针刀松解法对膝骨性关节炎应力刺激及临床症状的影响

目的:从良性应力刺激角度并结合临床症状,探讨针刀松解法治疗膝骨性关节炎的机制及方法。方法:膝骨性关节炎患者41例,随机分为针刀组和电针组,其中针刀组24例,电针组17例。用步态分析仪观察治疗前后的应力刺激(时间积分),并同时记录相应的膝关节疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)膝关节评分的变化。结果:治疗后,针刀组改善患肢疼痛VAS评分也非常显著地低于电针组(P<0.01)。随着疼痛的减少,针刀组较电针组能非常显著的增加患肢的应力刺激,同时降低健侧过大的应力刺激(P<0.01);同时,针刀组JOA总分治疗后显著高于电针组,具有非常显著性意义(P<0.01)。结论:针刀松解法可以通过松解局部挛缩、粘连的病变软组织缓解疼痛,达到增加患肢良性应力刺激的作用,进而恢复膝关节内部的力平衡,促进关节软骨的自我修复,最终改善临床症状。

Effects of Needle Knife Relaxing Therapy on Stress Stimulation and Clinical Symptoms of Knee Osteoarthritis

Objective:To probe into the mechanism and methods of needle knife relaxing therapy for the treatment of osteoarthritis of knee from the benign stress stimulation and clinical symptoms view.Methods:41 cases of KOA were randomly assigned to needle knife group(n=24)and electroacupuncture group(n=17).The time integration of gait analysis,VAS score,JOA score were observed before and after the treatment.Results:After the treatment,there is a significant difference of VAS score between the needle-knife group and the electroacupuncture group(P<0.01).Coupled with the decrease of VAS score,the benign stress stimulation(time integration of gait)of the affected limbs was increased,and the excessive stress stimulation of the healthy side was decreased at the same time.The JOA score of needle-knife group was significantly higher than the electroacupuncture group after the treatment(P<0.01).Conclusion:The needle knife relaxing therapy can relieve the neurovascular compression or traction syndrome by relaxing the local contracted,adhesive soft tissue,so as to relieve tension pain,and further to increase the benign stress stimulation of the affected limbs.Finally recover internal force equilibrium of the knee Joint,provide a condition for the self rehabilitation of the articular cartilage,and improve clinical symptoms.