针刺联合燎灸治疗初次全膝关节置换术后瘢痕增生临床研究  

Clinical Study on Acupuncture Combined with Liao Moxibustion on Scar Hyperplasia after Primary Total Knee Arthroplasty

作　　者：曾宪中 赵金龙[1] 魏锦强 李泽晖 徐逸生[2] 曹学伟[2] ZENG Xianzhong;ZHAO Jinlong;WEI Jinqiang;LI Zehui;XU Yisheng;CAO Xuewei(The Second School of Clinical Medical Sciences,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Guangdong Province Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广东省中医院,广东广州510120

出　　处：《中国中医药信息杂志》2022年第9期117-121,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：广东省中医院与香港中文大学医学院生物医学学院基础临床协同创新计划项目(YN2018HK04);广东省中医药局中医药人才培养项目(0103030908)。

摘　　要：目的观察西医常规治疗基础上,针刺联合燎灸治疗初次全膝关节置换术后瘢痕增生的早期疗效。方法采用随机数字表法将60例患者分为治疗组与对照组各30例。2组均予常规术后消炎镇痛、预防血栓、功能锻炼等治疗,治疗组在对照组基础上予针刺联合燎灸,1周1次。2组均连续治疗4周,随访12周。观察2组临床疗效,比较2组治疗前,治疗2、4周及随访时温哥华瘢痕评分、静息与活动疼痛视觉模拟量表(VAS)评分、膝关节西安大略和麦克马斯特大学骨关节炎指数量表(WOMAC)评分、膝关节关节活动度(ROM),观察2组不良反应。结果与本组治疗前比较,2组治疗2、4周及随访时温哥华瘢痕评分、静息VAS评分、活动VAS评分、WOMAC评分及膝关节ROM均有所改善(P<0.05);治疗组治疗2、4周及随访时温哥华瘢痕评分明显低于对照组(P<0.001);治疗组治疗4周及随访时静息VAS评分、活动VAS评分、WOMAC评分明显低于对照组(P<0.001);2组治疗2、4周及随访时膝关节ROM比较差异无统计学意义(P>0.05)。2组均未见明显不良反应。结论在西医常规治疗基础上,针刺联合燎灸可明显改善初次全膝关节置换术后早期的瘢痕增生状态,缓解全膝关节置换术后疼痛,安全性较好。Objective To observe the early efficacy of acupuncture combined with Liao Moxibustion in the treatment of scar hyperplasia after primary total knee arthroplasty on the basis of conventional Western medicine.Methods Totally 60 patients were divided into treatment group and control group according to random number table method,with 30 cases in each group.Both groups were given routine postoperative anti-inflammatory analgesia,thrombosis prevention,functional exercise and other treatments,and the treatment group was treated with acupuncture combined with Liao Moxibustion on the basis of routine treatment in the control group once a week.Both group were treated for 4 weeks and followed up for 12 weeks.The clinical efficacy of the two groups was observed.The Vancouver Scar score,resting and active VAS score,knee WOMAC score,knee range of motion(ROM)of the two groups before treatment,2 and 4 weeks of treatment and follow-up were compared.The adverse reactions of both groups were observed.Results Compared with before treatment,Vancouver Scar score,resting VAS score,activity VAS score,WOMAC score and knee ROM at 2 and 4 weeks of treatment and follow-up in the two groups were improved(P<0.05).The Vancouver Scar score of the treatment group was significantly lower than the control group after 2 and 4 weeks of treatment and follow-up(P<0.001).After 4 weeks of treatment and follow-up,the scores of resting VAS,active VAS and WOMAC in the treatment group were significantly lower than those in the control group(P<0.001).There was no significant difference in knee ROM between the two groups at 2 and 4 weeks of treatment and follow-up(P>0.05).There were no significant adverse reactions in both groups.Conclusion Acupuncture combined with Liao Moxibustion on the basis of conventional Western medicine can significantly improve the early scar hyperplasia after primary total knee arthroplasty,alleviate the pain after total knee arthroplasty,with good safety.

关 键 词：针刺 燎灸 全膝关节置换术 瘢痕增生 临床研究 

分 类 号：R274.9[医药卫生—中西医结合]