整体辨证三期分治膝骨性关节炎300例随机对照临床研究  

A Randomize-Controlled Trail of Overall Three-Stage Pattern Differentiation for 300 Cases of Knee Osteoar-thritis

作　　者：郝军[1] 赵文海[2] 詹红生[3] 何伟[4] 高文香[1] 邹春雨[1] 

机构地区：[1]河南省洛阳正骨医院,河南省洛阳市启明南路82号471002 [2]长春中医药大学附属医院 [3]上海中医药大学附属曙光医院 [4]广州中医药大学第一附属医院

出　　处：《中医杂志》2014年第2期121-124,共4页Journal of Traditional Chinese Medicine

基　　金：河南省中医药继承与创新专项基金资助项目(豫中医业[2007]9号);国家中医药管理局"十一五"重点专科(专病)建设项目(16J1X1L116K114)

摘　　要：目的观察整体辨证三期分治膝骨性关节炎(OA)的临床疗效及成本效益。方法将450例OA患者随机分为治疗组300例和对照组150例。治疗组口服筋骨痛消丸,并根据X线分级标准分为早、中、晚3期分别治疗,早期以微创针刀松解术为主;中期以皮牵引+中药熏洗+矫形鞋垫为主;晚期以皮牵引+按摩推拿手法为主。对照组各期患者均进行皮牵引+中药熏洗+按摩推拿手法+口服筋骨痛消丸治疗。两组均治疗4周。治疗后比较两组临床疗效、住院时间和费用,并于治疗前后观察两组西部安大略和麦克马斯特国际关节炎调查表(WOMAC)评分、视觉模拟评分(VAS评分)及疼痛、僵硬、功能障碍评分。结果治疗组临床疗效总有效率、住院时间、住院费用分别为94.00%、(14.34±6.18)d、(3929.9±1367.0)元,对照组分别为88.67%、(20.53±2.83)d、(6424.2±709.72)元,治疗组临床疗效优于对照组,住院时间及费用均少于对照组(P<0.05)。两组患者治疗后疼痛、僵硬和功能障碍评分、WOMAC评分和VAS评分均较治疗前明显减少(P<0.05);治疗后治疗组以上指标的改善均明显优于对照组(P<0.05)。结论整体辨证3期分治治疗OA疗效确切,且能减少患者住院时间及费用。Objective To observe the therapeutic effect and cost-effectiveness of overall three-stage pattern dif- ferentiation for knee osteoarthritis （OA）. Methods Totally 450 cases of knee OA were randomized into the treat- ment group of 300 cases and control group of 150 cases. The treatment group was treated by overall three-stage pattern differentiation according to X-ray grade. The patients at early stage were given minimally invasive needle knife. The patients at mid stage were given skin traction, Chinese herb fumigation and orthotic insoles. The patients at advanced stage were given skin traction and massage. The control group was given skin traction, Chinese herb fumigation, mas- sage and Jingu Tongxiao Pill （pill to relieve bone and muscle pain）. Both groups were treated for 4 weeks as one treatment course. The therapeutic effect, hospitalization time and costs were compared between groups. The Western Ontario McMaster Questionnaire （WOMAC） score, visual analogue scale （VAS） score, pain score, stiffness score and dysfunction score were observed before and after treatment in both groups. Results The total effective rate, hospitalization time and hospitalization cost in the treatment group was 94.00%, （ 14.34 ±6. 18 ） d and （ 3929.9± 1367.0）Yuan respectively. The total effective rate, hospitalization time and hospitalization cost in the control group was 88.67%, （20.53 ±2.83）d and （6424. 2 ±709.72）Yuan respectively. The total effective rate of the treatment group was superior to that of the control group （P 〈 0.05 ）. Comparing with the control group, the hospitalization time and cost in the treatment group was significantly decreased （P 〈 0.05 ）. The pain score, stiffness score, dysfunction score, WOMAC score and VAS score were significantly decreased in both groups after treatment （P 〈 0. 05 ）, espe- cially in the treatment group （P 〈 0.05 ）. Conclusion The overall three-stage pattern differentiation is effective for OA with short hospitalization time and

关 键 词：膝骨性关节炎 针刀松解术 皮牵引 中药熏洗 推拿 

分 类 号：R274.9[医药卫生—中西医结合]