超声引导技术在针刀治疗膝骨性关节炎中的应用  

Efficacy of Ultrasound-guided technique in acupotomy therapy for knee osteoarthritis

作　　者：马彦红[1] 丁康[1] 

机构地区：[1]解放军第305医院理疗科,北京100017

出　　处：《北京医学》2013年第7期545-547,共3页Beijing Medical Journal

摘　　要：目的探讨超声引导技术在针刀治疗膝骨性关节炎中的应用价值,比较超声定位和痛点定位针刀疗法的疗效差异。方法选择2008年5月至2010年6月我院理疗科膝骨性关节炎患者,随机分为超声引导组和痛点定位组,每组各24例;超声引导组根据超声探查情况在滑膜增生肥厚处、肌纤维排列紊乱、增生、肥厚处,腱端骨面毛糙、不连续处体表定点标记,行针刀松解治疗,痛点定位组根据压痛点定位后针刀松解治疗,采用疼痛视觉模拟评分法为观察指标,比较两组并发症发生率。结果本组48例中3例中途放弃,余45例进入结果分析。疼痛评分比较:2组治疗后VAS评分较治疗前均有改善,且超声引导组改善程度优于痛点定位组,比较差异有统计学意义(t=3.18,P<0.05)。超声引导组并发症(血肿、神经损伤)发生率明显低于痛点定位组,差异有统计学意义(P<0.05)。结论针刀治疗膝骨性关节炎疗效满意,应用超声定位较痛点定位疗效更为满意,为针刀医务工作者提高临床疗效及有效避免风险提供了良好技术支持,且简单、快捷、费用低廉,值得在临床中推广应用。Objective To evaluate the value of ultrasound-guided technique in acupuncture therapy for knee osteoarthritis,to assess the efficacy of acupotomology using ultrasound-guided positioning compared with using pain points positioning.Methods Patients with knee osteoarthritis in physiotherapy department of the No.305 PLA Hospital during May 2008-June 2010 were recruited.Patients were randomized into ultrasound positioning arm and pain points positioning arm,with 24 patients in each arm.Ultrasound-guided armacupotomy therapy point was marked as the synovial hypertrophy,muscle fiber derangement,hyperplasia,hypertrophy and rough,discontinuity surface of bone with tendon end according to ultrasound.Pain points positioning arm acupotomy therapy point marked at tender point.Visual analogue pain score was recorded as indicators and the incidence of complications were compared.Results A total of 48 patients were included,3 patients drop-out during the study,and the remaining 45 cases were included in the result analysis.Visual analogue pain scores（VAS） improved after treatment and the improvement of ultrasound-guided arm were more evident than pain point positioning arm,the difference was statistically significant（t = 3.18,P 〈0.05）.The complication rateof the ultrasound-guided arm（hematoma,nerve injury） wassignificantly lower than the pain point positioning arm,the difference was statistically significant（P 〈0.05）.Conclusion The efficacy of acupotomy treatment of knee osteoarthritis is satisfactory,ultrasound-guided positioning is more effective than pain point positioning.It provides a good technical support for medical workers to improve efficacy and avoid risks.This study has shown that this approach is beneficial and simple,quick,and inexpensive.It is worth to be adapted in clinical practice.

关 键 词：针刀 骨性关节炎 超声 

分 类 号：R246[医药卫生—针灸推拿学]