针刺治疗全膝关节置换术后手术切口周围皮肤麻木临床研究  

Clinical Study on Acupuncture for Skin Numbness Around Surgical Incision After Total Knee Arthroplasty

作　　者：高明[1] 龚建文[1] 肖俊强 陈博鉴 梁超伦 黄永明[2] 刘文渤 GAO Ming;GONG Jianwen;XIAO Junqiang;CHEN Bojian;LIANG Chaolun;HUANG Yongming;LIU Wenbo(Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510405,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine,Guangzhou Guangdong 510120,China;Shenzhen Pingle Orthopedic Hospital,Shenzhen Guangdong 518010,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第二附属医院/广东省中医院,广东广州510120 [3]深圳市平乐骨伤科医院,广东深圳518010

出　　处：《新中医》2024年第16期95-100,共6页New Chinese Medicine

基　　金：广东省自然科学基金项目(2018A030313643)。

摘　　要：目的:观察针刺治疗全膝关节置换术(TKA)术后手术切口周围皮肤麻木的临床疗效。方法:选取70例TKA术后2周首次复诊时出现手术切口周围皮肤麻木的患者,采用随机数字表法分为对照组和针刺组各35例(70膝)。研究期间,2组各剔除3例,最终纳入研究各32例(64膝)。对照组采用甲钴胺片治疗,针刺组在甲钴胺片基础上给予针刺治疗。比较2组皮肤麻木面积、膝关节活动度(ROM)、纽约特种外科医院(HSS)膝关节评分及满意度评分。结果:组别与时间的交互作用对皮肤麻木面积的影响有统计学意义(P<0.05)。组别与时间的交互作用对膝关节ROM、HSS膝关节评分的影响均无统计学意义(P>0.05)。时间因素对2组皮肤麻木面积、膝关节ROM及HSS膝关节评分的单独效应均有统计学意义(P<0.05)。治疗1个月,2组皮肤麻木面积均较治疗前缩小,膝关节ROM均较治疗前增加,HSS膝关节评分均较治疗前升高,差异均有统计学意义(P<0.05)。治疗2个月,2组皮肤麻木面积均较治疗1个月缩小,膝关节ROM均较治疗1个月增加,HSS膝关节评分均较治疗1个月升高,差异均有统计学意义(P<0.05)。随访6个月,2组皮肤麻木面积均较治疗2个月缩小,膝关节ROM均较治疗2个月增加,HSS膝关节评分均较治疗2个月升高,差异均有统计学意义(P<0.05)。组别因素对皮肤麻木面积的单独效应有统计学意义(P<0.05)。治疗2个月、随访6个月,针刺组皮肤麻木面积均小于同期对照组,差异均有统计学意义(P<0.05)。组别因素对膝关节ROM、HSS膝关节评分的单独效应均无统计学意义(P>0.05)。随访6个月,针刺组满意度评分高于对照组,差异有统计学意义(P<0.05)。结论:针刺可缓解TKA术后患者手术切口周围皮肤麻木,提高其满意度,但无法促进膝关节功能恢复。Objective:To observe the clinical effect of acupuncture on skin numbness around surgical incision after total knee arthroplasty(TKA).Methods:A total of 70 cases of patients who experienced numbness around the surgical incision during their first follow-up visit two weeks after undergoing TKA were selected and divided into the control group and the acupuncture group according to the random number table method,with 35 cases of patients(70 knees)in each group.During the study period,three cases were excluded from each group,and 32 cases(64 knees)were included in the study.The control group was treated with Mecobalamin Tablets,and the acupuncture group was additionally treated with acupuncture on the basis of Mecobalamin Tablets.The skin numbness area,the range of motion(ROM)of knee joint,and the knee joint scores of the Hospital for Special Surgery(HSS)and satisfaction scores were compared between the two groups.Results:The interaction between group and time had significant effects on the skin numbness area(P<0.05).The interaction of group and time had no statistically significant effects on ROM of knee joint and HSS knee joint scores(P>0.05).The time factor had significant effects on the skin numbness area,ROM of knee joint and HSS knee joint scores in the two groups(P<0.05).After one month of treatment,both groups showed a decrease in the skin numbness area and an increase in ROM of knee joint and HSS knee joint scores when compared with those before treatment,differences being significant(P<0.05).After two months of treatment,both groups showed a decrease in the skin numbness area and an increase in ROM of knee joint and HSS knee joint scores when compared with those after one month of treatment,differences being significant(P<0.05).After six months of follow-up,both groups showed a decrease in the skin numbness area and an increase in ROM of knee joint and HSS knee joint scores when compared with those after two months of treatment,differences being significant(P<0.05).The individual effect of the group factor o

关 键 词：全膝关节置换术后 手术切口周围皮肤麻木 针刺 满意度 膝关节功能 

分 类 号：R246.2[医药卫生—针灸推拿学]