陆氏针刀松解联合注射技术治疗跟痛症的临床疗效

跟痛症患者在行走或站立时足部出现明显的疼痛感或酸胀感,严重时如有针刺,举步维艰[1]。临床治疗跟痛症以改善患者的负重和行走功能、减轻疼痛为主要目标。当前的治疗手段包括手术、局部药物封闭和西药等,其中封闭治疗以及药物治疗能有效缓解患者急性期的炎症反应,但是尚不能减轻病变组织的慢性炎症反应,治标而不治本,远期的效果比较差。陆氏针刀松解术能直达病灶部位,切割、松解和剥离病变部位的粘连组织,使其高张力状态得到解除,降低局部软组织的张力,有效缓解筋膜的痉挛状态,促进生物力学平衡的恢复,从而达到治疗目的[2]。本研究在封闭治疗的基础上,创新性地联用陆氏针刀松解术,分析其治疗跟痛症的效果。

针刀治疗腰椎间盘突出症的临床观察

目的:探讨针刀治疗腰椎间盘突出症的临床效果。方法:选取120例腰椎间盘突出症患者随机分为对照组和研究组,每组60例。对照组给予封闭治疗,研究组给予针刀治疗,每周1次,3次为1个疗程,治疗1个疗程。比较两组患者治疗前后腰椎功能变化及临床疗效。结果:治疗后,两组患者日本骨科协会(JOA)评分较治疗前升高(P<0.05),且研究组高于对照组(P<0.05)。研究组总有效率为93.33%(56/60),高于对照组的83.33%(50/60)(P<0.05)。结论:针刀治疗可有效改善腰椎间盘突出症患者的腰椎功能,疗效确切,值得在临床中应用推广。

艾灸治疗膝骨性关节炎:随机对照研究

目的:观察艾灸对膝骨性关节炎患者疼痛、僵硬、功能障碍等症状的疗效,评价艾灸疗法的有效性和安全性。方法:59例膝骨性关节炎患者随机分为艾灸组(31例)和安慰艾灸组(28例),分别将治疗艾炷和安慰艾炷粘贴在内膝眼、犊鼻、阿是穴处给予艾灸治疗,每次每穴3壮,隔日1次,每周3次,连续治疗6周,统计治疗3周、6周时的疗效,并于治疗结束后6周对患者进行随访。采用骨关节炎调查量表(WOMAC)、46m最快步行时间评价关节功能恢复情况,使用UT-325数字温测仪记录膝关节疼痛最明显的治疗点艾灸前后温度变化。结果:艾灸组治疗3周、6周及随访时WOMAC量表各项评分均明显降低(P<0.05,P<0.01,P<0.001);安慰艾灸组随访时僵硬评分较治疗前降低(P<0.05);治疗6周及随访时,艾灸组较安慰艾灸组疼痛、僵硬、功能障碍评分下降更明显(P<0.01,P<0.05)。艾灸组治疗6周后46m最快步行时间较治疗前明显缩短(P<0.01),而安慰艾灸组治疗后改善不明显(P>0.05),组间比较差异无统计学意义(P>0.05)。艾灸组艾灸后治疗点温度为(49.81±3.10)℃,安慰艾灸组为(40.98±1.67)℃,两组均较治疗前局部皮肤温度明显升高(P<0.001,P<0.01),艾灸组温度升高更明显(P<0.001)。结论:艾灸可明显改善膝骨性关节炎患者疼痛、僵硬、功能障碍等临床症状,是一种安全、有效的治疗方法。

Preliminary clinical randomized controlled trial on knee osteoarthritis treated with moxibustion

Objective To observe the therapeutic effect of moxibustion on pain, stiffness and physical dysfunction caused by knee osteoarthritis （KOA）, and make an assessment on the effectiveness and safety of this therapy. Methods Fifty-nine cases of KOA were randomly divided into a moxibustion group （31 cases） and a sham-moxibustion group （28 cases）. The treatment of moxibustion was given at Nèixīyǎn （内膝眼 EX-LE 4）, Dúbí （犊鼻 ST 35） and Ashi points with real moxa cone in the moxibustion group and sham moxa cone in the sham-moxibustion group, 3 cones on each point per time, once every two days, 3 times per week for consecutively 6 weeks. The results were recorded in week 3 and 6 of the treatment, and the follow-up visit was performed 6 weeks after the end of treatment. The Western Ontario and Mcmaster Universities Osteoarthritis Index （WOMAC） and the shortest walking time of 46 m were adopted to evaluate the recovery situation of joint function. The UT-325 digital thermal detector was put to use to record the temperature change in the most obvious painful points of knee joint before and after the moxibustion. Results All the scores of WOMAC in the moxibustion group were apparently decreased in week 3 and 6 of the treatment as well as the follow-up visit, separately （P〈0.05, P〈0.01, P〈0.001）. The stiffness score of follow-up visit in the sham-moxibustion group, compared before the treatment, was lowered （P〈0.05）. The scores of pain, stiffness and physical function in the moxibustion group had a greater decrease than those in the sham-moxibustion group in week 6 of treatment and the follow-up visit （P〈0.01, P〈0.05）. The shortest walking time of 46 m in the moxibustion group after 6 weeks of the treatment was apparently reduced as compared with that before treatment （P〈0.01）, but there was no apparent improvement in the sham-moxibustion group （P〉0.05）, and the between-group difference was not significant statistically （P〉0.05）. The temperature of treatment point after the moxibustion was （49.81±3.10）？℃ in the moxibustion group and （40.98±1.67）？℃ in the sham-moxibustion group, which was both increased apparently as compared with that before the treatment （P〈0.001, P〈0.01）, and more obviously in the moxibustion group （P〈0.001）. Conclusion The moxibustion, which can obviously improve the clinical symptoms of the patients with KOA, such as pain, stiffness and physical dysfunction, is safe and effective.

微型针刀松解疗法治疗颈源性头痛的临床研究

目的:观察微型针刀松解疗法及针灸治疗颈源性头痛的疗效差异。方法:选取2015年7月~2018年6月在我院门诊确诊为颈源性头痛的71例患者,并随机分为针刀组(34例)和针灸组(37例),针刀组采用微型针刀松解治疗,针灸组给予单纯针灸治疗,分别于治疗前后采用视觉模拟评分法(VAS)进行疗效评定。结果:针刀组总有效率为97.05%,显著高于针灸组的81.08%(P<0.05);针刀组静息、活动VAS评分改善程度均显著优于针灸组(P<0.05)。结论:微型针刀松解疗法治疗颈源性头痛疗效显著,值得临床推广应用。