“以痛为腧”理论指导下关节镜治疗膝骨关节炎临床对照研究  

Clinical Comparative Study on the Treatment of Knee Osteoarthritis by Arthroscopy Based on the Theory of‘Tender-Point is Taken as the Acupoint'

作　　者：赵继阳 李泰贤 许根荣 李晓亮 董士宇 白晶 赵万宁 郭盛君 陈黎明 ZHAO Jiyang;LI Taixian;XU Genrong;LI Xiaoliang;DONG Shiyu;BAI Jing;ZHAO Wanning;GUO Shengjun;CHEN Liming(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院创伤关节科,北京100029

出　　处：《中国中医骨伤科杂志》2023年第9期32-35,44,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：北京中医药大学重点攻关项目(2020-JYB-ZDGG-142-2);北京中医药大学青年教师项目(2019-JYB-JS-160);中国博士后科学基金项目(2019M660954)。

摘　　要：目的:探讨“以痛为腧”理论在明确膝骨关节炎疼痛原因及提高关节镜临床疗效中的应用价值。方法:选取2021年1月至2022年6月因膝骨关节炎行膝关节镜手术患者共60例,将患者随机分为观察组和对照组,每组各30例。观察组术前于体表标记关节周围痛点,术中仔细探查痛点相应部位病变情况并进行处理,对照组进行常规关节镜下探查清理术,观察两组患者术前、术后1周、1个月、3个月、6个月随访时疼痛视觉模拟量表(VAS)评分、Lysholm评分、并发症发生率及中医疗效评价方面的差异。结果:至末次随访两组患者在中医疗效评价及术后并发症发生率方面差异无统计学意义(P>0.05);两组患者术后1周VAS评分及Lysholm评分差异无统计学意义(P>0.05),术后1个月、3个月、6个月观察组VAS评分明显低于对照组,Lysholm评分观察组明显优于对照组,差异有统计学意义(P<0.05)。结论:“以痛为腧”理论指导下关节镜治疗膝骨关节炎可进一步明确疼痛原因,并可显著提高临床疗效,值得临床借鉴和推广。Objective:To explore the application value of the theory of‘tender-point is taken as the acupoint'in clarifying the causes of pain in knee osteoarthritis and improving the clinical efficacy of knee arthroscopy.Methods:A total of 60 patients with knee osteoarthritis who underwent knee arthroscopic surgery from January 2021 to June 2022 were randomly divided into observation group and control group,with 30 cases in each group.The observation group was marked on the body surface before operation,and the lesions in the corresponding parts of the pain points were carefully explored and treated during the operation.The control group underwent routine arthroscopic exploration and cleaning.The visual analogue scale(VAS)score,Lysholm score,complication rate and traditional Chinese medicine curative efficacy evaluation of the two groups were observed before and after treatment.Results:There was no significant difference between the two groups in the evaluation of Traditional Chinese Medicine curative efficacy evaluation and the incidence of postoperative complications at the last follow-up(P>0.05).There was no significant difference in VAS score and Lysholm score between the two groups at 1 week after operation(P>0.05).The VAS score of the observation group was significantly lower than that of the control group,and the Lysholm score of the observation group was significantly better than that of the control group at 1 month,3 months and 6 months after operation(P<0.05).Conclusion:Arthroscopic treatment of knee osteoarthritis guided by the theory of‘tender-point is taken as the acupoint'can further clarify the causes of pain and significantly improve the clinical efficacy,which is worthy of clinical reference and promotion.

关 键 词：以痛为腧 关节镜 膝骨关节炎 疼痛原因 

分 类 号：R684.3[医药卫生—骨科学]