针刺-推拿按摩-药浴-功能锻炼综合干预老年骨性关节炎(脾虚水泛)随机平行对照研究  

Acupuncture, Massage and Medication-Medicated Bath-Functional Exercise Comprehensive Intervention on Aged Osteoarthritis(Spleen Deficiency/脾虚水泛)

作　　者：田可为[1] TIAN Kewei(Department of Hip Injury,Orthopedic Hospital of Luoyang,Henan Province, Luoyang 471002,Henan,China)

机构地区：[1]河南省洛阳正骨医院髋部损伤科,河南洛阳471002

出　　处：《实用中医内科杂志》2018年第5期59-61,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察针刺-推拿按摩-药浴-功能锻炼综合干预老年骨性关节炎(脾虚水泛)疗效。[方法]使用随机平行对照方法,将90例住院患者按就诊顺序号简单随机分两组。对照组45例布洛芬,2次/d,0.3g/次;疼痛剧烈关节内注射透明质酸,2m L/次,1次/周。治疗组45例综合干预:(1)针刺:血海、委中、膝眼、足三里、阳陵泉、太冲、犊鼻、合谷、梁丘、阿是穴等,得气后加电针,红外线局部照射,1次/d;(2)药浴(透骨草30g,海桐皮25g,伸筋草20g,独活、苏木、牛膝、防风各10g,花椒、桑枝、红花、艾叶、细辛、桂枝、川芎各6g,川乌5g),混合3000m L水,浸泡30min大火煮沸,后小火煎熬15min,趁热熏洗关节,1次/d;(3)推拿按摩:股四头肌按揉、拿捏、滚法等,膝眼、足三里、阳陵泉、血海、犊鼻等拇指点按,1min/穴;弹拨关节周围韧带和肌腱,屈伸关节;(4)功能锻炼:15~30min/次,2次/d;患者仰卧位,膝关节尽可能伸直,踝关节背屈,直腿抬高练习;侧卧位,伸直膝关节,髋关节外展,反复数次;仰卧位,伸直膝关节,皮球放置两腿间,用力夹紧。连续治疗3周为1疗程。观测临床症状、VAS评分、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效12例,有效31例,无效2例,总有效率95356%;对照组显效22例,有效14例,无效9例,总有效率80.00%;治疗组疗效优于对照组(P<0.05)。VAS评分两组均有改善(P<0.05),治疗组优于对照组(P<0.05)。[结论]骨科康复疗法干预老年骨性关节炎(脾虚水泛),疗效满意,无严重不良反应,值得推广。[Objective] To observe the therapeutic effect of acupuncture,massage,medicated bath and functional exercise on elderly osteoarthritis（water spleen deficiency）.[Methods] Randomized parallel control method was used to randomly divide 90 inpatients into two groups according to the number of visits.The control group consisted of 45 ibuprofen,2 times daily,and 0.3 g/time; painful intra-articular injection of hyaluronic acid,2 mL/time,1/week.In the treatment group,45 cases had comprehensive intervention： 1 acupuncture： blood sea,Venezuela,Knee eye,Zusanli,Yanglingquan,Taichong,Shubi,Hegu,Liangqiu,Ashi,etc.Infrared local irradiation,1 time/d; 2 Medicinal bath（Tougucao 30 g,Haitongpi 25 g,Shenjincao 20 g,Duhuuo,Sumu,Niuxi,Fangfeng each 10 g,Huajiao,Sangzhi,Honghua,Aiye,Xixin,Gui zhi,Chuanxiong each 6 g,Chuanwu 5 g）,mixed 3000 mL water,soaked for 30 min fire boiled,after a small fire torment for 15 min,while hot fumigation joints,1 time/d; 3 massage massage： quadriceps rubbing,pinching,rolling,etc.,Knees,Zusanli,Yanglingquan,Xuehai,Duobi,etc.,thumb click,1 min/acupuncture point; pluck the ligaments and tendons around the joint,flexion and extension joints; 4 functional exercise： 15-30 min/times,2 times/d; patient supine,knee joints as far as possible,ankle dorsiflexion,straight leg raising exercises; lateral position,straight knee,hip abduction,repeated several times; supine position Straighten the knee joint,place the ball between the legs,and clamp firmly.Continuous treatment for 3 weeks is a course of treatment.Clinical symptoms,VAS scores,and adverse reactions were observed.Treatment 1 course of treatment,determine the efficacy.[Results] In the treatment group,12 cases were markedly effective,31 cases were effective,2 cases were ineffective,and the total effective rate was 95356%.In the control group,22 cases were markedly effective,14 cases were effective,9 cases were ineffective,and the total effective rate was 80.00%.The curative effect of the treatment group was better than that of the control grou

关 键 词：老年骨性关节炎 痹症 脾虚水泛 康复疗法 针刺 电针 红外线照射 推拿按摩 药浴 功能锻炼 布洛芬 透明质酸 VAS评分 中医药治疗 中药复方 随机平行对照研究 

分 类 号：R684.3[医药卫生—骨科学]