开缝手法治疗伸膝装置创伤性粘连的临床评价：多中心、同期随机对照

背景：课题为国家中医药管理局中医临床诊疗技术整理与研究项目之一，项目完成并通过验收鉴定后，将在基层社区及农村地区进行技术推广。 目的：对开缝手法治疗伸膝装置创伤性粘连的疗效进行多中心临床评价。 设计、时间及地点：平行对照、分层随机分组、多中心试验，实验于2003-01/2006-10在河南中医学院第一附属医院、郑州市骨科医院、河南省中医院完成。 对象：选择2003-01/2006-10河南中医学院第一附属医院、郑州市骨科医院、河南省中医院3个中心因创伤导致伸膝装置粘连患者240例。随机分为试验组120例，男78例，女42例；平均年龄(42.50±13.93)岁；对照组120例，男71例，女49例；平均年龄(44.19±12.92)岁。 方法：试验组采用膝部开缝手法，即四指点穴和拔伸屈膝法，对照组治疗采用《中医筋伤学》中的手法。1次/d，治疗30 d，20 min/次。患者对治疗均知情同意。 主要观察指标：①两组治疗前后膝关节活动度、关节功能分级评分、膝关节主动屈曲功能评分。②两组中医疗效比较。 结果: 试验组脱落、剔除19 例，合格率84.17%；对照组脱落、剔除17例，合格率85.83%。 试验组显效率为87.13%，对照组显效率为68.93%，(P < 0.05)，试验组显效率优于对照组。两组膝关节活动度、膝关节功能评分、膝关节主动屈曲功能评分、关节功能分级评分比较，试验组优于对照组(P < 0.01)。 结论：开缝手法治疗伸膝装置创伤性粘连，疗效确切，方法安全，具有很强的可操作性和推广价值。

Clinical evaluation of slotted manuduction for the treatment of knee extension apparatus induced traumatic adhesion: A multi-center and randomized concurrent control study

BACKGROUND: This subject is one item of Traditional Chinese Medicine Clinical and Finishing Technology of State Administration of Traditional Chinese Medicine, which will be promoted and used in community and rural when it is finished. OBJECTIVE: To investigate the multi-center clinical evaluation of the treatment slotted manuduction to treat extension knee apparatus induced traumatic adhesions. DESIGN, TIME AND SETTING: The multi-center and randomized concurrent control study was performed at the First Affiliated Hospital of Henan College of Traditional Chinese Medicine, Zhengzhou Orthopaedics Hospital and Traditional Chinese Medical Hospital of Henan Province from January 2003 to October 2006. PARTICIPANTS: A total of 240 patients with knee extension apparatus who admitted in the First Affiliated Hospital of Henan College of Traditional Chinese Medicine, Zhengzhou Orthopaedics Hospital and Traditional Chinese Medical Hospital of Henan Province were selected, and randomized divided into the experimental group: 120 cases, including 78 male and 42 female, with mean aged (42.50±13.93) years; and the control group: 120 cases, containing 71 male and 49 female, with mean aged (44.19±12.92) years. METHODS: Knee slotted manipulation, i.e. the method of four-finger hole sowing and extension genuflex was adopted in experimental group. In the control group, methods from the Traditional Chinese Injury Science of Tendon were used. The treatment was once per day for 30 days, with 20 minutes once a time. Informed consent was obtained from each patient. MAIN OUTCOME MEASURES: The degree of knee joint activities, score of knee joint actively flexural behavior function, and the grading of joint function prior to and after treatment, as well as therapeutic effects were compared in two groups. RESULTS: The qualification rate of experimental group was 84.17% and control group was 85.83%, respectively. The significant efficiency rate was 87.13% in the experimental group and 68.93% in the control group (P < 0.05). Compared the degree of knee joint activities, score of knee joint function, score of knee joint actively flexural behavior function, and the grading score of joint function, the experimental group was better than the control group (P < 0.01). CONCLUSION: Slotted manuduction has an exact effect on treating knee extension apparatus induced traumatic adhesion, which has higher validity and maneuverability.