温针灸联合非甾体类消炎药治疗膝骨关节炎的临床研究

目的 观察温针灸联合非甾体类消炎药治疗膝骨关节炎的疗效.方法 将80例膝骨关节炎患者随机分为西药组和药灸联合组,各40例,西药组给予口服塞来昔布,药灸联合组在口服西药基础上联合温针灸,10 d 1疗程,2个疗程结束后观察疗效.在治疗前、 完成治疗时、 完成治疗后3月、6月、1年共5个时间点分别测骨关节炎指数(Western Ontario and McMaster University Osteoarthritis Index,WOMAC),以评价临床疗效.结果 药灸组治疗后WOMAC量表各项评分均较西药组显著降低(P<0.05),直至治疗后12月WOMAC总分仍显著低于对照组(P<0.05).在治疗后、随访3月、随访6月时药灸组治疗总有效率高于西药组(P<0.05).进一步年龄分层研究发现,60岁人群中药灸组与西药组的差距逐渐缩小,而<60岁人群中直至治疗后12月WOMAC总评分仍显著低于西药组(P<0.05).结论 联合温针灸治疗膝骨性关节炎疗效确切,尤其在60岁以下人群中疗效更为显著,值得临床推广应用.

Clinical Effect of Fire-needle Moxibustion Combined with NSAIDs on Knee Osteoarthritis

Objective To observe the curative effect of adjunctive treatment of fire-needle moxibustion and non-steroidal anti-inflammatory drugs (NSAIDs) for knee osteoarthritis. Methods 80 patients of knee osteoarthritis (KOA) were random-ly divided into the control group and treatment group, 40 cases in each group. The control group was administrated with NSAIDs. The treatment group was given with an adjunctive treatment of fire-needle moxibustion and NSAIDs, 10 d for one course. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was determined before treatment and 1 day, 3 months, 6 months, and 12 months after treatment to evaluate the clinical effect. Results The scale of WOMAC in treat-ment group were significantly lower than those in control group (P<0.05), and the global scale of WOMAC maintained lower than control group until 12 months after treatment (P<0.05). The total effective rate of treatment group was higher than the control group during 1 day, 3 months, 6 months, and 12 months after treatment (P<0.05). tUntil 6 months postoperatively, the recovery and markedly-effective rate was significantly higher in the observation group compared with that in the control group (P<0.05). Further age stratified analysis showed that the differences between the observation group and control group among 60 years populations has gradually diminished, while in the patients <60 years old the global scale of WOMAC in the observa-tion group maintained lower than the observation group until 12 months after treatment (P<0.05). Conclusion The adjunctive treatment of fire-needle moxibustion and NSAIDs is effective for KOA, especially in the populations <60 years old, which is worthy of clinical popularization.