魏氏伤科手法治疗膝骨关节炎疗效及对软骨退变影响  

Efficacy of Wei’s traumatology manipulation on knee osteoarthritis and its influence on cartilage degeneration

作　　者：陈朝蔚[1] 陈刚 顾晶亮 李飞跃[3] 樊天佑[1] 车涛[1] CHEN ZhaoWei;CHEN Gang;GU Jingliang;LI Feiyue;FAN Tianyou;CHE Tao(Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Philips(China)Investment Co.Ltd,Shanghai 200072,China;Ruijin Hospital,School of Medicine of Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]飞利浦(中国)投资有限公司,上海200072 [3]上海交通大学医学院附属瑞金医院,上海200025

出　　处：《现代中西医结合杂志》2021年第25期2737-2740,2753,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市科委项目(19401935400);李飞跃全国名老中医药专家传承工作室建设项目(MLZJGZS-2017001);上海市名老中医李飞跃学术经验研究工作室建设项目(SHGZS-2017010);全国中医药创新骨干人才培训项目;国家自然科学基金资助项目(81302987)。

摘　　要：目的观察魏氏伤科手法治疗膝骨关节炎的临床疗效及对软骨退变的影响。方法选取2020年8—10月在上海市中医医院门诊就诊且符合入组标准的膝骨关节炎患者66例,采用随机数字表法分为2组,手法组33例采用魏氏伤科手法结合红外线治疗仪治疗,对照组33例单纯采用红外线治疗仪治疗,2组均每周治疗3次,连续治疗6周。采用Lysholm膝关节评分评定患者的临床疗效,同时治疗前后采用GE 1.5T MR观察髌股关节面全层T2值的变化。结果2组治疗后Lysholm评分及疼痛评分、肿胀评分均明显高于治疗前(P均<0.05),且手法组屈伸活动度评分明显高于治疗前(P<0.05);手法组治疗后肿胀评分、关节屈伸活动度评分和Lysholm评分均明显高于对照组(P均<0.05),2组疼痛评分比较差异无统计学意义(P>0.05)。手法组治疗后外侧髌股关节面、内侧髌股关节面、中间髌股关节面T2值均明显低于治疗前及同期对照组(P均<0.05),对照组治疗后各区T2值均无显著变化(P均>0.05)。结论魏氏伤科手法能有效改善膝骨关节炎患者的疼痛、活动受限等临床症状,疗效优于红外线治疗仪治疗,且魏氏伤科手法可能具有缓解膝关节软骨退变的作用。Objective It is to observe the clinical efficacy of Wei’s traumatology manipulation in the treatment of knee osteoarthritis and its influence on cartilage degeneration.Methods A total of 66 patients with knee osteoarthritis who were treated in the outpatient department of Shanghai Municipal Hospital of Traditional Chinese Medicine from August to October 2020 and met the inclusion and exclusion criteria were selected and randomly divided into 2 groups by random number table method.33 cases in the manipulation group were treated with Wei’s traumatology manipulation combined with infrared therapy instrument,33 cases in the control group were treated with infrared therapy instrument alone,and both groups were treated for 3 times a week for 6 consecutive weeks.The Lysholm knee score was used to evaluate the clinical efficacy of the patients.At the same time,GE 1.5T MR was used to observe the changes in the full-thickness T2 value of the patellofemoral joint before and after treatment.Results The Lysholm scores and the individual scores of pain and swelling after treatment were significantly higher than those before treatment in the two groups(all P<0.05),and the scores of flexion and extension activities in the manipulation group were significantly higher than before treatment(P<0.05);the scores of swelling and joint flexion and extension activity and Lysholm score in the manipulation group were significantly higher after treatment than those in the control group(all P<0.05),and there was no significant difference in pain scores between the two groups(P>0.05).The T2 values of the lateral patellofemoral joint surface,the medial patellofemoral joint surface,and the middle patellofemoral joint surface of the manipulation group after treatment were significantly lower than those before treatment and of the control group at the same period(all P<0.05),and the T2 values of each area of the control group were not significantly changed after treatment(P>0.05).Conclusion Wei’s Traumatology manipulation can effectively im

关 键 词：膝骨关节炎 魏氏伤科手法 软骨退变 

分 类 号：R684.3[医药卫生—骨科学]