肌骨超声引导下针刀治疗膝关节内侧副韧带损伤的临床研究  

Efficacy of Musculoskeletal Ultrasound-guided Acupotomy in the Treatment of Medial Collateral Liga⁃ment Injury of the Knee Joint

作　　者：王大刚 易文博 蔡飞 田国杰 万飞[2] Wang Dagang;Yi Wenbo;Cai Fei;Tian Guojie;Wan Fei(Chongqing Qijiang District Hospital of Traditional Chinese Medicine,Chongqing 401420,China.)

机构地区：[1]重庆市綦江区中医院,重庆401420 [2]重庆医药高等专科学校,川渝共建中西医结合治疗脊柱相关疾病重点实验室,重庆401331

出　　处：《中国中医急症》2023年第10期1744-1747,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市中医药重点学科(针灸推拿学)建设项目;重庆市科卫联合中医药技术创新与应用发展项目(2020ZY024106);重庆市教委2022年度科技计划青年项目;重庆医药高等专科学校川渝共建中西医结合治疗脊柱相关疾病重点实验室(ygz2021501)。

摘　　要：目的 观察肌骨超声引导下针刀治疗膝关节内侧副韧带损伤的临床疗效。方法 选取膝关节内侧副韧带损伤患者87例,按随机数字表法分为试验组与对照组。试验组采用在肌骨超声引导下行小针刀治疗,对照组采用传统针刀治疗。两组受试者治疗1次,分别于治疗2周、4周后对膝关节功能量表(Lysholm)评分、滑膜厚度、炎症指标[血清白细胞介素-1(IL-1)]、周径、中医证候评分(晨僵、下肢浮肿、夜间痛等)、整体疗效进行评价。结果 两组在治疗2周和4周后Lysholm量表评分均较治疗前提高(P <0.01),且试验组较对照组提升幅度更大(P <0.05);膝关节周径方面,两组在治疗2周和4周后均较前治疗前缩短(P <0.05),且试验组较对照组周径缩短更明显(P <0.05);治疗4周后,两组IL-1水平、滑膜厚度均较前下降(P <0.05),且试验组下降幅度较对照组更大(P <0.05);治疗4周后试验组晨僵、下肢浮肿、夜间痛等评分均低于对照组(P <0.05);试验组治疗2周、4周后总有效率分别为93.33%、95.56%,均高于对照组的71.43%、73.81%(P <0.05)。结论 肌骨超声引导下针刀与传统针刀治疗均可在短期和中长期内降低患者膝关节肿胀、滑膜厚度、炎症指标,改善膝关节内侧副韧带损伤患者的临床症状,但肌骨超声引导下针刀疗效明显优于传统针刀治疗。Objective:To investigate the clinical efficacy of musculoskeletal ultrasound-guided acupotomy in the treatment of medial collateral ligament injury of the knee joint.Methods:87 patients were selected and ran⁃domly divided into a test group and a control group according to the random number table method.The test group was treated with small acupotomy under the guidance of musculoskeletal ultrasound,and the control group was treated with the traditional acupotomy method.Both groups were treated once,and the Lysholm score,synovial thickness,inflammatory index[serum interleukin 1(IL-1)],circumferential diameter,TCM symptom score(morn⁃ing stiffness,lower limb swelling,nocturnal pain,etc.),and overall efficacy were evaluated after 2 and 4 weeks of treatment,respectively.Results:The Lysholm scale scores improved in both groups after 2 and 4 weeks of treat⁃ment compared with those before treatment(P<0.01),and the improvement was greater in the test group compared with the control group(P<0.05);the circumferential diameter of the knee joint shortened in both groups after 2 and 4 weeks of treatment compared with that before treatment(P<0.05),and the circumferential diameter short⁃ened more significantly in the test group compared with the control group(P<0.05);after 4 weeks of treatment,the IL-1 and synovial thickness were reduced in both groups compared with before treatment(P<0.05),and the reduction was greater in the test group compared with the control group(P<0.05);after 4 weeks of treatment,the scores of morning stiffness,lower limb swelling and nocturnal pain in the test group were lower than those in the control group(P<0.05);in terms of overall efficacy,after 2 weeks of treatment,the total effective rate was 93.33%in the test group and 71.43%in the control group,and after 4 weeks of treatment,the total effective rate was 95.56%in the test group and 73.81%in the control group(P<0.05).Conclusion:Both musculoskeletal ultra⁃sound-guided acupotomy and traditional acupotomy can reduce the swelling,synovial thi

关 键 词：膝关节内侧副韧带损伤 肌骨超声 针刀治疗 

分 类 号：R684.7[医药卫生—骨科学]