运用毫火针与针推治疗TKA术后疼痛及关节运动障碍等疗效的对比观察

目的 对比运用毫火针与针推治疗TKA术后疼痛及关节障碍等并发症的临床疗效差异。方法 分为观察组（常规康复训练+毫火针，30例）和对照组（常规康复训练+普通针刺及推拿，30例），在治疗前和治疗后，分别给予关节活动范围（ROM）、视觉模拟评分（VAS）、骨关节指数（WOMAC）及WOMAC 量表评分。并比较两组间疗效差异。 结果 与治疗前比较，两组患者在治疗后 1周、2周的VAS 、 HSS、ROM、WOMAC均较治疗前有明显改善（均P ＜ 0.05）；组间比较 治疗1周后，VAS、HSS评分观察组优于对照组，差异有统计学意义（均P ＜ 0.05）；治疗2周后，VAS、ROM、HSS评分观察组优于对照组，差异有统计学意义（P ＜ 0.05、P ＜ 0.01、P ＜ 0.05）； 从WOMAC 量表里得出的各项评分可以看出，治疗后的评分均较治疗前明显下降(P＜0.05),两组患者的疼痛、僵硬、肿胀均得到了改善；组间比较：治疗第1周完成及第2周治疗完成后WOMAC 量表得出各项评分，观察组均优于对照组，差异具有明显的统计学意义（P＜0.01）。 火针组总有效率为96.7%,针推组为 90.0%,差异有统计学意义(P＞0.05)。 结论 毫火针与针推治疗TKA术后疼痛及关节运动障碍等并发症的疗效相当, 毫火针在改善TKA术后患者的疼痛，肿胀及僵硬感的临床疗效优于针推，在临床上值得推广应用。

Comparative observation on the effects of using a fire needle and acupuncture to treat postoperative pain and joint movement disorder after TKA

Objective To compare the clinical efficacy of the treatment of pain and joint disorders such as TKA after the treatment of TKA with needle and needle. Methods were divided into observation group (conventional rehabilitation training + fire needle, 30 cases) and control group (conventional rehabilitation training + ordinary acupuncture and massage, 30 cases), evaluation of visual analog score (VAS) before and after treatment, range of joint activity (ROM ), bone and joint index (WOMAC) and WOMAC scale scores. And compare the difference in efficacy between the two groups.Results Compared with before treatment, the HSS, ROM, VAS and WOMAC of the two groups were significantly improved compared with those before treatment (P < 0.05). After 1 week of treatment, the VAS and HSS scores were compared. The observation group was superior to the control group, and the difference was statistically significant (P < 0.05). After 2 weeks of treatment, the VAS, ROM, and HSS scores were superior to the control group, and the difference was statistically significant (P < 0.05, P < 0.01). , P < 0.05);The scores of the WOMAC scale were significantly lower than those before treatment (P<0.05). The pain, stiffness and swelling of the two groups were improved. Comparison between groups: WOMAC scale scores after 1 week and 2 weeks of treatment, The observation group was superior to the control group, and the difference was statistically significant (P<0.01).The total effective rate was 96.7% in the fire needle group and 90.0% in the needle push group. The difference was statistically significant (P>0.05).Conclusion The effect of acupuncture and needle acupuncture on the treatment of postoperative pain and joint movement disorders such as TKA is equivalent.The clinical effect of the fire needle in improving the pain, swelling and stiffness of patients after TKA is better than that of needle push, which is worthy of popularization and application in clinical practice.