腰-膝共治法治疗早中期膝关节骨性关节炎临床研究  

Clinical Study of Lumbar-knee Joint Therapy in Treatment of Early and Middle Stage Knee Osteoarthritis

作　　者：张永旺 薛炳鹤 范宇 左广 高天慈 杜双庆[1] ZHANG Yong-wang;XUE Bing-he;FAN Yu;ZUO Guang;GAO Tian-ci;DU Shuang-qing(Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050011)

机构地区：[1]河北省中医院,石家庄050011

出　　处：《河北中医药学报》2021年第6期20-23,33,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：河北省中医药管理局资助项目:No.2019003,No.2022037。

摘　　要：目的:探讨腰-膝共治法治疗早中期膝关节骨性关节炎(KOA)临床研究,为临床治疗提供创新思路。方法:126例KOA患者均来自河北省中医院骨伤三科,随机分为2组,对照组(63例)采用膝关节正骨手法治疗,试验组(63例)采用腰-膝共治法(腰椎定点旋转复位法、膝-踝调筋法与腰膝理筋法)治疗,并对受试者关节功能、疼痛程度、生活质量等评分变化情况进行观察并记录。结果:试验组治疗2、4周后的视觉模拟评分法(VAS)评分均显著低于对照组(P<0.05);试验组治疗后KOA严重性指数(ISOA)、国际KOA(WOMAC)量表评分低于对照组(P<0.05);试验组的总有效率为90.3%,显著高于对照组的77.4%,生活质量量表(SF-36)总评分显著高于对照组,差异均有显著性(P<0.05)。结论:对KOA受试者给予腰-膝共治法治疗,临床疗效更为明显,膝关节症状改善、疼痛减轻程度明显提高,疗效持续,较单纯膝关节正骨手法治疗效果更佳,提升了KOA患者生活质量。Objective:To explore the clinical study of lumbar-knee joint therapy in the treatment of early and middle stage knee osteoarthritis(KOA),and to provide innovative ideas for clinical treatment.Methods:126 KOA patients from the third Department of Orthopedics and Traumatology of Hebei Hospital of Traditional Chinese Medicine were randomly divided into two groups.The control group(63 cases)was treated with knee bone setting manipulation,and the experimental group(63 cases)was treated with lumbar-knee co-treatment(lumbar fixed-point rotary reduction,knee-ankle tendon adjustment and lumbar-knee tendon regulation methods).The scores of joint function,pain degree and quality of life were observed and recorded.Results:The scores of visual analogue scale(VAS)in the experimental group were significantly lower than those in the control group after 2 and 4 weeks of treatment(P<0.05);After treatment,the scores of KOA severity index(ISOA)and international KOA(WOMAC)scale in the experimental group were lower than those in the control group(P<0.05);The total effective rate of the experimental group was 90.3%,which was significantly higher than 77.4%of the control group.The total score of SF-36 was significantly higher than that of the control group(P<0.05).Conclusion:Lumbar-knee joint therapy treating KOA patients has more obvious clinical effect with the symptoms of knee joint improved,the pain significantly relieved,and the curative effect sustained.It is better than simple knee bone setting manipulation,and the quality of life of KOA patients was improved.

关 键 词：膝关节骨性关节炎 膝痹 骨痹 痛痹 历节 鹤膝风 腰-膝共治法 膝关节正骨手法 

分 类 号：R244.1[医药卫生—针灸推拿学]