正时中医与推拿治疗膝骨关节炎疗效评价

目的探讨西关正骨学术流派系列正时中医与推拿疗法在96例中度膝骨关节炎中的远期临床疗效评价。 方法选取广州市荔湾区骨伤科医院于2016年2月至2017年10月收治的192例中度膝骨关节炎患者，纳入符合1995年美国风湿病学会推荐的膝骨关节炎诊断标准的患者，排除严重心脏，脑血管，消化系统，内分泌系统等患有原发疾病并伴有精神障碍的患者；先天性畸形，严重创伤等患者，随机数字法将患者分为对照组(96例)和观察组(96例)。对照组给予口服非甾体抗炎药物塞来昔布胶囊治疗，观察组患者进行西关正骨流派中医及推拿疗法治疗，观察两组患者临床治疗效果采用卡方检验比较，两组患者治疗前后，对疼痛视觉模拟评分(VAS)、生活质量量表(GQOL-74)评分比较，采用两因素两水平析因设计方差分析。 结果观察组总有效率93.75%，明显高于对照组的81.25%(χ²＝7.304，P<0.01)。治疗后观察组VAS评分均明显低于对照组(t＝3.064，P<0.01)。两组治疗6周后，观察组的社会功能，生理功能，心理功能，物质生活得分均明显优于对照组，差异有统计学意义(t＝3.657、3.587、3.789、3.658，P<0.05)，且随访1年的数据也显示，观察组生活质量各维度值也优于对照组，差异有统计学意义(t＝4.826、4.536、4.955、4.789，P<0.05)。 结论对于膝骨关节炎患者，西关正骨学术流派正时中医与推拿疗法采用的治疗原则是早期发现和早期治疗。在疾病的早期阶段使用该疗法是有效的，并且可以有效地改善患者的疼痛，控制疾病的延迟，并且改善患者的生活质量，值得临床应用。

Evaluation of therapeutic effect of timing Chinese medicine and medicine stick massage on knee osteoarthritis

ObjectiveTo investigate the long-term clinical efficacy of Xiguan Zhenggu academic genre series of timing Chinese medicine and medicine stick massage therapy in 96 cases of moderate knee osteoarthritis. MethodsA total of 192 patients with moderate knee osteoarthritis admitted to the orthopaedic department of Guangzhou Liwan District Orthopedic Hospital from February 2016 to October 2017 were enrolled, and patients who met the diagnostic criteria for knee osteoarthritis recommended by the American College of Rheumatology in 1995 were included. The patients with severe diseases of heart, cerebrovascular, digestive system, endocrine system and other primary diseases with mental disorders, and the patients with congenital malformation and severe trauma were excluded. The patients were randomly divided into the control group (96 cases)and the observation group (96 cases). The control group were treated with oral non-steroidal anti-inflammatory drug celecoxib capsule. The observation group were treated with Xiguan orthopedic academic genre therapy including regular Chinese medicine and massage. The clinical treatment effect of the two groups was observed. Before and after treatment, the visual analogue score(VAS) and the generic quality of life (GQOL-74) scale were compared. Data were analyzed by Chi-square test or two-way ANOVA. ResultsThe total effective rate of the observation group was 93.75%, which was significantly higher than that of the control group (χ²=7.304, P <0.01). The VAS scores of the observation group were significantly lower than those of the control group (t=3.064, P <0.01). After six weeks of treatment, the social function, physiological function, psychological function and material life score of the observation group were significantly better than the control group, the difference was statistically significant (t=3.657, 3.587, 3.789, 3.658, P<0.05) at follow-up. The one-year data also showed that the quality of life in the observation group was also better than that in the control group, and the difference was statistically significant (t=4.826, 4.536, 4.955, 4.789, P<0.05). ConclusionsFor the patients with skeletal osteoarthritis, the principle of treatment used by Xiguan Zhenggu academic genre and Chinese medicine and medicine bar massage therapy is early detection and early treatment. The use of this therapy in the early stages of the disease is effective and can effectively improve the patient's pain, control the delay of the disease, and improve the quality of life of the patient, which is worthy of clinical application.