毫火针联合温针灸治疗风寒湿型膝关节骨性关节炎临床研究  

Clinical Study on Filiform Fire Needling Combined with Warming-needle Moxibustion for Knee Osteoarthritis of Wind-cold-dampness Type

作　　者：许美飞[1] 陈和禾 余静[1] ZHU Qunfei;HONG Lanlan

机构地区：[1]金华市中心医院

出　　处：《新中医》2020年第2期120-124,共5页New Chinese Medicine

摘　　要：目的:观察毫火针结合温针灸治疗风寒湿型膝关节骨性关节炎(KOA)患者的临床价值。方法:选取80例风寒湿型KOA患者随机分为对照组与观察组各40例,对照组采用温针灸疗法,观察组采用毫火针结合温针灸疗法,均连续治疗4周。治疗后比较2组临床疗效,采用视觉模拟评分(VAS)评定治疗前后患者膝关节疼痛改善情况,采用西安大略与麦克马斯特大学骨关节炎评分(WOMAC)评定骨关节炎症改善状况,采用日本骨科协会评分标准(JOA)评定患者患肢功能的改善情况,应用步态分析仪评定患者步态指标的变化,2组均随访1年,采用生活质量评价表(SF-36)评定患者生活质量的变化。结果:观察组总有效率为95.00%,显著高于对照组的77.50%,差异有统计学意义(P<0.05)。治疗前,2组VAS、WOMAC及JOA评分、步态各指标、SF-36量表比较,差异均无统计学意义(P>0.05)。治疗1、2、3、4周,2组VAS评分均降低(P<0.05),观察组治疗1、2、3、4周VAS评分均低于对照组,差异有统计学意义(P<0.05)。治疗4周,2组WOMAC、JOA评分均降低(P<0.05),且观察组WOMAC、JOA评分低于对照组(P<0.05);观察组步速、跨步长大于对照组,差异有统计学意义(P<0.05)。2组SF-36量表评分治疗后均上升,观察组治疗3、6、12个月SF-36量表评分高于对照组,差异均有统计学意义(P<0.05)。结论:毫火针联合温针灸治疗风寒湿型KOA疗效肯定,可降低患者WOMAC、VAS及JOA评分,提升患者SF-36评分,促进患者步态恢复。Objective:To observe the clinical value of filiform fire needling combined with warming-needle moxibustion for knee osteoarthritis(KOA)of wind-cold-dampness type.Methods:A total of 80 cases of KOA patients of wind-colddampness type were randomly divided into the control group and the observation group,40 cases in each group.The control group was treated with warming-needle moxibustion,and the observation group was additionally treated with filiform fire needling based on the treatment of the control group.Both groups were treated for four weeks.After treatment,the clinical effect in the two groups was compared.The improvement of knee pain before and after treatment was evaluated by Visual Analogue Scale(VAS),the improvement of osteoarticular inflammation by Western Ontario and Mcmaster Universities Osteoarthritis Index(WOMAC),the improvement of limb function by Japanese Orthopaedic Association(JOA),and the changes of indexes of gait by gait analyzers.Both groups were followed up for one year,and the changes of quality of life were evaluated by 36-Item Short Form Health Survey(SF-36).Results:The total effective rate was 95.00%in the observation group,significantly higher than that of 77.50%in the control group,the difference being significant(P<0.05).Before treatment,compared with the scores of VAS,WOMAC and JOA,the indexes of gait and the SF-36,there was no significance in the difference(P>0.05).In the first,second,third and fourth week after treatment respectively,the scores of VAS in the two groups were decreased(P<0.05),and the scores in the observation group were all lower than those in the control group,the difference being significant(P<0.05).In the fourth week after treatment,the scores of WOMAC and JOA in the two groups were decreased(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05);the walking speed and stride length in the observation group were larger than those in the control group,the difference being significant(P<0.05).The scores of SF-36 in t

关 键 词：膝关节骨性关节炎 风寒湿型 毫火针 温针灸 西安大略与麦克马斯特大学骨关节炎评分(WOMAC) 日本骨科协会评分标准(JOA) 生活质量评价表(SF-36) 步态 

分 类 号：R684.3[医药卫生—骨科学]