电针疗法在全膝关节置换术后康复中的应用

目的:探讨电针疗法在膝关节骨性关节炎(OA)患者全膝关节置换(TKR)术后康复中的作用。方法:70例行TKR的OA患者随机分为针康组和康复组,每组35例。针康组采用常规康复治疗配合电针治疗,电针取穴以病变局部为主,取患侧血海、梁丘、犊鼻、内膝眼、阳陵泉等;康复组行常规康复治疗。两组患者均分别于术前及术后2周、6周、12周采用纽约特种外科医院人工全膝关节置换术评分表(HSS)、患膝关节活动范围(ROM)、疼痛视觉模拟评分法(VAS)、徒手肌力检查法(MMT)评定患膝关节的功能。结果:术后2周、6周、12周针康组HSS评分明显高于康复组(P<0.05,P<0.01),VAS评分明显低于康复组(P<0.05,P<0.01),ROM和MMT比较,针康组虽然略优于康复组,但差异无统计学意义(均P>0.05)。结论:电针干预配合康复治疗可以明显抑制TKR患者康复过程中的疼痛反应,提高患者康复训练的耐受能力及积极性,明显促进膝关节整体功能恢复。

The application of electroacupuncture to postoperative rehabilitation of total knee replacement

Objective To explore the effect of electroacupuncture therapy for postoperative rehabilitation of total knee replacement of knee osteoarthritis.Methods Seventy cases of total knee replacement of knee osteoarthritis were randomly divided into an acupuncture-rehabilitation group and a rehabilitation group,thirty-five cases in each group.In acupuncture-rehabilitation group,routine rehabilitation therapy combined with electroacupuncture therapy was applied.The acupoints selection was mainly based on pathological location;Xuehai(SP 10),Liangqiu(ST 34),Dubi(ST 35),Neixiyan(EX-LE 4) and Yanglingquan(GB 34),etc.were selected.In rehabilitation group,routine rehabilitation therapy was applied.The functions of affected knee in both groups were evaluated by artificial total knee replacement scale of the New York Hospital for Special Surgery(HSS),range of motion(ROM) of affected knee,Visual Analogue Scale(VAS) of pain and Manual Muscle Test(MMT) before,and 2,6 and 12 weeks after surgery.Results HSS scores in acupuncture-rehabilitation group were markedly higher than those in rehabilitation group in 2,6 and 12 weeks after surgery(P<0.05,P<0.01);VAS scores in acupuncture-rehabilitation group were markedly lower than those in rehabilitation group(P<0.05,P<0.01);ROM and MMT in acupuncture-rehabilitation group were little superior to those in rehabilitation group,however,there was no significant difference(all P>0.05).Conclusion Rehabilitation therapy combined with electroacupuncture can obviously restrain the pain during rehabilitation process for total knee replacement patients,improve the endurance capacity of rehabilitation training and motivation,and obviously promote the recovery of total knee joint function.