温针灸结合康复训练治疗膝骨关节炎远期疗效观察
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摘要
目的:观察温针灸结合康复训练治疗地震后板房区膝骨关节炎远期疗效及安全性。方法:将88例膝骨性关节炎患者随机分为温针组和针刺组,每组44例。温针组采用温针灸法,穴取内膝眼、犊鼻,配合康复训练治疗;针刺组取穴及康复训练同温针组,只针刺,不施灸。观察治疗20次后及随访1个月、2个月的临床疗效。结果:温针组总有效率为100.0%(41/41),明显优于针刺组的85.4%(35/41,P<0.05);两组症状积分、疼痛及膝关节功能评分在治疗20次后均显著改善(均P<0.05),温针组在症状及疼痛改善方面明显优于针刺组(均P<0.05),且在随访2个月内仍保持较好的疗效,与针刺组比较差异有统计学意义(均P<0.05);但两组膝关节功能评分差异无统计学意义(均P>0.05)。结论:温针灸结合康复训练治疗地震后板房区膝骨关节炎远期疗效优于针刺配合康复训练,具有较好的安全性。
Objective To observe the long-term efficacy and safety of warm needling therapy combined with rehabilitation training in the treatment of knee osteoarthritis(KOA) for the patients living in simple room after earthquake.Methods Eighty-eight cases of KOA were randomized into a warm needling group and an acupuncture group,44 cases in each one.In the warm needling group,the warm needling therapy was applied at Neixiyan(EX-LE 4) and Dubi(ST 35),in combination with rehabilitation training.In the acupuncture group,the same rehabilitation training was received,and the same acupoints were selected as the warm needling group,but only stimulated with acupuncture without moxibustion applied.The clinical efficacy was observed after 20 treatments and in 1-2 months of follow-up.Results The total effective rate was 100.0%(41/41) in the warm needling group,which was apparently superior to 85.4%(35/41) in the acupuncture group(P<0.05).The symptom integral,pain and knee joint function score were all improved significantly after 20 treatments in both groups(all P<0.05).The improvements in symptoms and pain in the warm needling group were superior apparently to the acupuncture group(all P<0.05).The efficacy remained well within 2 months follow-up(all P<0.05).But the difference in knee joint function score was not statistically significant between the two groups(all P>0.05).Conclusion The combined therapy of warm needling and rehabilitation training achieves the superior efficacy and good safety in the treatment of KOA as compared with the combined therapy of simple acupuncture and rehabilitation training for the patients living in simple room after earthquake.
Objective To observe the long-term efficacy and safety of warm needling therapy combined with rehabilitation training in the treatment of knee osteoarthritis(KOA) for the patients living in simple room after earthquake.Methods Eighty-eight cases of KOA were randomized into a warm needling group and an acupuncture group,44 cases in each one.In the warm needling group,the warm needling therapy was applied at Neixiyan(EX-LE 4) and Dubi(ST 35),in combination with rehabilitation training.In the acupuncture group,the same rehabilitation training was received,and the same acupoints were selected as the warm needling group,but only stimulated with acupuncture without moxibustion applied.The clinical efficacy was observed after 20 treatments and in 1-2 months of follow-up.Results The total effective rate was 100.0%(41/41) in the warm needling group,which was apparently superior to 85.4%(35/41) in the acupuncture group(P<0.05).The symptom integral,pain and knee joint function score were all improved significantly after 20 treatments in both groups(all P<0.05).The improvements in symptoms and pain in the warm needling group were superior apparently to the acupuncture group(all P<0.05).The efficacy remained well within 2 months follow-up(all P<0.05).But the difference in knee joint function score was not statistically significant between the two groups(all P>0.05).Conclusion The combined therapy of warm needling and rehabilitation training achieves the superior efficacy and good safety in the treatment of KOA as compared with the combined therapy of simple acupuncture and rehabilitation training for the patients living in simple room after earthquake.
引文
[1]高树中.针灸治疗学[M].上海:上海科学技术出版社,2009:36.
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[3]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:350-352.
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[6]陈瑾,刘光谱,唐勇.中枢及外周5-HT、5-HIAA在针刺镇痛后效应中的作用[J].中医药学刊,2003,21(9):1446-1449.
[7]黄仕荣.针刺镇痛的后效应、针刺耐受与针刺频度[J].中国疼痛医学杂志,2006,12(6):360-362.
[8]冯凤珍.温针灸治疗寒湿型腰腿痛的理论及临床研究[D].南京:南京中医药大学,2010.
[9]洪秀娥.温针治疗风寒湿阻型膝骨性关节炎的临床研究[D].福州:福建中医药大学,2011.
[10]俞晓杰,吴毅,胡水善,等.膝关节骨关节炎患者等长、等速向心和等速离心测试的比较观察[J].中华物理医学与康复杂志,2006,28(7):469-472.
[11]朱才兴,焦伟国,陈利平,等.手法加运动疗法治疗中、老年膝关节骨性关节炎疗效观察[J].中国康复理论与实践,2009,15(4):377-388.
[12]Palmer S H,Servant C T,Maguire J,et al.Ability tokneel after total knee replacement[J].J Bone JointSurg Br,2002,84B(2):320-322.
[13]李放,白玉龙,杨晓冰,等.膝关节骨关节炎的关节源性肌肉软弱的等速评估[J].中国运动医学杂志,1999,18(4):333-334.
[14]倪国新.制动对骨骼肌的影响[J].中华物理医学与康复杂志,2000,22(2):125-126.
[15]Trudel G.Differentiating the myogenic and arthro-genic components of joint contractures[J].Int J Re-habil Res,1997,20(4):397-404.
[2]Elders M J.The increasing impact of arthritis on publichealth[J].J Rheumatol Suppl,2000,60(10):6-8.
[3]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:350-352.
[4]卓大宏.康复治疗处方手册[M].北京:人民卫生出版社,2007:129-130.
[5]赵俊,李树人,宋文阁.疼痛诊断治疗学[M].郑州:河南科技大学出版社,1999:555.
[6]陈瑾,刘光谱,唐勇.中枢及外周5-HT、5-HIAA在针刺镇痛后效应中的作用[J].中医药学刊,2003,21(9):1446-1449.
[7]黄仕荣.针刺镇痛的后效应、针刺耐受与针刺频度[J].中国疼痛医学杂志,2006,12(6):360-362.
[8]冯凤珍.温针灸治疗寒湿型腰腿痛的理论及临床研究[D].南京:南京中医药大学,2010.
[9]洪秀娥.温针治疗风寒湿阻型膝骨性关节炎的临床研究[D].福州:福建中医药大学,2011.
[10]俞晓杰,吴毅,胡水善,等.膝关节骨关节炎患者等长、等速向心和等速离心测试的比较观察[J].中华物理医学与康复杂志,2006,28(7):469-472.
[11]朱才兴,焦伟国,陈利平,等.手法加运动疗法治疗中、老年膝关节骨性关节炎疗效观察[J].中国康复理论与实践,2009,15(4):377-388.
[12]Palmer S H,Servant C T,Maguire J,et al.Ability tokneel after total knee replacement[J].J Bone JointSurg Br,2002,84B(2):320-322.
[13]李放,白玉龙,杨晓冰,等.膝关节骨关节炎的关节源性肌肉软弱的等速评估[J].中国运动医学杂志,1999,18(4):333-334.
[14]倪国新.制动对骨骼肌的影响[J].中华物理医学与康复杂志,2000,22(2):125-126.
[15]Trudel G.Differentiating the myogenic and arthro-genic components of joint contractures[J].Int J Re-habil Res,1997,20(4):397-404.
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