针刀结合髌骨内推及股四头肌锻炼治疗髌股关节炎的疗效  

Therapeutic effect of acupotomy combined with internal patellar push and quadriceps muscle exercise on patellofemoral arthritis

作　　者：李垂青[1] 徐哲 韩冰[1] 姜大帅 冯学涛[1] LI Chuiqing;XU Zhe;HAN Bing;JIANG Dashuai;FENG Xuetao

机构地区：[1]潍坊市中医院东院区,山东潍坊261000

出　　处：《中医临床研究》2023年第24期102-108,共7页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技项目(2020M142)。

摘　　要：目的:观察针刀松解髌骨外侧支持带结合髌骨内推及股四头肌锻炼对老年髌股关节炎患者膝关节功能及临床症状的影响。方法:选取2020年11月―2021年12月符合要求的100例老年髌股关节炎患者,随机分为治疗组与对照组,每组50例。治疗组行松解髌骨外侧支持带、髌骨内推结合股四头肌锻炼治疗,入组男15例,女35例,年龄52~84岁,平均(67.16±9.58)岁;病程0.1~48个月,平均(11.14±11.48)个月。对照组对比治疗组减少针刀松解治疗,其余治疗方案与治疗组一致,入组男11例,女39例;年龄50~83岁,平均(69.32±8.78)岁;病程0.3~42个月,平均(9.73±10.26)个月。采用视觉模拟评分法(Visual Analogue Scale,VAS)评分及髌股关节Kujala评分法及改良Lysholm评分进行疗效评定。结果:两组均于治疗结束后0.5个月及1个月进行随访,治疗结束后0.5个月治疗组VAS评分由(5.30±1.59)分降至(3.94±2.32)分,髌股关节Kujala评分由(50.76±10.88)分提高至(67.42±8.99)分;对照组VAS评分由(5.54±1.75)分降至(4.84±1.67)分,髌股关节Kujala评分由(51.20±11.01)分提高至(56.20±9.89)分;两组治疗前后比较,差异均有统计学意义(P<0.05)。两组间相比,治疗组经治疗后关节功能及疼痛情况明显优于对照组,差异存在统计学意义(P<0.05)。治疗后1个月随访,进行改良Lysholm评分,治疗组改良Lysholm评分(85.76±11.67)分明显高于对照组的改良Lysholm评分(74.36±17.45)分,治疗组优良率明显高于对照组,差异均有统计学意义(P<0.05)。结论:针刀松解髌骨外侧支持带结合髌骨内推和股四头肌功能锻炼能够显著改善老年髌股关节炎患者的临床症状和关节功能。Objective:To observe the effect of acupotomy releasing the lateral retinaculum of the patella combined with patellar internal push and quadriceps muscle exercise on knee function and clinical symptoms in elderly patients with patellofemoral arthritis.Methods:A total of 100 elderly patients with patellofemoral arthritis who met the requirements from November 2020 to December 2021 were randomly divided into the treatment group and the control group,with 50 cases in each group.In the treatment group,15 males and 35 females,aged 52-84(67.16±9.58)years,were treated with lateral patellar support band release,patella internal push combined with quadriceps muscle exercise.The course of disease was 0.1-48(11.14±11.48)months.The control group received no needle-knife release treatment,and the remaining treatment plan was consistent with that in the treatment group.There were 11 males and 39 females in the control group,aged 50-83(69.32±8.78)years.The course of disease was 0.3-42(9.73±10.26)months.VAS score,Kujala score of patellofemoral joint and modified Lysholm score were used to evaluate the efficacy.Results:Both groups were followed up half a month and one month after the end of treatment,half month after treatment,the VAS score in the treatment group was decreased from(5.3±1.59)to(3.94±2.32),Kujala score of patellofemoral joint was increased from(50.76±10.88)to(67.42±8.99).VAS score in the control group was decreased from(5.54±1.75)to(4.84±1.67),Kujala score of patellofemoral joint was increased from(51.2±11.01)to(56.20±9.89).There were statistically significant differences between the two groups after treatment(P<0.05).Comparison was made between the two groups,the joint function and pain in the treatment group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).One month after treatment,the modified Lysholm score in the treatment group of(85.76±11.67)was significantly higher than that in the control group of(74.36±17.45),and the excellent and

关 键 词：髌股关节炎 针刀 外侧支持带松解 

分 类 号：R274[医药卫生—中医骨伤科学]