髋膝联合针刺疗法对早中期膝骨关节炎患者下肢运动功能的影响  

Effects of hip and knee acupuncture therapy on motor function of lower limbs of patients with early-middle knee osteoarthritis

作　　者：沈海[1] 何春江[2] 罗小兵[1] 张纯[2] 田国刚 何栩[1] SHEN Hai;HE Chunjiang;LUO Xiaobing;ZHANG Chun;TIAN Guogang;HE Xu(Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China;Chengdu Sport Institute,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省骨科医院,四川成都610041 [2]成都体育学院,四川成都610041

出　　处：《中医正骨》2018年第12期4-8,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：四川省科技厅科技支撑项目(2014SZ0003-2)

摘　　要：目的:观察髋膝联合针刺疗法对早中期膝骨关节炎(knee osteoarthritis,KOA)患者下肢运动功能的影响。方法:将80例符合要求的早中期(Kellgren-Lawrence分级为0级、Ⅰ级、Ⅱ级或Ⅲ级) KOA患者随机分为2组,每组40例。联合针刺组采用髋膝联合针刺疗法治疗,局部针刺组在膝关节周围取穴针刺治疗。2组针刺治疗均隔天1次,3次为1个疗程,间隔2 d后开始下一疗程,共治疗4个疗程。分别于治疗前和治疗结束后进行等速肌力测试和单脚站立时间测定。结果:治疗前2组患者的膝关节伸直肌力、膝关节屈曲肌力、髋关节伸直肌力、髋关节屈曲肌力、髋关节外展肌力、髋关节内收肌力及单脚站立时间比较,组间差异均无统计学意义[(1. 170±0. 456) Nm·kg^(-1),(1. 251±0. 415) Nm·kg^(-1),t=-0. 065,P=0. 614;(0. 637±0. 294) Nm·kg^(-1),(0. 793±0. 332) Nm·kg^(-1),t=-0. 051,P=0. 688;(1. 440±0. 800) Nm·kg^(-1),(1. 450±0. 707) Nm·kg^(-1),t=-0. 034,P=0. 729;(1. 031±0. 462) Nm·kg^(-1),(1. 084±0. 331) Nm·kg^(-1),t=-0. 073,P=0. 596;(0. 829±0. 355) Nm·kg^(-1),(0. 858±0. 281) Nm·kg^(-1),t=-0. 031,P=0. 735;(0. 746±0. 319) Nm·kg^(-1),(0. 742±0. 335) Nm·kg^(-1),t=0. 016,P=0. 830;(3. 2±0. 3) s,(2. 9±0. 3) s,t=0. 409,P=0. 224)]。治疗结束后,2组患者的膝关节伸直肌力、膝关节屈曲肌力、髋关节伸直肌力、髋关节屈曲肌力、髋关节外展肌力、髋关节内收肌力及单脚站立时间均较治疗前增加[联合针刺组:t=-2. 175,P=0. 023;t=-2. 492,P=0. 003; t=-2. 280,P=0. 014; t=-2. 193,P=0. 019; t=-2. 457,P=0. 006; t=-2. 363,P=0. 009; t=-4. 061,P=0. 000。局部针刺组:t=-2. 018,P=0. 044; t=-2. 275,P=0. 014; t=-2. 110,P=0. 027; t=-2. 079,P=0. 033; t=-2. 166,P=0. 024; t=-2. 254,P=0. 015; t=-4. 270,P=0. 000];联合针刺组的膝关节伸直肌力、膝关节屈曲肌力、髋关节伸直肌力、髋关节屈曲肌力、髋关节外展肌力、髋关节内收肌力及单脚站立时间均大于局部针刺组[(1. 559±0. Objective:To observe the effects of hip and knee acupuncture therapy on motor function of lower limbs of patients with early-middle knee osteoarthritis(KOA).Methods:Eighty patients with early-middle KOA(Kellgren-Lawrence grade 0,Ⅰ,ⅡandⅢ)enrolled in the study were randomly divided into group A and group B,40 cases in each group.The patients in group A were treated with acupuncture therapy at hip and knee,while the patients in group B were treated with acupuncture therapy at acupoints around the knee.The acupuncture therapies were performed in patients of the 2 groups on alternate days for 4 courses of treatment,three times for each course with a 2-day rest-insertion between courses.The isokinetic muscle strength and one-foot standing time were measured before treatment and after the end of the treatment respectively.Results:There was no statistical difference in knee extensor muscle strength,knee flexor muscle ip extensor muscle strength,hip flexor muscle strength,hip abductor muscle strength,hip adductor muscle strength and one-foot standing time between the 2 groups before the treatment(1.170+/-0.456 vs 1.251+/-0.415 Nm/kg,t=-0.065,P=0.614;0.637+/-0.294 vs 0.793+/-0.332 Nm/kg,t=-0.051,P=0.688;1.440+/-0.800 vs 1.450+/-0.707 Nm/kg,t=-0.034,P=0.729;1.031+/-0.462 vs 1.084+/-0.331 Nm/kg,t=-0.073,P=0.596;0.829+/-0.355 vs 0.858+/-0.281 Nm/kg,t=-0.031,P=0.735;0.746+/-0.319 vs 0.742+/-0.335 Nm/kg,t=0.016,P=0.830;3.2+/-0.3 vs 2.9+/-0.3 seconds,t=0.409,P=0.224).The knee extensor muscle strength,knee flexor muscle strength,hip extensor muscle strength,hip flexor muscle strength,hip abductor muscle strength,hip adductor muscle strength and one-foot standing time increased in both of the 2 group after the end of the treatment compared to pre-treatment(Group A:t=-2.175,P=0.023;t=-2.492,P=0.003;t=-2.280,P=0.014;t=-2.193,P=0.019;t=-2.457,P=0.006;t=-2.363,P=0.009;t=-4.061,P=0.000.Group B:t=-2.018,P=0.044;t=-2.275,P=0.014;t=-2.110,P=0.027;t=-2.079,P=0.033;t=-2.166,P=0.024;t=-2.254,P=0.015;t=-4.270,P=0.000).The knee extensor

关 键 词：骨关节炎 膝 针刺疗法 肌力 姿势平衡 临床试验 

分 类 号：R246.9[医药卫生—针灸推拿学]