点按局部腧穴与坐位调膝法联用治疗膝关节骨关节炎疼痛的临床观察＊

目的 观察点按局部腧穴与坐位调膝法联用治疗膝关节骨关节炎（knee osteoarthritis,KOA）疼痛的临床疗效。方法 采取随机数字表法将60例KOA患者随机分为推拿组和药物组,每组各30例。推拿组采用点按局部腧穴与坐位调膝法联用治疗,药物组采用口服塞来昔布胶囊治疗,治疗周期均设定为4周。两组患者于治疗前、治疗后进行压痛阈值（pressure pain thresholds,PPTs）、视觉模拟评分（visual analogue scale,VAS）、西安大略和麦克马斯特大学（Western Ontario and McMaster Universities,WOMAC）骨关节炎指数、股直肌均方根肌电值（root mean square,RMS）、疼痛灾难化量表（pain catastrophizing scale,PCS）评估,同时进行安全性评价。结果 最终共有55例患者完成试验,其中推拿组28例,药物组27例。经过4周治疗,两组患者PPTs和VAS评分结果分析显示,推拿组和药物组与治疗前相比差异显著（P < 0.05）,推拿组明显优于药物组,组间差异有统计学意义（P < 0.05）。WOMAC骨关节炎指数各项评分、股直肌RMS结果分析显示,推拿组和药物组治疗后较治疗前均有改善,组间具有统计学差异（P < 0.05）,推拿组改善更为明显,差异有统计学意义（P < 0.05）。PCS评分结果分析显示,推拿组和药物组治疗后积分较治疗前有统计学意义（P < 0.05）,推拿组改善更为明显,组间差异有统计学意义（P < 0.05）。安全性评价结果分析显示,推拿组无不良事件发生,安全性优于药物组。结论 点按局部腧穴与坐位调膝法能有降低膝关节局部疼痛敏感性,改善膝关节功能。

Clinical Observation on the Intervention of Pressing Points of Local Acupoint plus Sitting Position and Knee Adjustment on the Pain of Knee Osteoarthritis

Objective To observe the clinical efficacy of pressing points of local acupoint plus sitting position and knee adjustment in the treatment of pain in knee osteoarthritis (KOA).Methods By taking a random number table method, 60 patients with KOA were randomly divided into tuina group (n = 30) and drug group (n = 30). The tuina group was treated with pressing points of local acupoint plus sitting position and knee adjustment, and the drug group was treated with celecoxib capsule, and the the treatment period was 4 weeks. Before and after treatment, the patients in the two groups were evaluated by the pressure pain thresholds (PPTs), visual analog score (VAS), Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, root mean square (RMS) of rectus femoris, pain catastrophizing scale (PCS), and the safety was evaluated at the same time.Results A total of 55 patients completed the trial, including tuina group (n = 28) and drug group (n = 27). After 4 weeks of treatment, the results of PPTs and VAS score of the two groups showed that there were significant differences in the tuina group and the drug group compared with those before treatment, and the tuina group was significantly better than the drug group(P < 0.05), and there was a significant difference between the two groups (P < 0.05). The scores of WOMAC osteoarthritis index and the results of RMS of rectus femoris muscle showed that the tuina group and the drug group were improved after treatment, and there was a significant difference between the two groups (P < 0.05), and the difference was more obvious in the tuina group (P < 0.05). The analysis of PCS score showed that the scores of tuina group and drug group after treatment were significantly higher than those before treatment (P < 0.05), and the improvement of tuina group was more obvious, and there was a significant difference between the two groups (P < 0.05). The results of safety evaluation showed that there were no adverse events in the tuina group, and the safety of the tuina group was better than that of the drug group.Conclusion The combination of pressing points of local acupoint plus sitting position and knee adjustment can reduce the sensitivity of local pain of knee and improve the function of knee.