CO2激光灸治疗不同中医证型膝骨关节炎疗效观察

目的观察CO2激光灸对不同中医证型膝骨关节炎疗效。方法将88例膝骨关节炎患者根据中医辨证分为肾虚髓亏(A组28例)、阳虚寒凝(B组34例)、瘀滞筋骨(C组26例)3组,以10.6 m CO2激光照射犊鼻穴治疗。采用WOMAC VA3.1问卷,进行疗效评价。结果除A组治疗2星期、4星期时疼痛得分及2星期时僵硬得分外,治疗后3组WOMAC量表各项得分均较治疗前显著改善(P<0.05)。治疗后B组除2星期时疼痛得分外,WOMAC量表各项得分均显著优于A组(P<0.05),其治疗2星期时功能障碍得分亦显著优于C组(P=0.036);C组在治疗4星期时WOMAC量表各项得分及随访时僵硬、功能障碍得分均显著优于A组(P<0.01)。结论 CO2激光灸可有效治疗膝骨关节炎,但对不同中医证型膝骨关节炎疗效有差异,其总体趋势是阳虚寒凝型最好,其次是瘀滞筋骨型,再次为肾虚髓亏型。

Observations on the Therapeutic Effect of CO2 Laser Moxibustion on Knee Osteoarthritis of Different Syndrome Types of Traditional Chinese Medicine

Objective To investigate the therapeutic effect of CO2 laser moxibustion on knee osteoarthritis of different syndrome types of traditional Chinese medicine （TCM）. Method Eighty-eight patients with knee osteoarthritis were allocated to three groups according to syndrome differentiation of traditional Chinese medicine： kidney and marrow deficiency （group A of 28 cases）, yang deficiency and cold accumulation （group B of 34 cases） and stagnancy in muscles and bones （group C of 26 cases）. The therapeutic effects were evaluated using the WOMAC VA3.1. Result The scores of all items on the WOMAC Osteoarthritis Index decreased significantly in the three groups after treatment compared with before （P〈0,05） except the pain score at two and four weeks and the stiffness score at two weeks after the beginning of treatment in group A. The scores of all items on the WOMAC Osteoarthritis Index decreased significantly more in group B than in group A after treatment （P〈0.05） except the pain score at two weeks. The dysfunction score at two weeks after the beginning of treatment also decreased significantly more than in group C （P=0.036）. The scores of all items on the WOMAC Osteoarthritis Index at four weeks after the beginning of treatment and the stiffness and dysfunction scores at the follow-up decreased significantly more in group C than in group A （P〈0.01）. Conclusion CO2 laser moxibustion can effectively treat knee osteoarthritis, but there is a difference in therapeutic effect between different TCM syndrome types of knee osteoarthritis. The whole tendency is that the therapeutic effect ranks first on the yang deficiency and cold accumulation type, second on the stagnancy in muscles and bones type and third on the kidney and marrow deficiency type.