针刺结合艾灸、中药热敷治疗膝骨关节炎寒湿痹阻证的临床疗效观察  

Acupuncture combined with moxibustion and Chinese medicine hot compress in the treatment of knee osteoarthritis of cold-damp obstruction syndrome

作　　者：李金牛 霍素坤 任振家 李佳 朱桂霞 刘媛 刘琛 张玉婷 LI Jinniu;HUO Sukun;REN Zhenjia;LI Jia;ZHU Guixia;LIU Yuan;LIU Chen;ZHANG Yuting(General Department of TCM,Beijing Zhongguancun Hospital,Beijing 100190,China;Longzeyuan Community Health Service Center,Changping District of Beijing,Beijing 102200;Beixiaguan Community Health Service Center,Haidian District of Beijing,Beijing 100081)

机构地区：[1]北京市中关村医院中医综合科,北京100190 [2]北京市昌平区龙泽园社区卫生服务中心,北京102200 [3]北京市海淀区北下关社区卫生服务中心,北京100081

出　　处：《北京中医药》2024年第6期622-626,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：2020年度首都卫生发展科研专项(基层普及项目)(首发2020-3-7042)。

摘　　要：目的 比较针刺、中药热敷、针刺结合艾灸、针刺结合中药热敷治疗寒湿痹阻证膝骨关节炎(KOA)的临床疗效。方法 选择2020年12月—2022年10月北京市中关村医院、北京市昌平区回龙观社区卫生服务中心、北京市海淀区北下关社区卫生服务中心招募的KOA患者236例,采用区组随机分组、对照、非盲法按1∶1∶1∶1比例分为针刺组、中药热敷组、针刺结合艾灸组、针刺结合中药热敷组,每组59例。每组接受相应治疗,1次/d,5次/周,10次为1个疗程,共治疗2个疗程。对比4组治疗前,第1、第2疗程结束后,治疗结束后第1、2、3个月随访时的西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟评分(VAS)、疗效、安全性。结果 4组第1、2疗程后及3次随访WOMAC评分、VAS评分均较治疗前降低(P<0.05)。第1疗程后,针刺结合中药热敷组WOMAC评分低于针刺组(P<0.05);第2疗程后及3次随访,针刺结合中药热敷组WOMAC评分均低于针刺组、中药热敷组(P<0.05)。第1疗程后,针刺结合艾灸组与针刺结合中药热敷组VAS均低于针刺组(P<0.05);第2疗程后,针刺结合中药热敷组VAS均低于针刺组、中药热敷组(P<0.05);3次随访,针刺结合艾灸组与针刺结合中药热敷组VAS均低于针刺组、中药热敷组(P<0.05)。针刺结合中药热敷组临床疗效高于针刺组、中药热敷组及针刺结合艾灸组(P<0.05)。中药热敷组有1例发生轻度过敏反应,未经处理自愈。结论 针刺、中药热敷、针刺结合艾灸、针刺结合中药热敷治疗寒湿痹阻证KOA有效,针刺与艾灸或中药热敷联合应用效果优于单一疗法,其中针刺结合中药热敷更具优势。Objective To compare the clinical efficacy of acupuncture,Chinese medicine hot compress,acunpuncture combined with moxibustion,acupuncture combined with Chinese medicine hot compress in the treatment of patients with knee osteoarthritis(KOA)of cold-damp obstruction syndrome.Methods A total of 236 patients with KOA recruited from the Beijing Zhongguancun Hospital,Longzeyuan Community Health Service Center,Changping District of Beijing,Beixiaguan Community Health Service Center,Haidian District of Beijing from December 2020 to October 2022 were divided into acupuncture group,Chinese medicine hot compress group,acupuncture combined with moxibustion group,and acupuncture combined with Chinese medicine hot compress group according to randomly grouping,control and non-blind method in the proportion of 1∶1∶1∶1 with 59 cases in each group.The intervention of each group was delivered once daily,5 times a week,and one course of treatments was 10 times,2 courses were required.The scores of WOMAC and VAS were compared among the 4 groups before treatment,after the first and second courses of treatment,and after follow-up for 1,2,and 3 months,and the clinical efficacy and safety were evaluated.Results WOMAC score and VAS score of the 4 groups at each time point after treatment were decreased compared with those before treatment(P<0.05).After the first course of treatment,WOMAC score of acupuncture combined with Chinese medicine hot compress group was lower than that of the acupuncture group(P<0.05);after the second course of treatment and the third followup visit,WOMAC score of the acupuncture combined with Chinese medicine hot compress group was lower than that of the acupuncture group and Chinese medicine hot compress group(P<0.05).After the first course of treatment,VAS score of both the acupuncture combined with moxibustion group and the acupuncture combined with Chinese medicine hot compress group were lower than that of the acupuncture group(P<0.05);after the second course of treatment,VAS score of the acupuncture

关 键 词：膝骨关节炎 寒湿痹阻证 针刺 艾灸 中药热敷 

分 类 号：R274[医药卫生—中医骨伤科学]