针刀联合局部痛点注射治疗膝关节炎的临床研究  

Clinical Research on Knee Osteoarthritis Treated by Combination of Acupotomy and Injection Treatment for Pain Points

作　　者：张乐乐[1] ZHANG Lele(The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,Henan,China)

机构地区：[1]河南科技大学第一附属医院,河南科技大学临床医学院

出　　处：《辽宁中医杂志》2019年第11期2408-2411,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河南科技大学博士科研启动基金(201308)

摘　　要：目的:观察针刀联合局部痛点注射治疗膝关节炎(KOA)的临床疗效,进一步挖掘中医特色新疗法治疗KOA的临床优势。方法:将符合标准的60例KOA患者随机分为药物组、针刀组和联合组,各组20例,药物组使用双氯芬酸钠肠溶片+舒筋活血胶囊+玻璃酸钠关节腔注射的方法,玻璃酸钠每周注射1次;针刀组采用单纯3号针刀在髌下脂肪垫,内、外侧副韧带,腘肌,后关节囊等部位并结合痛点进行松解治疗,联合组采用在针刀组治疗的基础上配合痛点注射的方法。针刀组和联合组患者每3~7 d治疗1次,连续治疗3周(4~6次),3组患者均连续治疗3周,分别于治疗前、治疗后采用中医病证诊断疗效标准及国际公认的膝关节炎WOMAC评分量表对关节活动程度、关节活动难度、关节疼痛程度、关节僵硬程度以及总WOMAC状况进行评分,并对结果进行统计分析,比较3组间疗效的差异。结果:治疗3周后,与单纯药物组相比,针刀组和联合组患者的膝关节疼痛程度、关节功能活动程度、僵硬程度以及总WOMAC评分均明显低于治疗前水平(P<0.05),并且联合组在膝关节炎的临床疗效、膝关节疼痛程度、活动程度、以及总WOMAC评分方面均优于单纯药物组。结论:针刀联合局部痛点注射能有效改善膝关节炎患者的临床疗效、疼痛程度、关节功能活动程度、僵硬程度以及总WOMAC评分,作为一种简便易行的中医复合疗法,针刀联合局部痛点注射在治疗膝关节骨性关节炎方面具有明显优势,值得临床推广。Objective:To observe the clinical efficacy of knee osteoarthritis(KOA)treated by combination of acupotomy and injection treatment for pain points and confirm the clinical advantages of comprehensive therapies of traditional Chinese medicine(TCM)for treating KOA patients.Methods:Sixty patients in line with the diagnosis standard were randomly divided into the drug group(20 cases,treated by usual pharmacotherapy),the acupotomy group(20 cases,treated by acupotomy),and the combined group(20 cases,treated by acupotomy and injection treatment for pain points).The patients in the drug group were treated by taking Diclofenac Sodium Enteric-coated Tablets and drugs for activating blood circulation(Ds-ABC)and receiving the articular cavity injection therapy by sodium hyaluronate once a week.In the acupotomy group,No.3 acupotomy was used to loose the adhesion muscle and tissue on the fat pad under patellar,internal and external collateral ligaments,popliteal muscle and pain points,etc.The combined group was treated with injection for pain points on the basis of acupotomy group.Patients in the acupotomology group and the combined group were treated every 3-7 days for 3 weeks(4-6 times).All patients in the three groups were scored respectively before treatment.After 3 weeks treatment,the curative effect of TCM disease and the internationally recognized WOMAC rating scales of KOA,the pain degree,activities,difficulties,stiffness and WOMAC evaluation of joint function were assessed.After that,all data was statistically analyzed for comparing the difference among the three groups.Results:After 3 weeks treatment,the scores of pain degree,activities,stiffness and WOMAC evaluation of the acupotomy and combined groups decreased significantly than the basic levels(P<0.05).Especially,the clinical efficacy,the scores of pain degree,activities and the WOMAC evaluation in the combined group were less than the counterparts of the drug group(P<0.05).Conclusion:The combination of acupotomy and injection treatment for pain points can improve

关 键 词：针刀 痛点注射 膝关节炎 中医复合疗法 

分 类 号：R245.319[医药卫生—针灸推拿学]