针刀疗法治疗膝骨关节炎的临床观察

Clinical Observation on Therapeutic Effect of Needle Knife Therapy for Knee Osteo⁃arthritis Based on Theory of Myofascial Chains

目的探讨肌筋膜链理论针刀治疗膝骨关节炎(Knee osteoarthritis,KOA)的临床疗效。方法选取2022年5月—2022年12月期间于北京中医药大学房山医院骨伤科门诊治疗的KOA患者72例,按随机数字表法分为治疗组和对照组,每组各36例。对照组给予针刀疗法治疗,治疗组给予基于肌筋膜理论针刀疗法治疗。治疗1、3、6个月后,观察比较两组患者治疗前后视觉模拟评分法(Visual analogue scale,VAS)评分、WOMAC骨关节炎指数评分量表评分、纽约特种外科医院膝关节评分(Hospital for Special Surgery,HSS)的变化。治疗6个月后,观察两组患者治疗前后的临床疗效。记录并比较两组患者在治疗期间的安全性。结果治疗1、3、6个月后两组患者VAS、WOMAC评分均较治疗前降低,HSS评分较治疗前升高,差异有统计学意义(P<0.05);且治疗组VAS、WOMAC评分均较对照组同期明显降低,HSS评分较对照组同期明显升高,差异有统计学意义(P<0.05)。治疗后治疗组患者临床总有效率97.22%(35/36)明显高于对照组86.11%(31/36),差异有统计学意义(P<0.05)。治疗期间,两组患者均未出现晕针、血肿及感染等不良反应。结论肌筋膜链理论针刀治疗可明显缓解KOA患者的疼痛及改善膝关节的活动功能,延缓KOA的进展,提高KOA患者的生活质量。

Objective To observe the clinical efficacy of needle knife therapy for knee osteoarthritis based on the theory of myofascial chains.Methods A total of 72 patients with knee osteoarthritis treated in the outpatient department of orthopedics and traumatology of Fangshan Hospital of Beijing University of Chinese Medicine from May to December in 2022 were selected and randomized into an observation group(n=36)and a control group(n=36)according to the random number table method.The control group was treated with needle knife therapy,and the observation group received needle knife therapy based on the theory of myofascial chains.After 1,3,and 6 months of treatment,the visual analogue scale(VAS)score,Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score,and Hospital for Special Surgery(HSS)score were determined.The clinical effects of the two groups were observed after 6 months of treatment.The safety of the two groups during treatment was recorded and compared.Results After treatment for 1,3,and 6 months,the VAS and WOMAC scores decreased and the HSS score increased(P<0.05).Moreover,the observation group had lower VAS and WOMAC scores and higher HSS score than the control group after treatment for the same period(P<0.05).The total response rate of the observation group was 97.22%(35/36),which was higher than that(86.11%,31/36)of the con⁃trol group(P<0.05).During the treatment period,neither group showed adverse reactions such as needle sickness,hema⁃toma,and infection.Conclusion The needle knife therapy based on the theory of myofascial chains can relieve the pain and improve the knee joint function to delay the progression of knee osteoarthritis and improve the quality of life of the pa⁃tients.