“矫筋正骨法”针刀治疗膝骨关节炎临床疗效观察

目的 观察“矫筋正骨法”针刀治疗膝骨关节炎（knee osteoarthritis,KOA）的临床疗效和对步态的影响。方法 纳入KOA患者65例,采用随机数字表法随机分为针刀组和对照组。其中针刀组32例,行“矫筋正骨法”针刀治疗;对照组33例,行常规针刺治疗,分别于治疗前后采用视觉模拟量表（visual analogue scale,VAS）评分、美国特种外科医院（Hospital for Special Surgery,HSS）膝关节评分及步态分析的方法进行疗效评估。结果 与治疗前比较,治疗后两组VAS显著降低（P<0.05）,HSS评分中的疼痛、功能、活动度评分和总分均显著升高（P<0.05）,治疗后针刀组屈曲畸形评分也较治疗前显著升高（P<0.05）,治疗后针刀组和对照组步频、步速、步长均显著改善（P<0.05）;与对照组比较,针刀组治疗后VAS显著降低（P<0.05）,HSS评分中疼痛、功能、活动度评分和总分均显著升高（P<0.05）,步频显著改善（P<0.05）;两组患者综合疗效比较,针刀组显著优于对照组（P<0.05）。结论 “矫筋正骨法”针刀可以显著减轻KOA患者的疼痛症状,并且可以使患者的关节功能、活动度以及步频同步得到改善,体现了KOA治疗中“筋骨并重、标本兼治”的思想。

Clinical Effect of Tendon regulating and Bone setting Acupotomy in Treatment of Knee Osteoarthritis

Objective To investigate the clinical effect of tendon regulating and bone setting acupotomy in the treatment of knee osteoarthritis (KOA) and its effect on gait. Methods A total of 65 patients with KOA were divided into acupotomy group and control group using a random number table. The 32 patients in the acupotomy group received tendon regulating and bone setting acupotomy, and the 33 patients in the control group received conventional acupuncture. Visual analogue scale (VAS) score, Hospital for Special Surgery (HSS) knee score, and gait analysis were used before and after treatment to evaluate clinical outcome. Results After treatment, both groups had a significant reduction in VAS score (P<0.05) and significant increases in total HSS score and the scores of pain, function, and range of motion (P<0.05); in addition, the acupotomy group had a significant increase in flexion deformity score (P<0.05), and both groups had significant improvements in stride frequency, step speed, and step length (P<0.05). Compared with the control group after treatment, the acupotomy group had a significant reduction in VAS score (P<0.05), significant increases in total HSS score and the scores of pain, function, and range of motion (P<0.05), and a significant improvement in stride frequency (P<0.05). The acupotomy group had a significantly better clinical outcome than the control group (P<0.05). Conclusion For patients with KOA, tendon regulating and bone setting acupotomy can significantly alleviate pain symptoms and improve joint function, range of motion, and stride frequency, which reflects the idea of "paying equal attention to tendon and bone and treating both manifestation and root cause of disease" in the treatment of KOA.