热敏灸联合关节腔注射玻璃酸钠治疗膝骨关节炎(寒湿痹阻型)的临床研究  

Clinical study on heat-sensitive moxibustion combined with intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis(cold-dampness blockade type)

作　　者：雷宗恒 蒋洪达 张天宇 肖少刚 杨志坚 LEI Zongheng;JIANG Hongda;ZHANG Tianyu;XIAO Shaogang;YANG Zhijian(Department of Orthopedics and Traumatology,Xianning Hospital of Traditional Chinese Medicine,Hubei,Xianning 437100,China)

机构地区：[1]湖北省咸宁市中医医院骨伤科,湖北咸宁437100

出　　处：《中国医药科学》2025年第3期131-135,共5页China Medicine And Pharmacy

基　　金：湖北省中医药管理局中医药重点项目(ZY2023F107)。

摘　　要：目的 研究热敏灸联合关节腔注射玻璃酸钠治疗轻中度膝骨关节炎(寒湿痹阻型)症状、延缓关节退变的疗效及安全性。方法 选取2023年2—12月在咸宁市中医医院骨伤科就诊的90例膝骨关节炎患者,按照随机数表法分为试验组和对照组,每组各45例。对照组予关节腔注射玻璃酸钠治疗,试验组增加热敏灸治疗。比较两组治疗前后及随访3、6个月后,在疼痛视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、骨性关节炎症状奎森功能演算指数(Lequesne指数)、中医证候积分、疗效及安全性方面的差异。结果 试验组总有效率为93.02%,对照组为77.27%,差异有统计学意义(P <0.05),试验组愈显率为37.21%,对照组为27.27%,差异无统计学意义(P> 0.05)。治疗结束,两组患者的各项评分均显著低于治疗前(P <0.01),试验组优于对照组,差异有统计学意义(P <0.05)。随访3个月,试验组各项评分优于对照组(P <0.05)。随访6个月,两组在VAS、WOMAC、Lequesne指数评分差异无统计学意义(P> 0.05),但中医证候积分差异有统计学意义(P <0.05)。试验组热敏穴位频次最高为犊鼻、内膝眼、膝下穴。热敏灸治疗皮肤刺激强度平均积分为0.37分,整体评价为“无刺激”。结论 热敏灸联合关节腔注射玻璃酸钠可有效改善膝骨关节炎患者疼痛、关节功能和中医症状,提高生活质量,且安全性良好。Objective To investigate the efficacy and safety of heat-sensitive moxibustion combined with intra-articular injection of sodium hyaluronate in treating mild to moderate knee osteoarthritis(cold-dampness blockade type)symptoms and delaying joint degener ation.Methods A total of 90 patients with knee os teoarthritis treated at the Department of Orthopedics and Traumatology of Xianning Hospital of Traditional Chinese Medicine from February to December 2023 were selected.They were divided into the test group and the control group using the randomized numerical table method,with 45 patients in each group.The control group received intraarticular injection of sodium hyaluronate,and the test group received additional heat-sensitive moxibustion treatment.Differences in the pain visual analogue scale(VAS)score,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lequesne index for osteoarthritis symptoms,classification quantitation score of Traditional Chinese Medicine syndrome,efficacy,and safety were compared between the two groups before and after treatment and after 3 and 6 months of follow-up.Results The total effective rate was 93.02%in the test group compared with 77.27%in the control group,with a statistically significant difference(P<0.05).The good improvement rate was 37.21%in the test group compared with 27.27%in the control group,with no statistically significant difference(P>0.05).At the end of treatment,all scores of patients in both groups were significantly lower than pre-treatment levels(P<0.01),and the test group was better than the control group,with statistically significant differences(P<0.05).At 3 months of follow-up,improvements in all scores were greater in the test group than those in the control group (P < 0.05). At 6 months of follow-up, there was no significant difference between the two groups in VAS, WOMAC, and Lequesne index scores (P > 0.05), but there was a statistically significant difference in the Traditional Chinese Medicine syndrome score (P < 0.05). The most frequen

关 键 词：热敏灸 膝骨关节炎 关节腔注射 玻璃酸钠 热敏穴位 

分 类 号：R684.3[医药卫生—骨科学]