基于经筋理论下的解筋正骨法针刀对膝骨关节炎患者膝关节功能的影响

Effects of acupotomy for relieving tendon and setting bone based on meridian tendon theory on knee joint function in patients with knee osteoarthritis

目的:研究经筋理论下的解筋正骨法针刀对膝骨关节炎(KOA)患者膝关节功能的影响。方法:将60例KOA患者随机分为治疗组和对照组,每组30例。对照组患者接受单纯针刀五点定位法,治疗组患者接受五点定位法联合解筋正骨法针刀治疗。每周1次,连续4周。分别于治疗前、第4周和第8周,对比两组患者股四头肌杨氏模量值(E值)、髌骨倾斜角、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟量表(VAS)以及综合疗效,评估针刀对患者膝关节功能的影响。结果:第4周和第8周时,两组患者股四头肌E值、髌骨倾斜角、WOMAC和VAS评分均较治疗前显著降低(P<0.05),且治疗组显著低于对照组(P<0.05);治疗组总有效率显著高于对照组(P<0.05)。结论:基于经筋理论下的解筋正骨法针刀治疗KOA,可以显著改善股四头肌的弹性,缓解膝关节疼痛,从而显著改善患者的膝关节功能,相较于单纯针刀五点定位法在提高临床疗效,改善预后方面更具优势,值得临床推广及应用。

Objective:To explore the effects of acupotomy for relieving tendon and setting bone based on meridian tendon on knee function in patients with knee osteoarthritis(KOA).Methods:Sixty patients with KOA were randomly assigned to treatment group and control group,with 30 cases in each group.Patients in control group received acupotomy with simple fivepoint localization method;the treatment group was treated with acupotomy with five-point positioning combined with relieving tendon and setting bone.Once a week for 4 weeks.The quadriceps Young modulus(E),patellar angle,Western Ontario and McMaster College osteoarthritis Index(WOMAC),visual analogue scale(VAS),and total response rate were compared between the two groups before treatment,after 4 and 8 weeks of treatment,respectively,to evaluate the effects of acupotomy on knee function.Results:At week 4 and 8,the quadriceps E value,patellar inclination angle,WOMAC and VAS scores in 2 groups were significantly lower than before treatment(P<0.05),and treatment group was significantly lower than the control group(P<0.05).The total effective rate in treatment group was significantly higher than the control group(P<0.05).Conclusion:The acupotomy for relieving tendon and setting bone treating knee osteoarthritis based on the tendon theory can significantly improve the elasticity of the quadriceps muscle,relieve knee pain,and thus significantly improve the knee function of patients.Compared with the simple five-point positioning method,it has more advantages in improving clinical efficacy and prognosis,and is worthy of clinical promotion and application.