揿针耳穴联合揉膝推髌点穴法干预训练后诱发膝骨关节炎疼痛的临床研究  

Clinical study of rubbing-knee,pushing-patella and pressing-points combined with pressing needle for treatment of osteoarthritis pain induced by training

作　　者：林木南 许丽梅 薛维婳 高松 罗芳芳 查全萍 陈建梅 韩雪松 陈金水 李西海 LIN Munan;XU Limei;XUE Weihua;GAO Song;LUO Fangfang;ZHA Quanping;CHEN Jianmei;HAN Xuesong;CHEN Jinshui;LI Xihai(th Hospital of Joint Logistics Support Force,Fuzhou 350002,China;College of Integrative Chinese and Western Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院,福州350002 [2]福建中医药大学中西医结合学院,福州350122

出　　处：《中华中医药杂志》2024年第8期4488-4492,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82074461);军队中医药服务能力培育与提升专项计划面上项目(No.2021ZY035);福建省自然科学基金项目(No.2021J011258)。

摘　　要：目的:探讨揿针耳穴及揉膝推髌点穴法联合运用治疗训练后膝骨关节炎疼痛的临床疗效。方法:选取2021年11月—2023年1月于中国人民解放军联勤保障部队第九〇〇医院收治的120例膝骨关节炎患者作为研究对象,随机数表法将其分为4组,分别采用揿针耳穴联合扶他林乳胶剂外用(耳穴组)、揉膝推髌点穴法联合扶他林乳胶剂外用(手法组)、揿针耳穴联合揉膝推髌点穴法加扶他林乳胶剂外用(联合组)、外用扶他林乳胶剂(西药组),每组30例,均治疗4周。Lysholm膝关节评分标准、视觉模拟评分法(VAS)、西安大略和麦克马斯特大学(WOMAC)评分评价关节功能、状态;检测患膝关节屈曲活动度、股四头肌肌力;酶联免疫吸附法(ELISA)检测滑液白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)含量的变化。结果:治疗后,各组Lysholm评分、膝关节活动度、股四头肌肌力均较治疗前增高(P<0.01,P<0.05),且联合组高于其他3组(P<0.01,P<0.05);治疗后VAS评分、WOMAC评分均较前降低(P<0.01),联合组VAS评分低于其他3组(P<0.01,P<0.05),WOMAC评分低于耳穴组、西药组(P<0.01);各组IL-1β、TNF-α含量均较治疗前降低(P<0.01),联合组含量低于其他3组(P<0.01,P<0.05);各组疗效比较,联合组有效率高于其他3组(P<0.05)。结论:揿针耳穴联合揉膝推髌点穴法较单一疗法能进一步改善膝骨关节炎患者疼痛及其他症状,其膝关节功能、关节活动度得到提升,炎症反应减轻,该法简便有效,适宜在基层及临床推广运用。Objective: To explore the clinical efficacy of pressing needle at ear combined with rubbing-knee, pushingpatella and pressing-points(RKPPPP) in the treatment of knee osteoarthritis(KOA) pain after training. Methods: A total of 120cases with KOA pain admitted to the 900th Hospital of Joint Logistics Support Force from November 2021 to January 2023 were selected as research objects and divided into 4 groups by random number table method. They were treated with pressing needle ear(pressing needle group), RKPPPP method(manipulation group), pressing needle ear point combined with RKPPPP method(combination group), and external diclofenac diethylamine emulsion(western medicine group). All the above were treated for 4weeks. Lysholm knee scoring standard, visual analog scale(VAS) and Western Ontario and McMaster Universities(WOMAC)osteoarthritis index scale evaluated joint functional status;Knee range of motion(ROM) and quadriceps muscle strength were measured;The contents of interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) in the synovial fluid were detected by enzymed-linked immunosorbent assay(ELISA). Results: Lysholm scores, ROM and quadriceps muscle strength increased in the each group after treatment(P<0.01, P<0.05), and the combination group was higher than that of the other three groups(P<0.01, P<0.05). VAS and WOMAC scores decreased in the each group after treatment(P<0.01), VAS in the combination group was lower than that of the other three groups(P<0.01, P<0.05) and WOMAC score was lower than pressing needle group and western medicine group(P<0.01). The level of IL-1β and TNF-α decreased in the each group after treatment(P<0.01), and the combination group was lower than that of the other three groups(P<0.01, P<0.05). Comparing the efficacy of the each group, the combined group had a higher effective rate than the other three groups(P<0.05). Conclusion: Pressing needle at ear combined with RKPPPP is more beneficial than single therapy in decreasing KOA pain, improving knee function and ROM in patie

关 键 词：骨关节炎 临床试验 揿针耳穴 揉膝推髌点穴法 

分 类 号：R246.9[医药卫生—针灸推拿学]