针灸推拿对膝骨关节炎患者屈伸肌功能的影响

目的:观察和评价针灸推拿治疗膝骨关节炎的临床疗效,并对患者屈伸肌群的功能进行分析.方法:将80例患者随机分为观察组和对照组,每组40例.观察组采用针刺结合推拿治疗,针刺取穴主要为内膝眼、鹤顸、犊鼻等,推拿治疗主要手法为攘法、揉法、拿法、擦法及关节被动运动等;对照组口服芬必得.比较两组治疗前后的疗效评定、JOA评分以及等速测试系统评估结果.结果:①观察组总有效率为90.0%(36/40),对照组总有效率为87.5%(35/40),两组疗效相当(P>0.05);两组患者治疗后JOA评分较治疗前明显提高(均P<0.01).②两组患者等速测试示,峰力矩(PT)、总功(TW)、平均功率(AP)治疗后均较治疗前明显提高(P<0.05,P<0.01),观察组治疗后较对照组提高更明显(P<0.05).结论:针灸推拿治疗能显著改善患者症状,提高膝骨关节炎患者屈伸肌肌力、做功等,其疗效优于口服芬必得.

Abstract：

Objective To observe and evaluate the clinical efficacy of acupuncture and Chinese massage on knee osteoarthritis and conduct the analysis on the functions of knee flexors and extensors in patients. Methods Eighty cases were randomly divided into an observation group and a control group, 40 cases in each one. In observation group, acupuncture combined with Chinese massage was applied. The main acupoints for acupuncture were Nèixīyǎn(内膝眼EX-LE 4),Hèdǐng(鹤顶EX-LE 2),Dúbí(犊鼻ST 35), etc. In Chinese massage, gun-fa (rolling), rou-fa (kneading), na-fa (grasping), ca-fa (rubbing) and passive movements of joints were applied. In control group, Fenbid was administered orally. The efficacy evaluation, JOA score and the result of isokinetic testing were compared before and after treatment in two groups. Results ①The total effective rate was 90.0% (36/40) in observation group and was 87.5% (35/40) in control group, indicating equivalent efficacy between two groups (P>0.05). JOA score after treatment increased remarkably compared with that before treatment in two groups (both P<0.01).②It was indicated in isokinetic test of two groups that peak torque (PT), total work (TW) and average power (AP) after treatment were all improved in comparison with those before treatment (P<0.05, P<0.01) and the improvement after treatment in observation group was much more remarkable as compared with that in control group (all P<0.05). Conclusion Acupuncture and Chinese massage can improve significantly in the symptoms, the muscle strength of the flexors and extensors as well as motor function of the patients with knee osteoarthritis, which is superior to that achieved with Fenbid.

Effects of acupuncture and Chinese massage on the functions of knee flexors and extensors in patients with knee osteoarthritis: randomized controlled trial