小针刀配合针灸辨证治疗膝骨性关节炎的临床观察

目的观察小针刀配合针灸辨证治疗膝骨性关节炎的临床疗效。方法将149例患者随机分为治疗组76例和对照组73例,组内再根据中医证候分型相应分为Ⅰ(阳虚寒凝证)、Ⅱ(肾虚髓亏证)及Ⅲ(瘀血阻滞证)组。治疗组采用小针刀配合针灸辨证治疗,对照组采用透明质酸钠关节腔注射,观察治疗5周后两组疼痛、肿胀程度及活动度改善情况并进行疗效评定。结果治疗组患者治疗后在疼痛、肿胀程度及活动度方面较治疗前均有明显改善(P<0.01),其中,在肿胀治疗方面治疗Ⅱ组治疗前后差异有统计学意义(P<0.05)。对照组活动度较治疗前改善明显(P<0.01),在疼痛及肿胀程度方面也得到了缓解(P<0.05)。治疗组各证型治疗后,除治疗Ⅱ组在缓解肿胀程度较对照Ⅱ组差异无统计学意义(P>0.05)外,与相应对照组比较差异有统计学意义(P<0.05,P<0.01)。结论小针刀配合针灸辨证治疗膝骨性关节炎是有效、可行的治疗方法,且对瘀血阻滞型膝骨性关节炎缓解疼痛更明显,值得临床上推广使用。

Clinical observation of needle-scalpel accompanied with acupuncture on patients with knee osteoarthritis

Objective To observe the clinical efficacy of needle-scalpel accompanied with acupuncture on 76 patients with knee osteoarthritis.Methods 149 patients were randomly divided into therapeutic group with 76 patients and control group with 73,and then within groups these patients were correspondingly divided into GroupⅠwith Yang-insufficiency and cold-congelation,GroupⅡwith kidney deficiency and marrow depletion,and Group Ⅲ with blood stasis stagnation according to syndrome differentiation of TCM.The needle-scalpel accompanied with Acupuncture was applied in therapeutic group,and intraarticular injection of Sodium Hyaluronate in control group.After 5 weeks treatment,the pain,swelling and the mobility of joint were observed to evaluate the therapeutic effects.Results The pain,swelling and motion of the joint in therapeutic group were obviously improved after the treatment(P<0.01),the swelling in Group Ⅱ was improved significantly(P<0.05).The mobility of the joint in control group was obviously improved after the treatment(P<0.01),and pain and swelling were also released(P<0.05).The effects of all types in therapeutic group were statistical different compared with the corresponding subgroups in control group(P<0.05)except for that in Group Ⅱ was no statistical different in swelling between the groups(P>0.05).Conclusion The needle-scalpel accompanied with acupuncture is effective and feasible therapeuty for knee osteoarthritis,and is more obvious to relief the pain in the blood stasis type.