基于穴位敏化理论探讨敏化状态腧穴对膝关节骨性关节炎疗效的影响  

Based on Acupoint Sensitization Theory to Investigate the Effect of Sensitized Acupoints on the Efficacy of Knee Osteoarthritis

作　　者：黄河[1] 王晶 方园 谭舒怀 曾理 刘密[1,2] 常小荣 HUANG He;WANG Jing;FANG Yuan;TAN Shuhuai;ZENG Li;LIU Mi;CHANG Xiaorong(College of Acupuncture-Moxibustion and Tuina,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Liuyang Hospital of Chinese Medicine,Liuyang,Hunan 410300,China)

机构地区：[1]湖南中医药大学针灸推拿学院,湖南长沙410208 [2]浏阳市中医医院,湖南浏阳410300

出　　处：《湖南中医药大学学报》2020年第4期460-464,共5页Journal of Hunan University of Chinese Medicine

基　　金：国家自然科学基金项目(81590951);国家重点基础研究发展计划(973计划)项目(2015CB554502)。

摘　　要：目的本研究以膝关节骨性关节炎(knee osteoarthritis,KOA)患者为观察对象,针刺同一组腧穴,量化膝关节局部敏化态腧穴温度、压痛阈值,观察穴位敏化与穴位非敏化之间的疗效差异。方法156例受试者依据是否符合敏化态腧穴诊断界值,分为穴位敏化组125例、穴位非敏化组31例。采用SPSS 19.0软件PSM功能均衡组间基线资料,最终纳入23对匹配患者,即穴位敏化组23例、穴位非敏化组23例。两组均采用针刺治疗,每次30 min,隔日1次,连续治疗4周。观察两组治疗前后及3个月后随访西安大略和麦克马斯特大学(western ontario and mcmaster universities,WOMAC)骨关节炎指数和健康调查12条简表(12-item short-form health survey,SF-12)评分情况。结果(1)两组性别、年龄、病程、BMI指数、WOMAC评分、SF-12评分在组间不均衡的协变量经匹配后均达到均衡(P>0.05)。(2)治疗后,两组WOMAC评分均较治疗前显著降低(P<0.01),SF-12评分均较治疗前显著提高(P<0.01);且穴位敏化组的WOMAC评分低于穴位非敏化组(P<0.01),SF-12评分显著高于穴位非敏化组(P<0.01)。(3)随访时,穴位敏化组WOMAC评分依然显著低于穴位非敏化组(P<0.01),SF-12评分显著高于穴位非敏化组(P<0.01)。结论针刺同一组腧穴,穴位敏化组对KOA患者的临床疗效优于穴位非敏化组,为针灸临床治疗KOA提供进一步参考。Objective Taking patients with knee osteoarthritis(KOA)as research objects,and acupuncturing the same group of acupoints,to quantize the temperature,tenderness threshold of local sensitization points of the knee joint,to observe the difference in clinical efficacy between acupoint sensitization and acupoint non-sensitization.Methods A total of 156 cases were divided acupoint sensitization group(125 cases)and acupoint non-sensitization group(31 cases)according to whether they met the diagnostic threshold of sensitization acupoint.PSM function of SPASS 19.0 software was used to balance the baseline data between the groups,and finally 23 pairs of matched patients were included,which were 23 cases in the acupoint sensitization group and 23 cases in the acupoint non-sensitization group.The 2 groups were treated with acupuncture,30 mins each time,once every other day,continuous treatment for 4 weeks.The western ontario and mcmaster universities osteoarthritis index(WOMAC)score and 12-item short-form health survey(SF-12)scores were observed before and after treatment and after3 months.Results(1)The gender,age,course of disease,BMI index,WOMAC score and SF-12 score of the 2 groups were balanced after matching among the unbalanced covariates(P>0.05).(2)After treatment,the WOMAC scores of the 2 groups were significantly decreased than those before treatment(P<0.01),and the SF-12 scores were significantly increased than those before treatment(P<0.01).The WOMAC scores of acupoint sensitization group were significantly lower than those of acupoint non-sensitization group,while the SF-12 scores of the acupoint sensitization group were significantly higher than those of the acupoint non-sensitization group(P<0.01).(3)During follow-up,WOMAC score of acupoint sensitization group was still significantly lower than the acupoint non-sensitized group(P<0.01),and SF-12 evaluation was significantly higher than the acupoint non-sensitized group(P<0.01).Conclusion Acupuncturing at the same group of acupoints,acupoint sensitization group

关 键 词：针灸 穴位敏化 膝关节骨性关节炎 队列研究 

分 类 号：R245[医药卫生—针灸推拿学]