温针灸联合超声引导腰交感神经阻滞治疗膝关节炎的疗效观察

Observation on the efficacy of warm acupuncture combined with ultrasound-guided lumbar sympathetic nerve block in the treatment of knee arthritis

目的探讨温针灸联合超声引导腰交感神经阻滞对膝关节炎(KOA)的治疗效果。方法我院接收的180例KOA患者,按照随机数字表法分为温针灸组、神经阻滞组和联合组各60例。联合组接受温针灸联合超声引导腰交感神经阻滞治疗,温针灸组仅接受温针灸治疗,神经阻滞组仅接受超声引导腰交感神经阻滞治疗。对比三组临床疗效、膝关节疼痛度[视觉模拟评分(VAS)]、骨关节炎指数[骨关节炎指数评定表(WOMAC)]、膝关节功能[Ly-sholm膝关节评分量表]、骨代谢指标[TRACP和CTX-I]。结果与温针灸组和神经阻滞组相比,联合组总有效率更高(P<0.05);治疗后7、15d,三组VAS评分、WOMAC评分、TRACP和CTX-I水平下降,Ly-sholm评分升高(P<0.001),联合组改善更优(P<0.001)。结论温针灸联合超声引导腰交感神经阻滞治疗KOA具有显著的临床疗效,可减轻疼痛,改善关节功能,且安全性较高。

Objective To investigate the efficacy of warm acupuncture combined with ultrasound-guided lumbar sympathetic nerve block in the treatment of knee osteoarthritis(KOA).Methods A total of 180 patients with KOA in our hospital were selected.According to the random number table method,the patients were divided into a warm acupuncture group,a nerve block group and a combined group,60 in each group.The combined group received warm acupuncture combined with ultrasound-guided lumbar sympathetic nerve block.The warm acupuncture group only received warm acupuncture.The nerve block group only received ultrasoundguided lumbar sympathetic nerve block.The clinical efficacy,knee joint pain degree estimated by visual analogue scale(VAS),osteoarthritis index such as osteoarthritis index rating scale(WOMAC),knee joint function estimated by Lysholm knee joint rating scale,and bone metabolism index estimated by TRACP and CTX-I were compared among the three groups.Results Compared with the warm acupuncture group and the nerve block group,the total effective rate of the combined group was higher(P<0.05).After 7 and 15 days of treatment,the VAS score,WOMAC score,TRAC and CTX-I levels in the three groups were decreased(P<0.001),and the Lysholm score was increased(P<0.001),The improvement in the combined group was better(P<0.001).Conclusions Warm acupuncture combined with ultrasound-guided lumbar sympathetic nerve block has a significant clinical effect in the treatment of KOA.It can relieve the pain,improve the joint function and inhibit the bone resorption.It also has high safety.