温针灸联合药物治疗骨髓水肿综合征的疗效观察  

Observations on the Efficacy of Warm Needling Moxibustion Plus Medication for Bone Marrow Edema Syndrome

作　　者：董庆[1] 徐复娟[1] 樊小平[1] DONG Qing;XU Fu-juan;FAN Xiao-ping(Zhejiang Changshan County People’s Hospital,Changshan 324200,China)

机构地区：[1]浙江省常山县人民医院,常山324200

出　　处：《上海针灸杂志》2020年第11期1444-1448,共5页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的观察温针灸联合药物治疗髋关节骨髓水肿综合征(BMES)的临床疗效。方法将48例髋关节BMES患者随机分为治疗组和对照组,每组24例。治疗组采用温针灸联合药物治疗,对照组采用单纯药物治疗。观察两组治疗前后视觉模拟量表(VAS)评分、Harris评分、骨髓水肿面积及血浆脂蛋白a、纤溶酶原激活抑制因子-1(PAI-1)水平的变化情况,并比较两组临床疗效及随访半年内患侧髋关节骨折发生率。结果两组治疗后VAS评分、Harris评分、骨髓水肿面积及血浆脂蛋白a、PAI-1水平与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后VAS评分、Harris评分、骨髓水肿面积及血浆脂蛋白a、PAI-1水平与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率和随访半年内患侧髋关节骨折发生率分别为87.5%和0.0%,对照组分别为62.5%和16.7%,两组比较差异均具有统计学意义(P<0.05)。结论温针灸联合药物治疗髋关节BMES疗效确切,可缓解患者疼痛症状,改善髋关节功能,促进骨髓水肿恢复,降低骨折风险,这可能与其降低患者血浆脂蛋白a、PAI-1水平相关。Objective To investigate the clinical efficacy of warm needling moxibustion plus medication for hip bone marrow edema syndrome(BMES)of the hip.Method Forty-eight patients with hip BMES were randomized to treatment and control groups,with 24 cases in each group.The treatment group received warm needling moxibustion plus medication and the control group,medication alone.The Visual Analogue Scale(VAS)score and the Harris score were recorded and bone marrow edema area and plasma lipoprotein a and plasminogen activator inhibitor-1(PAI-1)levels were measured in the two groups before and after treatment.The clinical therapeutic effects and the incidences of affected-side hip fracture at the six-month follow-up were compared between the two groups.Result There were statistically significant pre-/post-treatment differences in the VAS score,the Harris score,bone marrow edema area,and plasma lipoprotein a and PAI-1 levels in the two groups(P<0.05).There were statistically significant post-treatment differences in the VAS score,the Harris score,bone marrow edema area,and plasma lipoprotein a and PAI-1 levels between the treatment and control groups(P<0.05).The total efficacy rate and the incidence of affected-side hip fracture at the six-month follow-up were 87.5%and 0%,respectively,in the treatment group and 62.5%and 16.7%,respectively,in the control group with statistically significant differences between the two groups(P<0.05).Conclusion Warm needling moxibustion plus medication has a definite therapeutic effect on hip BMES.It can relieve pain symptoms,improve hip function,promote recovery from bone marrow edema and reduce fracture risk in the patients.Those may be related to its decreasing plasma lipoprotein a and PAI-1 levels.

关 键 词：温针疗法 骨髓水肿综合征 针药并用 脂蛋白A 纤溶酶原激活抑制因子-1 

分 类 号：R246.2[医药卫生—针灸推拿学]