变的临床研究

Clinical Study on the Effect of "Feilong Zaitian" Acupuncture Therapy on Synovial Lesions of Knee Osteoarthritis Based on Musculoskeletal Ultrasound Quantitative Evaluation

目的 拟通过肌骨超声量化探测滑膜厚度变化和滑囊积液变化情况,并评价“飞龙在天”针法对膝关节骨性关节炎(KOA)滑膜病变患者的疗效。方法 选取2020年10月至2022年2月在成都第一骨科医院、四川省中医院门诊及住院的KOA患者共90例,随机分为3组,A组采用“飞龙在天”针法联合口服西乐葆治疗,B组采用电针治疗联合口服西乐葆治疗,C组采用口服西乐葆治疗。结果 与治疗前比较,3组分别在治疗结束及随访6月时,视觉模拟评分法(VAS)、麦马斯特大学骨性关节炎指数(WOMAC)评分、髌上囊关节囊厚度、关节腔积液方面均有改善,差异有统计学意义(P<0.05),但3组间比较差异无统计学意义(P> 0.05)。结论 “飞龙在天”针法治疗KOA可取得与电针或西乐葆类似的临床疗效,通过肌骨超声量化评估KOA滑膜病变,为“飞龙在天”针法治疗KOA提供了临床循证依据。

Objective To evaluate the effect of "Feilong Zaitian" acupuncture therapy on synovial lesions of knee osteoarthritis(KOA) through quantitative detection of changes in synovial thickness and synovial fluid accumulation by musculoskeletal ultrasound. Methods A total of 90 KOA patients in No. 1 Orthopedics Hospital of Chengdu and Sichuan Hospital of Traditional Chinese Medicine from October 2020 to February 2022 were selected and randomly divided into three groups. Group A was treated with "Feilong Zaitian" acupuncture combined with oral administration of Celebrex,group B was treated with electroacupuncture combined with oral administration of Celebrex,and group C was treated with oral administration of Celebrex alone. Results The visual analogue scale(VAS),the western ontario and MaMaster universities arthritis index(WOMAC) score,joint capsule thickness of suprapatellar bursa and joint cavity effusion in the three groups at the end of treatment and at 6 months of follow-up were improved compared with those before treatment,respectively,and the differences were statistically significant(P< 0.05). However,there was no significant difference in the above indicators among the three groups(P> 0.05). Conclusion "Feilong Zaitian" acupuncture therapy is as effective as electroacupuncture or Celebrex in the treatment of synovial lesions of KOA. Quantitative evaluation of KOA synovial lesions by musculoskeletal ultrasound provides a clinical evidence basis for the treatment of KOA with "Feilong Zaitian" acupuncture therapy.