电针、自我按摩联合肌力训练治疗膝骨关节炎随机平行对照研究

目的]观察电针、自我按摩联合肌力训练治疗膝骨关节炎疗效。方法]使用随机平行对照方法,将68例门诊患者按随机数字表法分为两组。对照组34例电针治疗(梁丘、血海、膝眼、足三里、阴陵泉),采用相同频率脉冲。治疗组34例电针治疗同对照组。针灸后医师或康复治疗师现场指导患者对患膝行自我按摩治疗,同时配合肌力训练。①按摩治疗方法:患者拿捏患侧股四头肌,着重在髌上部;点按和点揉鹤顶、梁丘、血海、膝眼、足三里、委中穴,以按揉弹拨法交替作用于膝髌韧带、内外侧副韧带,并提拿髌骨;最后在膝关节周围摩擦发热后结束治疗。5次/周,20min/次。②肌力训练:患者坐位。患腿直腿上抬至水平位,踝背部负重量为维持10s所能承受的最大负荷为训练标准,每次训练10s,休息10s为1个运动单元。每次10个运动单元,每周训练5d。连续治疗2个疗程(20d),判定疗效。对治愈患者随访半年,观测复发率。结果]治疗组治愈28例,好转5例,无效1例,总有效率97.06%。对照组治愈19例,好转8例,无效7例,总有效率79.41%。临床疗效治疗组优于对照组(P<0.05)。治疗组复发率明显低于对照组(P<0.05)。结论]电针、自我按摩联合肌力训练治疗膝骨关节炎疗效显著,远期疗效理想,无不良反应,患者在家中可以自己完成,是一种有效安全容易推广的膝骨关节炎防治方法。

A Randomized and Controlled Study about Electro-acupuncture,Self-massage and Strength Training in the Treatment of Knee Osteoarthritis

Objective]To investigate the clinical efficacy of electro-acupuncture,self-massage and strength training in treating knee osteoarthritis.Method]68 outpatients were divided into two groups by randomized controlled method with random number table.The 34 cases of Control group were electro-acupunctured on the acupoints including Liangqiu,Xuehai,knee eye,Zusanli,Yinlingquan,using the same frequency pulse.The 34 cases of Treatment group were electro-acupunctured by the same way for the control group.After then the treatment group patients self-massage and strength training while physician or rehabilitation therapist is guiding them on-site.① massage treatments: the patient squeeze the ipsilateral quadriceps,the focus in the upper part of the patellar;Tap and knead Heding,liangqiu,Xuehai,knee eye,Zusanli and Weizhong point;plucked law alternating role patellar ligament,medial and lateral collateral ligament in the knee,and lift the patella;Finally,in the friction heat around the knee after the end of treatment.5 times / week,20min / times.② strength training: patient sitting.The affected leg straight legs raised above the level of bits the ankle back negative weight for maintaining the 10s can withstand the maximum load of training standards,each training 10s,rest 10s as a sports unit.10 each movement unit,weekly training 5d.Continuous treatment of two courses(20d),to determine efficacy.Cure the patients were followed up for six months,observed recurrence rate.Results] treatment group,28 cases were cured,5 cases improved,and 1 case ineffective,the total efficiency of 97.06%.Control group,19 cases were cured,improved in 8 cases,7 cases ineffective,the total effective rate of 79.41%.The clinical efficacy of the treatment group is better than the control group(P<0.05).The recurrence rate of the treatment group was significantly lower than the control group(P<0.05).Conclusion] EA,self-massage and muscle training in the treatment of knee osteoarthritis efficacy significant ideal long-term efficacy and adverse reactions,can do it themself at home for patients with osteoarthritis of knee is easy to promote an effective and safe control methods.