针刀松解法对膝骨关节炎软组织张力的影响

目的评价针刀松解法对膝骨关节炎（KOA）患者关节周围软组织张力的影响,探讨其治疗KOA的机理。方法 180例KOA患者随机分为针刀组和电针组,每组90例,分别给予针刀松解法和电针干预,共3周。采用JZL-Ⅱ软组织张力计垂直于触诊压痛最痛点皮肤平面,测出该点的500 g压力位移与组织能量吸收比,比较2组治疗前后及随访6个月时的变化。结果 2组治疗后及随访时500 g压力位移均比治疗前显著下降（P〈0.05,P〈0.01）,2组治疗后和随访时与治疗前差值比较,差异均无统计学意义（P〉0.05）。针刀组治疗后及随访时组织能量吸收比较治疗前显著上升（P〈0.01）,而电针组差异则无统计学意义（P〉0.05）。2组治疗后与治疗前差值比较,差异无统计学意义（P〉0.05）,而针刀组随访时与治疗前差值显著大于电针组（P〈0.05）。结论针刀松解法不仅能够使关节周围软组织刚度增高,且能增强其变形能力,从而恢复关节的力学平衡,这可能是针刀治疗KOA的机理之一。

Effect of Acupotomy on Soft Tissue Tension in Patients with Knee Osteoarthritis

Objective To evaluate the effect of acupotomy on soft tissue tension around knee joints in patients with knee osteoarthritis(KOA),and to study the mechanism of acupotomy.Methods A total of 180 patients were randomly assigned to acupotomy therapy group(n=90) and electro-acupuncture(EA) therapy group(n=90) for 3 weeks.With JZL-Ⅱ tensiometer,on the most obvious skin tender point,vertical to skin,1 mm/s acceleration,the 500 g pressure displacement and the absorbed energy proportion were measured before and after treatment,and at the time of follow-up(6 months).Results After treatment and at follow-up,the 500 g pressure displacement of two groups decreased obviously(P<0.05,P<0.01),but there was no obvious difference of D-value between after treatment,at follow-up and before treatment of two groups(P>0.05).After treatment and at follow-up,the absorbed energy proportion of acupotomy therapy group increased obviously(P<0.01),but which of EA therapy group was not obviously(P>0.05).There was no obvious difference of D-value between before treatment and after treatment of two groups(P>0.05),but the D-value between at follow-up and before treatment of acupotomy therapy group was greater than that of EA therapy group(P<0.05).Conclusion Acupotomy therapy can not only increase the soft tissue stiffness around the knee joint,but also increase soft tissue distortion ability,and recover the mechanics balance of knee,which may be one of the mechanisms of acupotomy therapy on KOA.