经筋理论指导下燔针射频术治疗膝骨关节炎疗效观察  

Efficacy of fan-needle radiofrequency for knee osteoarthritis guided by meridians-muscles theory

作　　者：侯春福[1] 韦嵩[1] 李慧[1] 陈志煌[1] 李晓昊[1] 郭晶[1] HOU Chun-fu;WEI Song;LI Hui;CHEN Zhi-huang;LI Xiao-hao;GUO Jing(Department of TCM,General Hospital of Guangzhou Military Region,Guangzhou 510010,Guangdong Province,China)

机构地区：[1]广州军区广州总医院中医科

出　　处：《中国针灸》2019年第1期37-41,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金项目:81573883;广东省科技计划项目:2015B020233011

摘　　要：目的:观察经筋理论指导下燔针射频术与口服药物治疗膝骨关节炎(KOA)的疗效差异。方法:将100例膝骨关节炎患者随机分为燔针射频术组和药物组,每组50例。燔针射频术组在经筋理论指导下,在关节周围经筋病灶点(阿是穴)行燔针射频治疗,每次治疗4个点,2周1次,共治疗2次。药物组口服塞来昔布胶囊,每次1粒,每日1次,连续服用4周。观察两组患者治疗前后及治疗后4周随访时视觉模拟量表(VAS)评分和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分变化,并评价临床疗效。结果:两组患者治疗后及治疗后4周VAS评分均低于治疗前(均P<0.05),且燔针射频术组评分均低于药物组(均P<0.05)。两组治疗后、治疗后4周WOMAC疼痛、僵硬、活动功能评分及总分均低于治疗前(均P<0.05),且燔针射频术组均低于药物组(均P<0.05)。治疗后,燔针射频术组总有效率为80.0%(40/50),优于药物组的56.0%(28/50,P<0.05)。治疗后4周随访时,燔针射频术组总有效率为76.0%(38/50),优于药物组的40.0%(20/50,P<0.05)。结论:经筋理论指导下燔针射频术治疗膝骨关节炎疗效优于口服塞来昔布胶囊,能缓解关节疼痛、僵硬程度,改善关节活动功能,并且有效持续时间长。Objective To observe the efficacy difference between fan-needle radiofrequency guided by meridians-muscles theory and oral administration of medication for knee osteoarthritis(KOA). Methods One hundred patients with KOA were randomly divided into an acupuncture group and a medication group, 50 cases in each one. The patients in the acupuncture group were treated with fan-needle radiofrequency guided by meridians-muscles theory at tendon nodes around knee joints(ashi points), 4 points per treatment, once every two weeks and two treatments were given. The patients in the medication group were treated with oral administration of celecoxib capsules, 1 capsule every day for 4 weeks. The visual analogue scale(VAS) and Western Ontario and McMaster Universities(WOMAC) in the two groups were observed before treatment, after treatment and during 4-week follow-up visit. The clinical efficacy was evaluated. Results Compared before treatment, the VAS was reduced in the two groups after treatment and during 4-week follow-up visit(all P<0.05), and the VAS score in the acupuncture group was lower than that in the medication group(both P<0.05). Compared before treatment, the pain score, stiffness score, activity function score and total score of WOMAC were reduced in the two groups after treatment and during 4-week follow-up visit(all P<0.05), and the scores in the acupuncture group were lower than those in the medication group(all P<0.05). After treatment, the total effective rate was 80.0%(40/50) in the acupuncture group, which was superior to 56.0%(28/50) in the medication group(P<0.05). During 4-week follow-up visit, the total effective rate was 76.0%(38/50) in the acupuncture group, which was superior to 40.0%(20/50) in the medication group(P<0.05). Conclusion The efficacy of fan-needle radiofrequency guided by meridians-muscles theory is superior to oral administration of celecoxib capsules for KOA, which could relieve joint pain and stiffness, improve joint mobility, and has long effective duration.

关 键 词：膝骨关节炎 燔针 射频 经筋 横络 结点 

分 类 号：R246.2[医药卫生—针灸推拿学]