针刀松解股四头肌筋结点治疗髌股关节炎的临床研究

Clinical Research on Treatment of Patellofemoral Arthritis by Release Tendons Knot of Quadriceps Femoris Muscle with Acupotomy

目的:观察针刀松解股四头肌肌腹筋结点治疗轻中度髌股关节炎的临床疗效。方法:2017年3月至2018年10月,选取在中国中医科学院望京医院及骨伤科研究所门诊就诊的轻中度髌股关节炎患者92例,按照随机数字表法分为两组,试验组46例,对照组46例。试验组采用针刀松解股四头肌肌腹部位筋结点治疗,对照组在膝前髌周疼痛部位外用扶他林治疗。观察周期为3周,分别在治疗前和治疗结束1周后采用VAS评分、局部疼痛压痛测定、Lysholm评分、总体疗效评定标准对患者膝前疼痛症状及关节功能进行评价。结果:治疗后试验组各项评分与治疗前比较差异均有统计学意义(P<0.01),治疗后对照组各项评分与治疗前比较差异均有统计学意义(P<0.01)。治疗后两组在局部压痛测定方面差异有统计学意义(P<0.05),在VAS评分、Lysholm评分方面差异无统计学意义(P>0.05)。总体疗效评定方面,试验组有效率高于对照组。结论:针刀松解股四头肌肌腹筋结点能够缓解轻中度髌股关节炎患者的膝前疼痛症状,改善关节功能,是一种安全、有效、值得进一步研究的治疗方法。

Objective:To observe the clinical effect of release tendons knot of quadriceps femoris muscle with acupotomy for mild to moderate patellofemoral arthritis.Methods:From March 2017 to October 2018,92 patients with mild to moderate patellofemoral arthritis were observed in Wangjing hospital of Chinese academy of Chinese medicine sciences.These patients were randomly divided into experimental group and control group,46 patients in each group.In the experimental group,there were 46 patients who were treated with acupotomy.In the control group,there were 46 patients who were treated with diclofenac diethylamine emulsion.The observation period lasted for three weeks.Visual analogue scale(VAS),the data of algometer from the most obvious tenderness around the patellar,Lysholm score and the overall curative effect evaluation were evaluated pain and joint function before and 1 week after treatments.Results:There were significant differences of scores in the experimental group before and after treatment(P<0.01).There were significant differences of scores in the control group before and after treatment(P<0.01).After treatment,here were no statistical differences of VAS score and Lysholm score(P>0.05),but significant differences of the data of algometer(P<0.05)between experimental and control groups.Efficient rate of experimental group was higher than that in control group.Conclusion:The method of acupotomy release tendons knot of quadriceps femoris muscle was able to relieve pain and recovery of joint activities of mild to moderate patellofemoral arthritis.It is an effective,security and worthy of further study method.