改良膝关节封闭疗法联合针灸治疗膝骨性关节炎合并退行性腰椎病变临床研究  

Application of modified knee block therapy combined with acupuncture in treatment of knee osteoarthritis and degenerative lumbar lesions

作　　者：马朋朋[1] 苏峰[1] 宗治国[1] 刘肃[1] 张鑫[1] 李伟[1] 张春林[1] 张志敏[1] 蔡明 MA Peng-peng;SU Feng;ZONG Zhi-guo;LIU Su;ZHANG Xin;LI Wei;ZHANG Chun-lin;ZHANG Zhi-min;CAI Ming(Department of Orthopedics,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000)

机构地区：[1]河北北方学院附属第一医院骨外科,河北张家口075000

出　　处：《湖北中医药大学学报》2022年第3期91-94,共4页Journal of Hubei University of Chinese Medicine

基　　金：河北省卫健委青年科技项目(项目编号:201909);河北省张家口市市级科技计划自筹经费项目(项目编号:2021061D)。

摘　　要：目的观察改良的膝关节封闭疗法联合针灸治疗膝骨性关节炎合并退行性腰椎病变临床疗效。方法将我院治疗的膝骨性关节炎合并退行性腰椎病变患者90例采用随机数字表为对照组(改良膝关节封闭疗法治疗)与联合组(改良膝关节封闭疗法联合针灸治疗)各45例。比较两组临床疗效及治疗前后中医证候积分;比较两组治疗前后疼痛数字评分法(NRS)、膝关节功能评分量表(Lysholm)评分、国际骨关节炎评分(Lequesne)及膝关节液炎症因子肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)、白介素1(IL-1)水平。结果治疗后,联合组治疗总有效率高于对照组(P<0.05);联合组中医证候积分及NRS评分低于对照组,Lysholm评分高于对照组(P<0.05);联合组TNF-α、IL-6、IL-1水平低于对照组(P<0.05);联合组膝关节活动度大于对照组,疼痛、行走距离、活动能力评分低于对照组(P<0.05)。结论应用改良膝关节封闭疗法联合针灸治疗膝骨性关节炎合并退行性腰椎病变有效率高,可缓解患者临床症状,改善膝关节功能,减轻炎症反应,且安全性高。Objective To observe the application value of modified knee block therapy combined with acupuncture in patients with knee osteoarthritis(KOA)and degenerative lumbar lesions.Methods Ninety patients with KOA and degenerative lumbar lesions were randomly divided into control group(modified knee block therapy)and combination group(modified knee block therapy combined with acupuncture),45 cases in each group.The curative effect,scores of TCM syndromes and numerical rating scale(NRS),Lysholm knee score(Lysholm)and score of International Osteoarthritis(Lequesne),and levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1]in knee joint fluid before and after treatment were compared between the two groups.Results After treatment,the total response rate in combination group was higher than that in control group(P<0.05);TCM syndromes and NRS scores in combination group were lower than those in control group,while Lysholm score was higher than that in control group(P<0.05);levels of TNF-α,IL-6 and IL-1 in joint fluid in combination group were lower than those in control group(P<0.05);the knee range of motion in combination group was greater than that in control group;scores of pain,walking distance and activity ability in combination group were lower than those in control group(P<0.05).Conclusion The response rate of modified knee block therapy combined with acupuncture is high in treatment of KOA combined with degenerative lumbar lesions,which can relieve clinical symptoms,improve knee function,and reduce in flammation response of patients with high safety.

关 键 词：膝骨性关节炎 改良膝关节封闭疗法 针灸 退行性腰椎病变 关节功能 

分 类 号：R274.9[医药卫生—中西医结合]