Warm needling on the four knee acupoints combined with Chinese herb in the treatment of knee pain after stroke  

温针灸膝四穴配合中药治疗中风后膝痛的比较研究（英文）

作　　者：刘永锋[1] 马晓明[1] 闫兵[1] 缑燕华[1] 张少芸[1] 饶晓丹[1] 

机构地区：[1]广东省深圳市中医院针灸科

出　　处：《World Journal of Acupuncture-Moxibustion》2015年第3期21-25,共5页世界针灸杂志（英文版）

基　　金：Supported by key laboratory project of Shenzhen technical research and development funding condition and platform construction plan:CXB201111250113A

摘　　要：Objective To observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. Methods Sixty patients with knee pain after stroke were divided into a group A and a group B by random allocation, with 30 patients in each group. Patients in the group B only received the treatment by Chinese herb, which called Dúhuó Jìshēng Tāng（独活寄生汤 Pubescent Angelica and Mistletoe Decoction, add or remove ingredients depending on conditions）; patients in the group A additionally received warm needling on the basis of Chinese herb. Four knee acupoints were selected as master acupoints and Hèd ng（鹤顶 EXLE 2）, Yánglíngquán（阳陵泉 GB 34） and Zúsānl（足三里 ST 36） as combining acupoints. Perpendicular insertion was conducted on Xuèh i（血海 SP 10） and Liángqiū（梁丘 ST 34） for approximately 1 cun, and oblique insertion on Nèixīy n（内膝眼 EX-LE 4） and Dúbí（犊鼻 ST 35） for approximately 1 cun at 45° in inner and upper direction to push needle tip into joint cavity. After deqi, moxibustion stick was cut to 1.5 cm long, ignited, and inserted into the needle handles in the four knee acupoints. 1–2 strips were applied. After the moxa cones were burned up, needles were retained for 10 min. 7 d was a course of treatment and observation lasted for consecutive four courses. Visual analogue scale（VAS） and Barthel Index（BI） were adopted as observational indices. Clinical efficacy was classified as clinical cured, markedly effective, effective and ineffective according to the standards described in Guidelines of Clinical Research on Chinese New Herbal Medicine. Results After treatment, total effective rate was 93.3% in the group A, including full recovery in 8 cases, markedly effective in 15 cases, effective in 5 cases, and ineffective in 2 cases; while the total effective rate was 73.3% in the group B. The difference between the two groups was statistically significant（P0.05）. In目的:观察在中药治疗的基础上配合温针灸膝四穴治疗中风后膝痛的临床疗效。方法:采用随机分配表法将60例中风后膝痛患者分为观察组和对照组,每组30例。对照组患者只接受中药治疗,药物以独活寄生汤加减,观察组除接受以独活寄生汤加减的中药治疗外还施以温针灸,方法为选取膝四穴为主穴,鹤顶、阳陵泉、足三里为配穴。血海、梁丘直刺1寸左右;内外膝眼斜向内上45°斜刺1寸左右,使针尖深入关节腔内。得气后把灸条切成1.5 cm长,点燃后插在4个主穴的针柄上,施以1、2炷,待艾炷燃烧完后,再留针10 min。7 d为一疗程,连续观察4个疗程。采用视觉模拟评分法(VAS)和Barthel指数(BI)作为观察指标,根据《中药新药临床指导研究指导原则》标准评定分为临床痊愈、显效、有效、无效4个级别。结果:经治疗后观察组治愈8例,显效15例,有效5例,无效2例,总有效率为93.3%;对照组总有效率为73.3%,两组比较差异有统计学意义(P<0.05)。观察组患者治疗前后的VAS评分分别为6.53±1.39、1.53±0.80分,BI评分分别为58.38±8.67、67.55±12.99分;对照组患者治疗前后的VAS评分分别为6.63±1.81、3.33±0.96分,BI评分分别为57.89±9.65、64.87±12.18分。治疗后两组VAS评分和BI评分均显著改善,治疗前后比较差异有统计学意义(均P<0.05);且观察组VAS评分和BI评分均优于对照组(均P<0.05)。结论:在中药治疗基础上加用温针灸"膝四穴",能够提高中风后膝痛的疗效,有助于膝关节功能的迅速恢复,提高中风患者的生活质量。

关 键 词：Warm needling the four knee acupoints knee pain after stroke 

分 类 号：R246.6[医药卫生—针灸推拿学]