“杨氏”絮刺拔罐法治疗膝骨关节炎:多中心随机对照研究  

YANG's pricking-cupping therapy for knee osteoarthritis:a multi-center randomized controlled trial

作　　者：王波[1] 刘希茹[1] 胡智海[2] 孙爱军[3] 马燕文 陈颖盈 张虚之 刘美玲[3] 王毅[2] 王硕硕[2] 张蕴佳[1] 李一婧[1] 沈卫东[1] 

机构地区：[1]上海中医药大学附属曙光医院针灸科,上海201203 [2]上海市中西医结合医院 [3]上海市浦东新区潍坊社区卫生服务中心 [4]上海市浦东新区金杨社区卫生服务中心

出　　处：《中国针灸》2016年第2期113-118,共6页Chinese Acupuncture & Moxibustion

基　　金：上海市卫计委"海派中医流派传承研究基地建设"项目:ZYSNXD-CC-HPGC-JD-014;上海市卫计委"中医药专门人才计划"项目:ZY3-RCPY-3-1026

摘　　要：目的:评价"杨氏"絮刺拔罐法治疗膝骨关节炎的临床疗效。方法:进行多中心、随机、平行对照试验,将171例膝骨关节炎患者随机分为絮刺拔罐组(89例)和常规针刺组(82例)。两组取穴均为内膝眼、犊鼻穴和阿是穴,絮刺拔罐组采用"杨氏"絮刺拔罐法进行治疗,用七星针轻叩穴位,待微出血后加拔火罐;常规针刺组采用半标准化的毫针刺法进行治疗,共治疗4周(次数规定为最少5次,最多10次),治疗结束后随访4周。采用西安大略麦马斯特大学骨性关节炎指数(Ontario and McMaster Universities Osteoarthritis Index,WOMAC)和疼痛视觉模拟评分表(visual analogue scale,VAS)评价患者疗效。结果:治疗4周后与随访时,两组患者WOMAC疼痛评分、僵硬评分、日常生活难度评分、总分均低于治疗前(均P<0.0001);除治疗4周后,絮刺拔罐组的WOMAC僵硬评分与常规针刺组比较差异无统计学意义(P>0.05)外,絮刺拔罐组在治疗4周后与随访时WOMAC其余各项评分和总分均低于常规针刺组(P<0.0001,P<0.01)。治疗2周、4周后和随访时,两组患者VAS评分均低于治疗前(均P<0.0001),且随疗次增加VAS评分降低更明显(均P<0.0001);治疗4周后和随访时絮刺拔罐组VAS评分均低于常规针刺组(P<0.01,P<0.0001)。结论:"杨氏"絮刺拔罐与常规针刺疗法均能明显改善膝骨关节炎患者关节疼痛及功能,且相对安全。在取穴相同的前提下,絮刺拔罐疗法较常规针刺疗法更有优势。Objective To evaluate the clinical efficacy of YANG＇s pricking-cupping therapy for knee osteoarthritis（KOA）.Methods This was a multi-center randomized parallel controlled trial.One hundred and seventyone patients with KOA were randomly allocated to a pricking-cupping group（89 cases）and a conventional acupuncture group（82 cases）.Neixiyan（EX-LE 4）,Dubi（ST 35）and ashi points were selected in the two groups.Patients in the pricking-cupping group were treated with YANG＇s pricking-cupping therapy;the seven-star needles were used to perform pricking at acupoints,then cupping was used until slight bleeding was observed.Patients in the conventional acupuncture group were treated with semi-standardized filiform needle therapy.The treatment was given for 4 weeks（from a minimum of 5 times to a maximum of 10 times）.The follow-up visit was 4 weeks.The Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）and the visual analogue scale（VAS）were adopted for the efficacy assessments.Results The pain score,stiffness score,physical function score and total score of WOMAC were all reduced after 4-week treatment and during follow-up visit in the two groups（all P〈0.0001）.Except that the difference of stiffness score between the two groups was not significant after 4-week treatment（P0.05）,each score and total score of WOMAC in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit（P〈0.0001,P〈0.01）.After 2-week treatment,4-week treatment and during follow-up visit,the VAS was all reduced compared with that before treatment（all P〈0.0001）;with the increase of the treatment,the reducing trend of VAS was more significant（P〈0.0001）.The scores of VAS in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit（P〈0.01,P〈0.0001）.Conclusion The YANG＇s pricking-cupping and conventional acupuncture th

关 键 词：骨性关节炎 膝 针刺疗法 刺血疗法 拔罐 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]