针刀联合富血小板血浆注射疗法治疗膝关节骨性关节炎的临床疗效研究  

Therapeutic Effect of Acupotomy Combined with Platelet-Rich Plasma on Knee Osteoarthritis

作　　者：晋帅锋 乔晋琳[2] 丁宇[3] 付本升 刘倩[2] 焦浩洋 钟毓贤[2] JIN Shuaifeng;QIAO Jinlin;DING Yu;FU Bensheng;LIU Qian;JIAO Haoyang;ZHONG Yuxian(Department of Pain Treatment,Yuho Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100143,China;TCM Department of Rehabilitation,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China;TCM Department of Orthopedics,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]北京裕和中西医结合康复医院疼痛科,北京100143 [2]解放军总医院第六医学中心中医医学部康复医学科,北京100048 [3]解放军总医院第六医学中心中医医学部骨伤科,北京100048

出　　处：《世界中医药》2022年第15期2203-2206,共4页World Chinese Medicine

基　　金：军队中医药服务能力培育与提升重点课题(2021ZY006);军事训练伤防治专项课题(21XLS35);中国人民解放军总医院第六医学中心创新培育基金项目(CXPY202013)。

摘　　要：目的:观察针刀联合富血小板血浆(PRP)注射疗法治疗膝关节骨性关节炎(KOA)的临床疗效,并评估其对患者步行过程中膝关节活动度的影响。方法:选取2020年6月至2021年12月解放军总医院第六医学中心收治KOA患者65例作为研究对象,采用部分随机对照方式将患者分为对照组(n=33)和观察组(n=32)。对照组患者采用常规的膝关节腔内注射玻璃酸钠注射液和膝关节周围痛点封闭治疗,观察组患者采用针刀松解膝关节周围痛点,后给予膝关节腔内注射PRP及膝关节周围痛点注射PRP治疗,分别记录观察组和对照组2组患者在治疗前、治疗后1个月和3个月的疼痛视觉模拟评分法(VAS)、国际膝关节功能评定Lequesne指数和步行过程中患侧膝关节屈曲角度变化。结果:治疗后1个月和3个月,观察组和对照组的VAS评分、Lequesne指数均显著低于治疗前(均P<0.01),观察组的VAS评分分别低于对照组(P<0.05,P<0.01),观察组的Lequesne评分同样均显著低于对照组(均P<0.01)。治疗后3个月,观察组在步行过程中的患侧膝关节最大屈曲角度(ROMmax)大于对照组(P<0.01),步行过程中患侧膝关节最小屈曲角度(ROMmin)小于对照组(P<0.01)。结论:针刀联合PRP注射疗法可以有效缓解KOA疼痛症状,改善膝关节功能,并且能够积极影响步行过程中的膝关节活动度变化。Objective:To study the therapeutic effect and dynamic range of motion(ROM)of knee of acupotomy combined with platelet-rich plasma(PRP)on knee osteoarthritis(KOA).Methods:Sixty-five patients with KOA treated in the Sixth Medical Center of PLA General Hospital were assigned into an observation group(n=32)and a control group(n=33)in a partially randomized manner.The patients in the control group received intra-articular injection of sodium hyaluronate and local blocking and those in the observation group received acupotomy combined with intra-articular injection of PRP and pain point injection of PRP.The visual analogue scale(VAS)score,Lequesne score,and dynamic ROM of knee were recorded before treatment and after 1 and 3 months of treatment.Results:The VAS and Lequesne scores declined after treatment compared with those before treatment(P<0.01)and were lower in the observation group than in the control group after treatment(P<0.05 or P<0.01).The observation group had higher maximum dynamic ROM of affected knee and lower minimum dynamic ROM of affected knee than the control group after 3 months of treatment(P<0.01).Conclusion:Acupotomy combined with PRP injection can relieve the pain and improve the function of knee,positively affect the dynamic ROM of knee during walking,and eventually improve daily activities of the patients with KOA.

关 键 词：膝关节骨性关节炎 针刀 富血小板血浆 步态 疗效分析 关节活动度 注射疗法 临床研究 

分 类 号：R245.31[医药卫生—针灸推拿学] R274.32[医药卫生—中医临床基础]