蠲痹汤联合关节松动手法治疗膝骨关节炎的临床观察

目的:探讨蠲痹汤离子导入联合关节松动手法治疗膝骨关节炎的近期疗效。方法:将112例患者随机按数字表法分为试验组57例和对照组55例。对照组采用中低频电治疗仪和膝关节松动手法治疗。试验组在对照组治疗的基础上加用蠲痹汤离子导入治疗。2周为1个疗程,两组进行4个疗程后统计疗效,每个疗程之间间隔2 d。分别于治疗前、治疗后进行骨性关节炎指数(WOMAC)量表评分、膝关节VAS疼痛评分、膝关节体征评分和关节炎生活质量测量量表2-短卷(AIMS2-SF)的生活质量量表评分。结果:试验组临床疗效总有效率为94.74%,优于对照组的81.82%(P0.05);治疗后试验组WOMAC疼痛、僵硬和关节功能评分和总分均低于对照组(P0.01);治疗后试验组VAS评分和膝关节体征评分均低于对照组(P0.01);治疗后试验组AIMS2-SF量表躯体、症状、影响、社会及工作5个维度评分和总分均高于对照组(P0.01)。结论:蠲痹汤离子导入联合关节松动手法治疗膝骨关节炎能减轻疼痛,改善体征,促进关节功能恢复,提高患者生活质量,近期疗效显著。

Clinical Observation of Juanbi Decoction Combined with Joint Mobilization on Treatment of Knee Osteoarthritis

Objective:To discuss short-term effect of iontophoresis therapy of Juanbi decoction combined with mobilization techniques in treating knee osteoarthritis. Method:One hundred and twelve patients were randomly divided into control group (55 cases) and experimental group (57 cases) by random number table. Patients in control group were treated with middle and low frequency electric therapy apparatus and mobilization techniques. Besides the treatment of control group, patients in experimental group were additionally treated with iontophoresis treatment of Juanbi decoction. One course of treatment last for 2 weeks, both groups took four courses, with a break of 2-3 days between every course. Before and after treatment, the Western Ontario and McMaster Universities (WOMAC) osteoarthritis indexes, Visual Analogue Scale (VAS) pain scores and signs of knee joint and arthritis life quality measurement scale2-short form (AIMS2-SF) life quality scale were scored. Result:The total effective rate was 94.74% in experimental group, which was superior to 81.82% in control group (P<0.05). After treatment, the scores of WOMAC pain, stiffness and joint function and total score in experimental group were all lower than theses data in control group (P<0.01). Scores of VAS score and the knee joint symptoms in experimental group were inferior to these in control group (P<0.01). The five dimension scores as AIMS2-SF body scale, symptoms, influences, social and work, and total scores in experimental group were all higher than these in control group after treatment (P<0.01). Conclusion:Iontophoresis of Juanbi decoction combined loose joint technique to treat knee osteoarthritis can reduce pain, improve body signs, promote joint function recovery and enhance patients' quality of life. Its short-term curative effect is distinct.