The effect of five-knee-point acupuncture combined with herbal package warm compress for knee osteoarthritis

Objective:To observe the therapeutic effect differences among five-knee-point acupuncture combined with Chinese medication package warm compress therapy of Shēntòng Zhúyū Decoction(身痛逐瘀汤 generalized pain stasis-expelling decoction),simple five-knee-point acupuncture and simple Chinese medication package warm compress therapy of Shēntòng Zhúyū Decoction in treating knee osteoarthritis(KOA).Methods:A total of 126 KOA patients were randomized into a five-knee-point acupuncture combined with Chinese medication package warm compress therapy group(combined treatment group),where there were 42 cases,including 28 cases of unilateral KOA and 14 cases of bilateral KOA,totally 56 affected knees involved,a Chinese medication package warm compress therapy group(medication package group,42 cases,including 22 cases of unilateral KOA,20 cases of bilateral KOA,totally 62 affected knees involved)and a five-knee-point acupuncture group(five-knee-point group,42 cases,including 27 cases of unilateral KOA,15 cases of bilateral KOA,totally 57 affected knees involved).The basic health education was provided in all of the groups.Additionally,in the combined treatment group,acupuncture was applied to the five knee points on the affected side for 30 min.The warm compress with herbal package of Shēntòng Zhúyū Decoction was given for 10 to 15 min.In the medication package group,the warm compress with Shēntòng Zhúyū Decoction was exerted on the affected area for 10 to 15 min.In the fiveknee-point group,acupuncture was applied to SP 10,ST 34,EX-LE 2,EX-LE 4 and ST 35 and the needles were retained for 30 min.The treatment in each group was given once a day,consecutively for 2 weeks.Before and after treatment,the visual analogue scale(VAS)and Lysholm knee scale were adopted to evaluate the pain degree and knee joint motor function in KOA patients.The clinical therapeutic effects were evaluated too.Results:A total of 121 cases accomplished the final observation and 5 cases were dropped out in the three groups,in which,2 cases(2 affected knees)were dropped out in the combined treatment group,1 case(2 affected knees)in the medication package group and 2 cases(3 affected knees)in the fiveknee-point group.VAS scores after treatment were all lower than those before treatment in the three groups and the scores of Lysholm knee scale were all higher than those before treatment,indicating the significant differences(all P<0.05).The total effective rate was 98.1%(53/54)in the combined treatment group,which was higher than 86.7%(52/60)in the medication package group and 92.6%(50/54)in the five-knee-point group,indicating the significant differences(all P<0.05).After treatment,VAS score(2.24±1.24)in the combined medication group was lower than(2.48±1.08)in the medication package group and(2.63 ± 1.44)in the five-knee-point group,presenting the significant difference(all P<0.05).The score of Lysholm knee scale was(60.50±13.76)in the combined medication group,higher than(52.23±11.65)in the medication package group and(52.14±11.77)in the five-knee-point group,indicting the significant differences(all P<0.05).Conclusion:Compared with the simple application of Chinese medication package warm compress therapy of Shēntòng Zhúyū Decoction or the five-knee-point acupuncture therapy,five-knee-point acupuncture combined with Shēntòng Zhúyū Decoction relieves the clinical symptoms of KOA patients more effectively and achieves a better clinical therapeutic effect.

杨永晖针刀联合神经触激术治疗膝骨关节炎经验

杨永晖教授诊治膝骨关节炎强调“筋骨并重”“杂合以治”,总结多种针刀治法的优缺点,基于膝关节稳定的生物力学特点,以改善髌股关节周围力学平衡为目的,提出运用“五点定位法”针刀治疗膝骨关节炎,并配合神经触激术,更好调整下肢力线,改善患者症状,临床疗效显著。

耳穴贴压联合五音疗法缓解全膝关节置换术患者术前焦虑的效果观察

目的探讨耳穴贴压联合五音疗法在全膝关节置换术(total knee arthroplasty,TKA)患者术前焦虑中的应用效果。方法将91例符合纳入标准的患者随机分为对照组45例和观察组46例,对照组实施耳穴贴压,观察组在对照组的基础上施加五音疗法。比较两组患者干预前后的焦虑自评量表(self-rating anxiety scale,SAS)评分情况。结果干预前,两组患者的SAS各条目评分及总分差异无统计学意义(P>0.05);干预后,两组患者的SAS总评分均低于干预前,且观察组低于对照组(P<0.01);两组患者的SAS条目1(紧张)、条目2(害怕)、条目3(惊恐)、条目7(躯体疼痛)、条目10(心慌)、条目19(睡眠障碍)的评分均低于干预前(P<0.01),且观察组低于对照组,差异有统计学意义(P<0.01或P<0.05)。结论耳穴贴压联合五音疗法能有效缓解TKA患者术前焦虑,而且效果优于单用耳穴贴压。

五点定位法针刀治疗膝骨关节炎的临床研究

目的观察五点定位法针刀治疗膝骨关节炎的临床疗效。方法将符合诊断标准的60例患者随机分成对照组和治疗组,每组30例,对照组采取经典定位法,治疗组采取五点定位法进行针刀治疗,观察并比较两组患者治疗前后视觉模拟评分(visual analogue scale,VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster university osteoarthritis index,WOMAC)、改良美国纽约特种外科医院量表(Hospital for Special Surgery,HSS)评分、近期和远期综合疗效。结果与治疗前比较,治疗后两组患者VAS评分、WOMAC评分显著降低,改良HSS评分显著升高,差异均有统计学意义(P<0.05);两组上述指标比较,差异均有统计学意义(P>0.05)。治疗组短期综合疗效优于对照组(P<0.05),治疗后1个月复诊时两组综合疗效差异无统计学意义(P>0.05)。结论五点定位法针刀治疗膝骨关节炎和经典定位法都具有良好的缓解疼痛、改善功能的效果,疗效相当,但五点定位法的短期疗效好,患者痛苦小。