电针结合推拿治疗膝关节骨性关节炎的临床研究  

Study of Knee Osteoarthritis on Electroacupuncture Combined with Tuina

作　　者：杨松 孟灵 赵焰[2] 张玮 杜革术 龙安国 何常春 蒋学余 Yang Song;Meng Ling;Zhao Yan;Zhang Wei;Du Geshu;Long Anguo;He Changchun;Jiang Xueyu(Hunan University of Chinese Medicine,Hunan,Changsha 410208,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖北省中医院,湖北武汉430060 [3]江西中医药大学第二附属医院,江西南昌330012 [4]湖南省长沙市中医医院,湖南长沙410002 [5]湖南省常德市第一中医医院,湖南常德415099 [6]湖南省衡阳市中医医院,湖南衡阳421009 [7]湖南省岳阳市中医医院,湖南岳阳414000

出　　处：《中国中医急症》2022年第7期1177-1180,1192,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家重点研发计划课题(2018YFC1707806);湖南省自然科学基金面上项目(2019JJ40217);湖南省临床医疗技术创新引导项目(2020SK52801);第二轮湖南省高层次卫生人才“225”工程培养对象(湘卫函[2019]196号)。

摘　　要：目的评价从脾胃论治电针结合推拿治疗膝关节骨性关节炎(KOA)的临床疗效。方法将750例膝关节骨性关节炎患者随机分为电针组(250例,脱落27例)、推拿组(250例,脱落25例)和联合组(250例,脱落22例)。电针组患者接受电针治疗,推拿组患者接受推拿治疗,联合组患者接受电针结合推拿治疗。各组均连续治疗10 d,并在治疗结束后10 d进行随访。各组患者在治疗前、治疗后和随访时采用疼痛视觉模拟量表(VAS)评价疼痛程度,在治疗前后采用安大略西部麦克马斯特大学骨关节炎指数(W0MAC)评价患侧膝关节的关节功能,采用膝关节屈曲及伸直时的活动范围评价患侧膝关节的关节活动度,并评定各组的临床疗效。结果联合组的总有效率为87.89%(196/223),优于电针组80.89%(182/225,P<0.05)和推拿组的80.26%(183/228,P<0.05)。各组患者治疗后和随访时VAS评分均较治疗前降低(PV0.05),治疗后W0MAC总评分较治疗前降低(P<0.05),关节活动度较治疗前增大(P<0.05)。结论从脾胃论治的电针疗法与推拿疗法均可有效缓解K0A患者疼痛、僵硬和活动障碍,改善膝关节功能,且两者合用疗效更好。Objective:To evaluate the clinical efficacy of electroacupuncture combined with Tuina in the treatment of knee osteoarthritis(KOA)from spleen and stomach theory. Methods:A total of 750 patients with KOA were randomly divided into the electroacupuncture group(250 cases,27 cases dropped off),Tuina group(250cases,25 cases dropped off) and combined group(250 cases,22 cases dropped off). The electroacupuncture group received electroacupuncture,the Tuina group received Tuina,and the combined group received electroacupuncture combined with Tuina. All three groups were treated continuously for 10 days and were followed for 10days after treatment. The pain visual analogue scale(VAS)was used to evaluate the pain degree of the patients in the three groups before treatment,after treatment and during follow-up. The knee joint function of the affected knee joint was evaluated by the Western Ontario McMaster University Osteoarthritis Index(WOMAC)before and after treatment. The range of motion of the affected knee joint was evaluated by the range of motion during flexion and extension of the knee joint before and after treatment,and the clinical efficacy of the three groups was evaluated. Results:The total effective rate of the combined group was 87.89%(196/223),which was better than that of80.89% of the electroacupuncture group(182/225,P < 0.05)and 80.26% of the Tuina group(183/228,P < 0.05).The VAS scores of the three groups after treatment and during follow-up were lower than those before treatment(P < 0.05),the total WOMAC score after treatment was lower than that before treatment(P < 0.05),and the range of motion of joints was higher than that before treatment(P < 0.05). Conclusion:Both electroacupuncture therapyand Tuina therapy based on spleen and stomach can effectively relieve pain,stiffness and movement disorder in pa-tients with KOA,improve knee joint function,and the combination of the two is more effective,which is worthy tobe widely used in clinical treatment.

关 键 词：膝关节骨性关节炎 脾胃理论 电针 推拿 

分 类 号：R684.3[医药卫生—骨科学]