揿针留针疗法联合康复干预治疗中早期膝骨关节炎  

Therapeutic effect of intradermal needling combined with rehabilitation intervention on knee osteoarthritis in the middle and early stages

作　　者：徐纬[1] 孙丹[1] 叶文雄 李世民[1] 王方园 XU Wei;SUN Dan;YE Wen-xiong;LI Shi-min;WANG Fang-yuan(Department of Rehabilitation, the Third People's Hospital of Hangzhou, Hangzhou 310009, Zhejiang Province,China)

机构地区：[1]杭州市第三人民医院康复医学科,浙江杭州310009

出　　处：《中国针灸》2019年第6期609-612,共4页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科技计划项目:2015ZA142

摘　　要：目的:观察揿针留针疗法联合康复干预措施对中早期膝骨关节炎疗效的影响。方法:将70例患者随机分为观察组和对照组,每组35例。排除脱落病例,最后观察组34例、对照组32例纳入统计。观察组给予揿针埋针联合常规康复干预,埋针穴位为犊鼻、内膝眼、血海、梁丘、阳陵泉、阿是穴,施埋24 h;对照组单纯给予常规康复干预。两组患者于治疗前、初次治疗结束时、治疗1个月后及治疗后3个月随访时采用疼痛视觉模拟评分法(VAS)评判患膝的疼痛程度;同时于治疗前、治疗1个月后采用西安大略和麦克马斯特骨关节炎指数(WOMAC)评定患膝的关节功能,采用主动屈膝关节活动范围(ROM)评定患膝的关节活动度,并评定两组疗效。结果:初次治疗结束时,观察组VAS评分较治疗前及对照组改善明显(均P<0.05),而对照组与治疗前比较,差异无统计学意义(P>0.05)。治疗1个月后,两组VAS评分、WOMAC评分、ROM测定较治疗前均明显改善(均P<0.05),且观察组优于对照组(均P<0.05);观察组总有效率为97.1%(33/34),优于对照组的81.3%(26/32,P<0.05)。随访时,两组患者VAS评分较治疗1个月时稍有上升,但与治疗前比较,差异仍有统计学意义(P<0.05),且观察组仍优于对照组(P<0.05)。结论:揿针留针疗法联合康复干预能有效缓解患膝疼痛以及改善关节功能,揿针留针疗法对中早期膝骨关节炎的康复有趋利作用。Objective To observe the effect of intradermal needing combined with rehabilitation intervention on middle and early knee osteoarthritis. Methods Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. Excluding the dropping cases, finally, 34 cases in the observation group and 32 cases in the control group were included in the statistics. Intradermal needing combined with rehabilitation intervention were given in the observation group, the intradermal needing was applied at Dubi(ST 35), Neixiyan(EX-LE 8), Xuehai(SP 10),Liangqiu(ST 34), Yanglingquan(GB 34), ashi point, and retained for 24 h;the simple conventional rehabilitation intervention was given in the control group. The visual analogue scale(VAS) was used to evaluate knee pain before treatment, the end of initial treatment, 1 month after treatment, and 3 months after treatment. The Western Ontario and McMaster Osteoarthritis index(WOMAC) was used to assess the joint function of the knee, the active knee flexion range(ROM) was used to assess the joint mobility of the knee before treatment and 1 month after treatment, and the efficacy of the two groups was evaluated. Results At the end of the initial treatment, the VAS score in the observation group were significantly improved as compared with that before treatment and the control groups(P<0.05), but there was no significant difference in the control group compared with that before treatment(P>0.05). After 1 month of treatment, the VAS score,WOMAC score and ROM measurement in the two groups were significantly improved as compared with those before treatment(P<0.05), and the observation group was superior to the control group(P<0.05);the total effective rate in the observation group was 97.1%(33/34), which was better than 81.3%(26/32) in the control group(P<0.05). At the follow-up, the VAS scores in the two groups were slightly higher than those after 1 month of treatment, but the difference was still statistically significant as compared with those before

关 键 词：膝骨关节炎 揿针 康复 视觉模拟评分法 

分 类 号：R246.6[医药卫生—针灸推拿学]