手法为主四联疗法治疗膝骨性关节炎的临床观察

目的：探讨手法为主四联疗法治疗膝骨性关节炎的临床效果。方法：将膝骨性关节炎患者240例，随机分为两组，对照组120例单纯采用玻璃酸钠膝关节腔内注射，每周1次，5次为1疗程；治疗组120例为手法为主的四联疗法组，施行中医推拿手法为主，我院自拟中药方内服加外熏洗，以及玻璃酸钠膝关节腔内注射四联治疗方案，1月为1疗程。分别于治疗前及治疗后1月、3个月、随访12个月对膝关节进行评分，包括膝关节功能指数、疼痛、肿胀各项指标，对所得数据进行统计学分析。结果：治疗组总有效率为95．8％，对照组总有效率为70．8％，两组比较差异有统计学意义（P〈0．01）。结论：采用中医推拿手法为主，自拟中药方内服加外熏洗，玻璃酸钠膝关节腔内注射四联疗法治疗膝骨性关节炎具有良好的临床效果，值得推广应用。

Clinical Observation of Manipulation-based Quadruple Therapy in the Treatment of Knee Osteoarthritis

Objective：To observe the clinical results of manipulation-based quadruple therapy in treating knee osteoarthritis. Methods：In this study, 240 cases with knee osteoarthritis were selected from outpatient clinics and wards, and randomized into group A and group B, 120 in each group. Patients in group A were treated with intra-articular injection of sodium hyaluronate once a week, 5 times as a course of treatment, while patients in group B were treated with manipulation-based quadruple therapy （namely manipulation, oral decoction, herbal fumigation, and intra-artieular injection of sodium hyaluronate）, 1 month as a course of treatment. Before the treatment, 1 month and 3 months after the treatment as well as 12 month follow-up, the results were evaluated, inclu- ding index of knee function, pain, swelling, etc. Result：The total effective rate was 95.8~ in the treatment group and 70.8% in the control group, indicating significant difference between the two groups （P〈0.01）. Conclusion： The manipulation-based quadruple therapy combined with oral herbal medicine, external fumigation, and intra-articular injection of sodium hyaluronate has good clinical efficacy.