针刺经筋病灶点联合自拟消肿止痛外敷剂治疗膝骨性关节炎临床观察
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摘要
目的 :探讨采用针刺经筋病灶点联合自拟消肿止痛外敷剂治疗膝骨性关节炎(KOA)的临床疗效。方法:将符合相应标准的86例KOA病人按就诊顺序随机分入联合组与基础组各43例,基础组给予病人单纯的西医综合疗法进行治疗,联合组在除基础组治疗外,再加入针刺经筋病灶点联合自拟消肿止痛外敷剂进行治疗;两组治疗均10 d为1个疗程,治疗3个疗程。结果 :两组治疗后膝关节滑液中各项炎性细胞因子水平均有所下降(P<0.05),且联合组较基础组的下降更为明显(P<0.05);两组治疗后KOA严重程度评分均有所下降(P<0.05),且联合组较基础组的下降更为明显(P<0.05);两组治疗后膝关节运动功能评分均有所下降(P<0.05),且联合组较基础组的下降更为明显(P<0.05);在中医证候疗效的比较上,联合组的总有效率要优于基础组(P<0.05),且联合组的痊愈情况亦要明显优于基础组(P<0.01)。结论 :针刺经筋病灶点联合自拟消肿止痛外敷剂治疗KOA的临床疗效显著。
Objective :To explore the clinical efficacy of reinforced lesion point the tendon puint acupuncturing combined with self-made relieving swelling and pain external application for the treatment of KOA. Methods :The 86 patients with KOA who met the corresponding criteria were randomly assigned to the combined group and the basic group according to the order of treatment. The basic group was treated with simple Western medicine combined therapy. The combined group was treated with acupuncture in addition to the basic group. Treatment of tendon points combined with self-made relieving swelling and pain external application;treatment in both groups was 10 days for 1 course,3 courses for treatment. Results :The levels of inflammatory cytokines in the synovial fluid of knee joints were decreased after treatment(P<0.05),and the decrease in the combined group was more significant than that in the basic group(P<0.05). The severity of KOA scores after treatment in both groups were all decreased(P<0.05),and the decrease in the combined group was more significant than that in the basic group(P<0.05). The knee motor function scores decreased after treatment(P<0.05),and the combined group decrease was more obvious than that of the basic group(P<0.05). In the comparison of the efficacy of TCM syndromes,the total effective rate of the combined group was better than that of the basic group(P<0.05),and the recovery of the combined group was also better than the basic group(P<0.01). Conclusion :The clinical efficacy of acupuncture through reinforced lesion point combined with self-made relieving swelling and pain external application for the treatment of KOA is remarkable.
Objective :To explore the clinical efficacy of reinforced lesion point the tendon puint acupuncturing combined with self-made relieving swelling and pain external application for the treatment of KOA. Methods :The 86 patients with KOA who met the corresponding criteria were randomly assigned to the combined group and the basic group according to the order of treatment. The basic group was treated with simple Western medicine combined therapy. The combined group was treated with acupuncture in addition to the basic group. Treatment of tendon points combined with self-made relieving swelling and pain external application;treatment in both groups was 10 days for 1 course,3 courses for treatment. Results :The levels of inflammatory cytokines in the synovial fluid of knee joints were decreased after treatment(P<0.05),and the decrease in the combined group was more significant than that in the basic group(P<0.05). The severity of KOA scores after treatment in both groups were all decreased(P<0.05),and the decrease in the combined group was more significant than that in the basic group(P<0.05). The knee motor function scores decreased after treatment(P<0.05),and the combined group decrease was more obvious than that of the basic group(P<0.05). In the comparison of the efficacy of TCM syndromes,the total effective rate of the combined group was better than that of the basic group(P<0.05),and the recovery of the combined group was also better than the basic group(P<0.01). Conclusion :The clinical efficacy of acupuncture through reinforced lesion point combined with self-made relieving swelling and pain external application for the treatment of KOA is remarkable.
引文
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[8]庞坚,曹月龙,陈博,等.基于WOMAC与AIMS2-SF评分的膝骨关节炎主症与生存质量的多元线性回归分析[J].中国中医骨伤科杂志,2013,21(9):13-14.
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[13]邝高艳,严可,柴爽,等.加味独活寄生合剂治疗膝骨关节炎临床疗效及对关节液中IL-1,IL-6,TNF-α及NO的影响[J].中国实验方剂杂志,2017,23(1):174-178.
[14]钟赣生.中药学[M].4版.北京:中国中医药出版社,2016:76-113.
[15]董宝强,林星星,王树东,等.经筋刺法与针至病所理论的关系[J].中医杂志,2017,58(3):189-194.
[16]刘立会,董宝强,王树东.针刺循经筋阿是穴配合中药治疗膝骨性关节炎疗效观察[J].辽宁中医药大学学报,2016,18(3):57-59.
[17]唐波,单佳婧.温针灸结合中药汤剂内服外敷治疗风寒湿痹型膝骨性关节炎临床疗效[J].辽宁中医药大学学报,2018,20(3):127-130.
[18]杨世泽,杨永菊,胡晓丽,等.针灸“从筋论治”治疗膝骨性关节炎[J].辽宁中医药大学学报,2018,20(9):199-201.
[19]蒋宗伦,许清华,张迎春.针灸联合现代康复手段治疗膝骨性关节炎的临床研究[J].辽宁中医杂志,2018,45(2):381-383.
[2]刚嘉鸿,宓轶群,王华敏.电针与美洛昔康治疗早中期膝骨关节炎临床疗效比较:随机对照研究[J].中国针灸,2016,36(5):467-470.
[3]张伯礼,吴勉华.中医内科学[M].4版.北京:中国中医药出版社,2016:112-174.
[4]张鹏,董宝强,宋杰.比较传统经穴、结筋病灶点和激痛点治疗KOA的临床疗效评价研究[J].辽宁中医药大学学报,2015,17(9):140-142.
[5]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):793-796.
[6]张栋,王庆甫,石鑫超,等.膝骨关节炎肌骨超声与X线片表现的比较与分析[J].中国骨伤,2016,29(5):429-433.
[7]薛立功.中国经筋学[M].北京:中医古籍出版社,2009:49-63.
[8]庞坚,曹月龙,陈博,等.基于WOMAC与AIMS2-SF评分的膝骨关节炎主症与生存质量的多元线性回归分析[J].中国中医骨伤科杂志,2013,21(9):13-14.
[9]严广斌.视觉模拟评分法[J].中华关节外科杂志(电子版),2014,8(2):273.
[10]Guralnik JM,Simonsick EM,Ferrucci L,et al. A short physical performance battery assessing lower extremity function:association with self-reported disability and prediction of mortality and nursing home admission[J].J Gerontol,1994,49(2):85-94.
[11]邓启龙.关节对应针刺结合坐—立试验治疗膝骨关节炎的临床研究[J].湖北中医药大学,2013,27(5):370-371.
[12]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:127-135.
[13]邝高艳,严可,柴爽,等.加味独活寄生合剂治疗膝骨关节炎临床疗效及对关节液中IL-1,IL-6,TNF-α及NO的影响[J].中国实验方剂杂志,2017,23(1):174-178.
[14]钟赣生.中药学[M].4版.北京:中国中医药出版社,2016:76-113.
[15]董宝强,林星星,王树东,等.经筋刺法与针至病所理论的关系[J].中医杂志,2017,58(3):189-194.
[16]刘立会,董宝强,王树东.针刺循经筋阿是穴配合中药治疗膝骨性关节炎疗效观察[J].辽宁中医药大学学报,2016,18(3):57-59.
[17]唐波,单佳婧.温针灸结合中药汤剂内服外敷治疗风寒湿痹型膝骨性关节炎临床疗效[J].辽宁中医药大学学报,2018,20(3):127-130.
[18]杨世泽,杨永菊,胡晓丽,等.针灸“从筋论治”治疗膝骨性关节炎[J].辽宁中医药大学学报,2018,20(9):199-201.
[19]蒋宗伦,许清华,张迎春.针灸联合现代康复手段治疗膝骨性关节炎的临床研究[J].辽宁中医杂志,2018,45(2):381-383.