膝四穴恢刺配合整脊手法治疗膝骨性关节炎临床研究

Clinical Study of Relaxing Needling at Knee Four Acupoints in Combination with Spine-Resetting Manipulations in Treating Knee Osteoarthritis

【目的】研究膝四穴恢刺配合整脊手法治疗膝骨性关节炎(KOA)的临床疗效,将中医'下病上治'理论应用于临床,分析腰膝同治法的可行性,为治疗KOA提供新的思路。【方法】将65例KOA患者(均为单侧)随机分为治疗组33例和对照组32例。治疗组给予膝四穴恢刺配合整脊手法治疗,对照组给予口服布洛芬片治疗,疗程为2周。观察2组患者治疗前后疼痛程度数字评价量表(NRS)及西安大略麦马斯特大学骨关节炎指数量表(WOMAC)评分的变化情况,并评价2组患者的疗效。【结果】(1)治疗后及治疗后1个月,治疗组的总有效率分别为96.97%和93.94%,对照组分别为81.25%和68.75%,治疗组的总有效率和总体疗效均优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者的关节疼痛NRS评分均较治疗前降低(P<0.05),且治疗组对关节疼痛NRS评分的降低作用明显优于对照组(P<0.05)。(3)治疗后及治疗后1个月,2组患者的WOMAC量表评分均较治疗前明显降低(P<0.05),且治疗组对WOMAC量表评分的降低作用明显优于对照组(P<0.05)。【结论】膝四穴恢刺配合整脊手法治疗KOA患者,具有较好疗效,能有效减轻关节疼痛,缓解关节僵硬程度,改善关节活动度,防止病情的进一步复发。

Objective To investigate the clinical efficacy of relaxing needling at four knee acupoints in combination with spine-resetting manipulations in treating knee osteoarthritis(KOA)based on the traditional Chinese medical theory of‘needling acupoints in the upper to treat disease in the lower’,and to explore the feasibility of waist-knee concurrent therapy so as to provide a new idea for the treatment of KOA.Methods Sixtyfive patients with unilateral KOA were randomly divided into treatment group(n=33)and control group(n=32).The treatment group received relaxing needling(one of the twelve needling methods,needling into the muscles of the focus and vibrating the needle body in various directions so as to relax the muscles)at four knee acupoints of Liangqiu(ST34),Xuehai(SP10)and bilateral Qipang extra points in combination with spine-resetting manipulations,and the control group was treated with Ibuprofen Tablets orally for 2 weeks.Before and after treatment,the knee pain scores of numerical rating scale(NRS)and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores in the two groups were observed.And the clinical efficacy in the two groups was evaluated after treatment.Results(1)At the end of treatment and one month after treatment,the total effective rate of the treatment group was 96.97%and 93.94%,and that of the control group was 81.25%and 68.75%,respectively.The total effective rate and overall efficacy of the treatment group were superior to those of the control group,the differences being significant(P<0.05).(2)At the end of treatment,joint pain NRS scores in the two groups were decreased(P<0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group(P<0.05).(3)At the end of treatment and one month after treatment,WOMAC scores in the two groups were decreased(P<0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group(P<0.05).Conclusion Relaxing needling at four knee acupoints in combination with spine-resetting manipulations is effective for the treatment of KOA by relieving joint pain and stiffness,improving the range of motion of the knee,and preventing against the recurrence of KOA.