电针联合康复训练方案在寒湿痹阻证膝骨关节炎患者中的应用

Application of Electroacupuncture Combined with Rehabilitation Training Program in Patients with Knee Osteoarthritis of Cold-dampness Obstruction Syndrome

目的:探究电针联合康复训练对寒湿痹阻证膝骨关节炎(KOA)患者膝关节功能、三维步态及炎症指标的影响。方法:选取2021年1月至2023年5月于复旦大学附属华东医院KOA患者162例作为研究对象,按简单随机化法分为电针组和对照组,每组81例。对照组采用常规康复训练治疗,电针组在此基础上采用电针治疗,均治疗4周,比较2组患者疗效、证候评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、Lysholm膝关节评分(LKS)、三维步态参数变化及炎症指标水平。结果:治疗后,电针组总有效率为92.59%,高于对照组77.78%(P<0.05);电针组中医证候积分低于对照组(P<0.05);电针组WOMAC评分低于对照组,LKS评分高于对照组(P<0.05);电针组步频、步速、步长、初始着地屈伸角度、摆动相最大屈伸角度、支撑相屈伸角度均高于对照组,矢状面最大外展力矩低于对照组;电针组白细胞介素-6、肿瘤坏死因子-α低于对照组,而转化生长因子-β1高于对照组(P<0.05)。结论:电针联合康复训练治疗KOA患者,可有效提高临床疗效、缓解患者临床症状、提升膝关节活动度和步行能力、改善膝关节功能评分、降低关节炎症水平,有助于膝关节的快速修复。

Objective:To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.Methods:A total of 162 KOA patients admitted to Huadong Hospital,Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for four weeks.The efficacy,symptom scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),three-dimensional gait parameters,and levels of inflammatory markers were compared between the two groups.Results:After treatment,the total effective rate in the electroacupuncture group was 92.59%,significantly higher than 77.78%in the control group(P<0.05).The electroacupuncture group showed lower TCM symptom scores(P<0.05),lower WOMAC scores,and higher LKS scores than the control group(P<0.05).Gait parameters,including step frequency,speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6 and tumor necrosis factor-αwere lower in the electroacupuncture group,while transforming growth factor-β1 was higher(P<0.05).Conclusion:Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.