基于“筋骨并重”理论刃针结合手法治疗膝骨性关节炎临床研究  

Clinical Study on Treatment of KOA with Blade Needling Combined with Massage Manipulations Based on Theory of‘Paying Equal Attention to Sinew and Bone’

作　　者：张健[1] 章新玲 江旭[1] 陶淑娟 陈幸生[2] ZHANG Jian;ZHANG Xinling;JIANG Xu;TAO Shujuan;CHEN Xingsheng(Anhui Tongling Hospital of Traditional Chinese Medicine,Tongling 244000,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽省铜陵市中医医院,安徽铜陵244000 [2]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《针灸临床杂志》2023年第7期19-24,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：安徽省铜陵市卫生健康委科研立项项目,编号:卫科研〔2021〕15号;安徽省名中医工作室建设项目,编号:皖中发展〔2022〕5号;安徽省中医药学术流派传承工作室建设项目,编号:皖中医药发展秘〔2021〕30号。

摘　　要：目的:观察刃针结合手法治疗膝骨性关节炎(KOA)的临床疗效。方法:将60例符合研究标准的KOA患者,按照随机数字表法分为观察组和对照组。观察组运用刃针结合手法,对照组采用常规针刺。对比分析治疗前后、随访第2周3个时间节点两组VAS评分、经筋辨证各型VAS评分、WOMAC量表评分、膝关节活动度、炎症指标及临床疗效。结果:疗程结束后、随访第2周时,两组VAS评分均较治疗前明显降低,差异具有统计学意义(P<0.05),观察组均低于对照组,差异具有统计学意义(P<0.05);两组各型经筋KOA的VAS评分均较治疗前明显降低,差异具有统计学意义(P<0.05),观察组各型经筋KOA的VAS评分均低于对照组,差异具有统计学意义(P<0.05);两组疼痛、僵硬、功能及WOMAC总积分均明显降低,差异具有统计学意义(P<0.05),观察组各维度评分及总分均低于对照组,差异具有统计学意义(P<0.05);两组ROM均明显升高,差异具有统计学意义(P<0.05),观察组ROM均高于对照组,差异具有统计学意义(P<0.05);两组CRP及ESR值均明显降低,差异具有统计学意义(P<0.05),观察组CRP及ESR值均低于对照组,差异具有统计学意义(P<0.05);观察组临床治愈率高于对照组,差异具有统计学意义(P<0.05),观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。结论:刃针结合手法可以改善KOA患者疼痛、僵硬、功能及关节活动度,近期疗效优于常规针刺。Objective:To observe the clinical efficacy of blade needling combined with massage manipulations in treatment of knee osteoarthritis(KOA).Methods:60 KOA patients,who met the study criteria,were randomly divided into the observation group and the control group.The observation group was treated with blade needling combined with massage manipulations,whereas the control group was treated with conventional acupuncture.VAS scores,VAS scores of various types of meridian-sinew differentiation,WOMAC scale scores,knee range of motion(ROM)and inflammation indexes were compared among before the treatment,after the treatment and on 2nd week of the follow-up in the two groups.Clinical efficacy was also compared between the two groups.Results:The VAS scores were decreased after the treatment and on 2nd week of the follow-up compared with those before the treatment in the two groups(P<0.05),and the scores of the observation group were lower than those of the control group after the intervention(P<0.05).The VAS scores of all types of meridian-sinew differentiation were significantly decreased after the treatment and on 2nd week of the follow-up compared with those before the treatment in the two groups(P<0.05),and the scores were lower in the observation group than those in the control group after the intervention(P<0.05).The scores of pain,stiffness and function,as well as the total WOMAC scores were significantly decreased in both groups(P<0.05),and the scores and the total scores of all dimensions in the observation group were lower than those in the control group(P<0.05).The ROM was increased significantly in both groups after the intervention(P<0.05),which was higher in the observation group than that in the control group(P<0.05).The values of CRP and ESR were significantly decreased in both groups after the intervention(P<0.05),which were lower in the observation group than those in the control group(P<0.05).The clinical cure rate of the observation group was higher than that of the control group(P<0.05),and the total effe

关 键 词：膝骨性关节炎 筋骨并重 刃针 手法 

分 类 号：R246.2[医药卫生—针灸推拿学]