温针配合玻璃酸钠关节内注射治疗膝关节骨性关节炎随机对照观察  

Randomized Controlled Clinical Trails for Treatment of Knee Osteoarthritis by Warm Acupuncture Combined with Intra-articular Injection of Sodium Hyaluronate

作　　者：张玉森[1] 王子轩[2] 

机构地区：[1]青岛市市立医院中医科,青岛266011 [2]青岛市市立医院介入放射科,青岛266011

出　　处：《针刺研究》2011年第5期373-376,共4页Acupuncture Research

摘　　要：目的:探讨温针配合玻璃酸钠关节内注射治疗膝关节骨性关节炎的临床增效作用。方法:将膝关节骨性关节炎患者随机分为治疗组(n=90)和对照组(n=89)。治疗组在玻璃酸钠关节内注射后第2天行温针疗法,穴取足三里、血海、梁丘、阴陵泉、阳陵泉、内膝眼、犊鼻、鹤顶,每天1次,共治疗25次;对照组仅行玻璃酸钠关节内注射治疗。在治疗前和治疗后2周、5周各进行1次膝关节运动功能评价并计算治疗有效率;治疗前及治疗5周后采用关节炎影响评定量表评价生活质量。结果:治疗后2周和5周,对照组和治疗组的膝关节运动功能评分均较治疗前逐步提高(P<0.001),治疗有效率亦相应升高。治疗后,治疗组运动功能评分均明显高于对照组(P<0.001),前者治疗有效率亦明显高于后者(P<0.05)。两组患者的生活质量均有显著改善(P<0.01),其中,治疗组明显优于对照组(P<0.01)。结论:温针配合玻璃酸钠关节内注射是治疗膝关节骨性关节炎的一种有效方法。Objective To observe the synergism of warm acupuncture combined with intra-articular injection of sodium hya-luronate on knee osteoarthritis（KOA）.Methods A total of 179 KOA outpatients were randomized into warm acupuncture group（n=90） and control group（n=89） according to a randomized numeral table.Warm acupuncture（needle warmed by moxibustion） was applied to Zusanli（ST 36）,Xuehai（SP 10）,Yinlingquan（SP 9）,Nèixīyǎn（EX-LE 4）,etc.from the second day on after intra-articular injection of sodium hyaluronate（2 mL,once a week for 5 weeks）.Sodium hyaluronate intra-articular injection was given to the patients alone in the control group.Knee joint motor function was scaled before,2 weeks（W） and 5 W after the therapy.The patients＇ quality of life was determined by using ＂Arthritis Impact Measurement Scale＂ before and 5 W after the the-rapy.Results In comparison with pre-therapy,the knee-joint motor function scores of both control group and acupuncture group were increased progressively and significantly 2 W and 5 W after the therapy.Both the knee-joint motor function score and the therapeutic effective rate of the acupuncture group were significantly higher than those of the control group（P0.001,P0.05）.After the therapy,the scores of the Arthritis Impact Measurement Scale were significantly improved in both groups（P0.01）,and that of the acupuncture group was obviously lower than that of the control group（P0.01）.Conclusion Warm acupuncture combined with intra-articular injection of sodium hyaluronate is an effective therapy for knee osteoarthritis.

关 键 词：膝关节骨性关节炎 温针疗法 玻璃酸钠 关节内注射 

分 类 号：R245.315[医药卫生—针灸推拿学]