针刀联合麻醉下手法松解治疗髋骨关节炎的临床研究  

Clinical Study on the Treatment of Hip Osteoarthritis with Acupotomy combined with Manipulation Release Under Anesthesia

作　　者：刘道兵[1] 李 王均玉[1] 谢斌[1] 何海军[1] 陈卫衡 LIU Dao-bing;LI Yan;WANG Jun-yu;XIE Bin;HE Hai-jun;CHEN Wei-heng(Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100102,China;The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]北京中医药大学第三附属医院,北京100029

出　　处：《中医药导报》2021年第11期109-112,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：科技部重大新药创制专项课题(2019ZX09731-002);国家自然科学基金面上项目(81873322)。

摘　　要：目的:探讨针刀联合麻醉下手法松解对髋骨关节炎患者疼痛及关节功能的影响。方法:选择髋骨关节炎患者91例(115髋),随机分为治疗组46例(59髋)和对照组45例(56髋)。治疗组患者采用针刀联合麻醉下手法松解术治疗,对照组患者采用麻醉下手法闭合松解术治疗。以视觉模拟评分法(VAS)评分、Harris(髋关节功能评分)、髋关节功能活动度及SF-36(生存质量量表)评分为疗效评价指标。治疗半年后进行临床随访,收集相关数据并进行统计学分析。结果:91例患者均完成治疗及随访。治疗后两组患者VAS评分低于治疗前(P<0.05),Harris评分、髋关节功能活动度均高于治疗前(P<0.05);治疗后,治疗组患者VAS评分低于对照组(P<0.05),Harris评分、髋关节活动度均高于对照组(P<0.05);治疗组患者治疗后SF-36量表8个维度评分均高于治疗前(P<0.05),对照组患者治疗后SF-36量表中生理功能(PF)、躯体疾病(BP)、总体健康(CH)、社会功能(SF)、情感职能(RE)、精神健康(MH)维度评分均高于治疗前(P<0.05),而生理职能(RP)、活力(VT)维度评分与治疗前比较,差异均无统计学意义(P>0.05);治疗后,治疗组患者SF-36量表8个维度评分均高于对照组(P<0.05)。结论:针刀联合麻醉下手法松解术治疗髋骨关节炎可明显缓解疼痛,改善关节功能,提高患者生活质量。Objective: To investigate the effect of acupotomy combined with manipulation release under anesthesia on pain and joint function of patients with hip osteoarthritis. Methods: The 91 patients(115 hips) with hip osteoarthritis were randomly divided into 46 cases(59 hips) in the treatment group and 45 cases(56 hips)in the control group. The patients in the treatment group were treated with acupotomy combined with manipulation release under anesthesia, while the patients in the control group were treated with manipulation release under anesthesia. VAS scores, Harris scores, hip functional activity scores and SF-36 quality of life scale were used as the evaluation indexes. Clinical follow-up was conducted half a year after treatment, and relevant data were collected and statistically analyzed. Results: 91 patients completed treatment and follow-up. After treatment, the VAS scores of the two groups were lower than that before treatment(P<0.05), while the Harris scores and hip function activity scores were higher than those before treatment(P<0.05). After treatment, the VAS scores of the treatment group were lower than that of the control group(P<0.05), and the Harris score and hip joint activity were higher than those of the control group(P <0.05). The scores of 8 dimensions of SF-36 in the treatment group were higher than those before treatment(P<0.05), and the scores of PF, BP, CH, SF, RE and MH in SF-36 in the control group were higher than those before treatment(P<0.05). After treatment, the scores of 8 dimensions of SF-36 scale in the treatment group were higher than those in the control group(P<0.05). Conclusion: Acupotomy combined with manipulation release under anesthesia in the treatment of hip osteoarthritis can significantly relieve pain, improve joint function and improve the quality of life of the patients.

关 键 词：髋骨关节炎 针刀 手法松解 疼痛 髋关节功能 生活质量 

分 类 号：R246.9[医药卫生—针灸推拿学]