针刺神经治疗类风湿性膝关节炎疼痛的效果评估及机制探讨  

Evaluation of the Effect of Acupuncture Nerve in the Treatment of Rheumatoid Knee Osteoarthritis Pain and Discus⁃sion of the Mechanism

作　　者：王立红 姜长林[2] WANG Li-Hong;JIANG Chang-Lin(Jiamusi University,Jiamusi,Heilongjiang,154007,China)

机构地区：[1]佳木斯大学,黑龙江佳木斯154007 [2]大庆油田总医院疼痛科,黑龙江大庆163316

出　　处：《黑龙江医学》2023年第7期795-797,共3页Heilongjiang Medical Journal

摘　　要：目的:观察针刺松解副神经、隐神经、胫后神经治疗类风湿性关节炎所致膝关节疼痛的临床疗效,为推广其应用提供客观依据。方法:选取2020年9月—2021年9月大庆油田总医院中医科及风湿免疫科收治的60例患者作为研究对象,随机分为观察组和对照组,每组各30例。观察组和对照组均常规治疗类风湿性关节炎。观察组在治疗基础上针灸针松解双侧副神经、隐神经、胫后神经镇痛治疗。采用数字分级法(NRS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较两组治疗效果。结果:治疗前,两组患者NRS、SAS、SDS评分比较,差异无统计学意义(P>0.05)。治疗2个疗程后,观察组患者NRS评分较对照组明显改善,且口服非甾体抗炎药总剂量低于对照组,差异有统计学意义(P<0.05)。观察组和对照组的SAS、SDS评分均较治疗前下降,观察组SDS改善明显,差异有统计学意义(P<0.05)。结论:针刺松解副神经、隐神经及胫后神经可有效减轻类风湿性膝关节炎引起的疼痛,降低口服镇痛药剂量,提高患者生活质量。Objective:To observe the clinical efficacy of acupuncture to release the paramedian nerve,saphenous nerve and posterior tibial nerve in the treatment of knee pain caused by rheumatoid arthritis,and to provide an objective basis for promoting their application.Methods:60 patients hospitalized in the hospital from September 2020 to September 2021 were selected for the study and randomly divided into observation and control groups,with 30 cases each.Both the observation and control groups were routinely treated for rheumatoid arthritis.The observation group was treated with acupuncture needles to release the bilateral para⁃median,saphenous and posterior tibial nerves for analgesia.The numerical rating scale(NRS),anxiety self-rating scale(SAS)and depression self-rating scale(SDS)scores were used to compare the treatment effects of the two groups.Results:Before treatment,there was no statistically significant difference in NRS,SAS,and SDS scores between the two groups(P>0.05).After 2 courses of treatment,the NRS scores of patients in the observation group improved significantly compared with the control group,and the total dose of oral NSAIDs was lower than that of the control group,with statistically significant differences(P<0.05).The SAS and SDS scores of both the observation and control groups decreased compared with those before treatment,and the SDS of the observation group improved significantly,with statistically significant differences(P<0.05).Conclusion:Acupuncture to release the paramedian nerve,saphenous nerve and posterior tibial nerve can effectively reduce the pain caused by rheumatoid knee osteoarthritis,lower the dose of oral analgesics and improve the quality of life of patients.

关 键 词：针刺 副神经 隐神经 胫后神经 类风湿性膝关节炎 

分 类 号：R245.3[医药卫生—针灸推拿学]