温针灸联合推拿治疗膝关节骨性关节炎的疗效及对中医证候积分、膝功能评分的影响

Efficacy Analysis of Warm Acupuncture Combined with Massage in Treatment of Knee Osteoarthritis and Its Influence on Traditional Chinese Medicine Syndrome Score and Knee Function Score

目的探讨温针灸联合推拿治疗膝关节骨性关节炎的疗效及对中医证候积分、膝功能评分的影响。方法回顾性分析2019年5月至2021年8月在南京医科大学附属无锡人民医院针灸科就诊的80例膝关节骨性关节炎患者的临床资料,按照治疗方式不同分为温针灸联合推拿组和推拿组,每组40例。记录两组治疗前后中医证候积分(包括屈伸不利、肿胀、晨僵、疼痛4项评分)、日本骨科协会(JOA)评分、视觉模拟评分法(VAS)评分、日常生活活动能力(ADL)评分,比较两组治疗效果、中医证候积分以及JOA、VAS、ADL评分。结果温针灸联合推拿组治疗总有效率高于推拿组[95.0%(38/40)比75.0%(30/40)](P<0.05),温针灸联合推拿组疗效优于推拿组(P<0.01)。两组治疗后屈伸不利、肿胀、晨僵、疼痛4项中医证候积分、VAS评分均低于治疗前(P<0.05),JOA、ADL评分均高于治疗前(P<0.05)。治疗后,温针灸联合推拿组上述4项中医证候积分、VAS评分低于推拿组[(1.02±0.32)分比(2.08±0.36)分、(1.06±0.25)分比(2.04±0.23)分、(1.02±0.20)分比(2.01±0.15)分、(1.23±0.19)分比(2.25±0.12)分、(2.02±0.05)分比(4.21±0.08)分](P<0.01),JOA、ADL评分均高于推拿组[(26.32±4.21)分比(19.65±4.23)分、(48.69±1.65)分比(39.65±1.62)分](P<0.01)。结论温针灸联合推拿治疗膝关节骨性关节炎可有效改善患者的中医证候积分、膝功能评分。

Objective To investigate the efficacy of warm acupuncture combined with massage in the treatment of knee osteoarthritis and its effect on traditional Chinese medicine(TCM)syndrome scores and knee function scores.Methods Retrospective analysis the clinical data of 80 patients with knee osteoarthritis treated in the Department of Acupuncture and Moxibustion of Wuxi People′s Hospital Affiliated to Nanjing Medical University from May 2019 to Aug.2021 and divided into a warm acupuncture combined with massage group and a massage group according to different treatment methods,40 cases in each group.The scores of TCM syndromes(including four scores of unfavorable flexion and extension,swelling,morning stiffness,and pain),the Japanese Orthopedic Association(JOA)score,the visual analogue scale(VAS)score,and the activity of daily living(ADL)score were recorded before and after treatment in the two groups,and the therapeutic effect,TCM syndrome scores,JOA,VAS,and ADL scores were compared between the two groups.Results The total effective rate of the warm acupuncture combined with massage group was higher than that of the massage group[95.0%(38/40)vs 75.0%(30/40)](P<0.05),and the effect of the warm acupuncture combined with massage group was better than that of the massage group(P<0.01).After treatment,the four TCM syndrome scores of unfavorable flexion and extension,swelling,morning stiffness and pain,and VAS scores in the two groups were lower than those before treatment(P<0.05),and the scores of JOA and ADL were higher than those before treatment(P<0.05).After treatment,the TCM syndrome scores and VAS score of the warm acupuncture combined with massage group were lower than those of the massage group(1.02±0.32 vs 2.08±0.36,1.06±0.25 vs 2.04±0.23,1.02±0.20 vs 2.01±0.15,1.23±0.19 vs 2.25±0.12,2.02±0.05 vs 4.21±0.08)(P<0.01),the JOA and ADL scores were higher than those in the massage group(26.32±4.21 vs 19.65±4.23,48.69±1.65 vs 39.65±1.62)(P<0.01).Conclusion Warm acupuncture combined with massage in the treatment of knee osteoarthritis can effectively improve the TCM syndrome score and knee function score of the patients.