中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
11期
12-14
,共3页
陈志刚%董超%梁程亮%况高华
陳誌剛%董超%樑程亮%況高華
진지강%동초%량정량%황고화
骨关节炎,膝%针刺疗法%穴位,经外奇
骨關節炎,膝%針刺療法%穴位,經外奇
골관절염,슬%침자요법%혈위,경외기
Osteoarthritis,knee%Acupuncture therapy%Points,extraordinary
目的:探讨董氏奇穴巨刺法治疗膝骨关节炎的临床疗效和安全性。方法:膝骨关节炎患者60例,随机分为观察组和对照组,每组30例,观察组采用董氏奇穴巨刺法治疗,对照组采用传统针刺疗法治疗。分别在治疗前、治疗6周后、治疗结束后3个月、6个月及12个月采用疼痛视觉模拟评分和 Lysholm 膝关节评分标准评价两组患者患膝疼痛及功能情况。结果:治疗前后各时间点间疼痛视觉模拟评分比较,差异有统计学意义,存在时间效应(F =1.955,p =0.287);两组患者间疼痛视觉模拟评分比较,观察组低于对照组,存在分组效应(F =19.512,p =0.000);治疗前两组患者间疼痛视觉模拟评分比较,差异无统计学意义[(8.5±0.9)分,(8.6±1.1)分;t =﹣0.385,p =0.701];治疗6周后、治疗结束后3个月、6个月,两组患者间疼痛视觉模拟评分比较,观察组低于对照组,差异均有统计学意义[(1.6±0.4)分,(2.9±0.5)分,t =﹣11.120,p =0.000;(2.2±0.6)分,(3.5±0.5)分, t =﹣9.117,p =0.000;(2.8±0.8)分,(3.7±0.7)分,t =﹣4.637,p =0.000];但治疗结束后12个月,两组患者间疼痛视觉模拟评分比较,差异无统计学意义[(3.9±1.0)分,(4.2±0.9)分,t =﹣1.221,p =0.227];时间因素与分组因素存在交互效应(F =0.009,p =0.048)。治疗前后各时间点间患膝功能评分比较,差异有统计学意义,存在时间效应(F =1.576,p =0.226);两组患者间患膝功能评分比较,观察组高于对照组,存在分组效应(F =10.835,p =0.034);治疗前两组患者间患膝功能评分比较,差异无统计学意义[(56.8±10.2)分,(55.2±9.5)分;t =0.629,p =0.532];治疗6周后、治疗结束后3个月、6个月,两组患者间患膝功能评分比较,观察组高于对照组,差异均有统计学意义[(80.6±8.4)分,(75.9±9.6)分;t =2.018,p =0.048;(78.2±8.6)分,(72.5±9.5)分;t =2.436,p =0.018;(75.8±8.3)分,(70.2±9.2)分;t =2.475,p =0.016];但治疗结束后12个月,两组患者间患膝功能评分比较,差异无统计学意义[(69.0±8.5)分,(66.9±8.9)分;t =0.935,p =0.354];时间因素与分组因素存在交互效应(F =0.008,p =0.039)。治疗期间两组均无断针、滞针、晕针、针孔感染等并发症发生。结论:董氏奇穴巨刺针法治疗膝骨关节炎可有效缓解患膝疼痛、改善患膝功能,安全可靠,近期疗效优于与传统针刺疗法。
目的:探討董氏奇穴巨刺法治療膝骨關節炎的臨床療效和安全性。方法:膝骨關節炎患者60例,隨機分為觀察組和對照組,每組30例,觀察組採用董氏奇穴巨刺法治療,對照組採用傳統針刺療法治療。分彆在治療前、治療6週後、治療結束後3箇月、6箇月及12箇月採用疼痛視覺模擬評分和 Lysholm 膝關節評分標準評價兩組患者患膝疼痛及功能情況。結果:治療前後各時間點間疼痛視覺模擬評分比較,差異有統計學意義,存在時間效應(F =1.955,p =0.287);兩組患者間疼痛視覺模擬評分比較,觀察組低于對照組,存在分組效應(F =19.512,p =0.000);治療前兩組患者間疼痛視覺模擬評分比較,差異無統計學意義[(8.5±0.9)分,(8.6±1.1)分;t =﹣0.385,p =0.701];治療6週後、治療結束後3箇月、6箇月,兩組患者間疼痛視覺模擬評分比較,觀察組低于對照組,差異均有統計學意義[(1.6±0.4)分,(2.9±0.5)分,t =﹣11.120,p =0.000;(2.2±0.6)分,(3.5±0.5)分, t =﹣9.117,p =0.000;(2.8±0.8)分,(3.7±0.7)分,t =﹣4.637,p =0.000];但治療結束後12箇月,兩組患者間疼痛視覺模擬評分比較,差異無統計學意義[(3.9±1.0)分,(4.2±0.9)分,t =﹣1.221,p =0.227];時間因素與分組因素存在交互效應(F =0.009,p =0.048)。治療前後各時間點間患膝功能評分比較,差異有統計學意義,存在時間效應(F =1.576,p =0.226);兩組患者間患膝功能評分比較,觀察組高于對照組,存在分組效應(F =10.835,p =0.034);治療前兩組患者間患膝功能評分比較,差異無統計學意義[(56.8±10.2)分,(55.2±9.5)分;t =0.629,p =0.532];治療6週後、治療結束後3箇月、6箇月,兩組患者間患膝功能評分比較,觀察組高于對照組,差異均有統計學意義[(80.6±8.4)分,(75.9±9.6)分;t =2.018,p =0.048;(78.2±8.6)分,(72.5±9.5)分;t =2.436,p =0.018;(75.8±8.3)分,(70.2±9.2)分;t =2.475,p =0.016];但治療結束後12箇月,兩組患者間患膝功能評分比較,差異無統計學意義[(69.0±8.5)分,(66.9±8.9)分;t =0.935,p =0.354];時間因素與分組因素存在交互效應(F =0.008,p =0.039)。治療期間兩組均無斷針、滯針、暈針、針孔感染等併髮癥髮生。結論:董氏奇穴巨刺針法治療膝骨關節炎可有效緩解患膝疼痛、改善患膝功能,安全可靠,近期療效優于與傳統針刺療法。
목적:탐토동씨기혈거자법치료슬골관절염적림상료효화안전성。방법:슬골관절염환자60례,수궤분위관찰조화대조조,매조30례,관찰조채용동씨기혈거자법치료,대조조채용전통침자요법치료。분별재치료전、치료6주후、치료결속후3개월、6개월급12개월채용동통시각모의평분화 Lysholm 슬관절평분표준평개량조환자환슬동통급공능정황。결과:치료전후각시간점간동통시각모의평분비교,차이유통계학의의,존재시간효응(F =1.955,p =0.287);량조환자간동통시각모의평분비교,관찰조저우대조조,존재분조효응(F =19.512,p =0.000);치료전량조환자간동통시각모의평분비교,차이무통계학의의[(8.5±0.9)분,(8.6±1.1)분;t =﹣0.385,p =0.701];치료6주후、치료결속후3개월、6개월,량조환자간동통시각모의평분비교,관찰조저우대조조,차이균유통계학의의[(1.6±0.4)분,(2.9±0.5)분,t =﹣11.120,p =0.000;(2.2±0.6)분,(3.5±0.5)분, t =﹣9.117,p =0.000;(2.8±0.8)분,(3.7±0.7)분,t =﹣4.637,p =0.000];단치료결속후12개월,량조환자간동통시각모의평분비교,차이무통계학의의[(3.9±1.0)분,(4.2±0.9)분,t =﹣1.221,p =0.227];시간인소여분조인소존재교호효응(F =0.009,p =0.048)。치료전후각시간점간환슬공능평분비교,차이유통계학의의,존재시간효응(F =1.576,p =0.226);량조환자간환슬공능평분비교,관찰조고우대조조,존재분조효응(F =10.835,p =0.034);치료전량조환자간환슬공능평분비교,차이무통계학의의[(56.8±10.2)분,(55.2±9.5)분;t =0.629,p =0.532];치료6주후、치료결속후3개월、6개월,량조환자간환슬공능평분비교,관찰조고우대조조,차이균유통계학의의[(80.6±8.4)분,(75.9±9.6)분;t =2.018,p =0.048;(78.2±8.6)분,(72.5±9.5)분;t =2.436,p =0.018;(75.8±8.3)분,(70.2±9.2)분;t =2.475,p =0.016];단치료결속후12개월,량조환자간환슬공능평분비교,차이무통계학의의[(69.0±8.5)분,(66.9±8.9)분;t =0.935,p =0.354];시간인소여분조인소존재교호효응(F =0.008,p =0.039)。치료기간량조균무단침、체침、훈침、침공감염등병발증발생。결론:동씨기혈거자침법치료슬골관절염가유효완해환슬동통、개선환슬공능,안전가고,근기료효우우여전통침자요법。
Objective:To explore the clinical curative effects and safety of acupuncture therapy by inserting needles in Dong’s extraor-dinary points in the treatment of knee osteoarthritis(KOA). Methods:Sixty patients with KOA were randomly divided into 2 groups,30 ca-ses in each group. The patients in observation group were treated with acupuncture therapy by inserting needles in Dong’s extraordinary points,while the others in control group were treated with traditional acupuncture therapy. The pain degree and function of knee were evalu-ated by using the visual analogue scale(VAS)and Lysholm knee scale respectively before the treatment and after 6-week treatment and at 3,6 and 12 months after the end of the treatment. Results:There was statistical difference in VAS scores between different time points,in other words,there was time effect(F = 1. 955,p = 0. 287). The VAS scores were lower in,the observation group compared to the control group,in other words,there was group effect(F = 19. 512,p = 0. 000). Before the treatment,there was no statistical difference in VAS scores between the two groups(8. 5 +/﹣ 0. 9 vs 8. 6 +/﹣ 1. 1 points;t = ﹣ 0. 385,p = 0. 701). The VAS scores were lower in the observation group compared to the control group after 6-week treatment and at 3 and 6 months after the end of the treatment(1. 6 +/﹣ 0. 4 vs 2. 9 +/﹣0. 5 points,t = ﹣ 11. 120,p = 0. 000;2. 2 +/﹣ 0. 6 vs 3. 5 +/﹣ 0. 5 points,t = ﹣ 9. 117,p = 0. 000;2. 8 +/﹣ 0. 8 vs 3. 7 +/﹣ 0. 7 points,t =﹣ 4. 637,p = 0. 000). There was no statistical difference in VAS scores between the two groups at 12 months after the end of the treatment (3. 9 +/﹣ 1. 0 vs 4. 2 +/﹣ 0. 9 points,t = ﹣ 1. 221,p = 0. 227). There was interaction between time factor and grouping factor(F = 0. 009, p = 0. 048). There was statistical difference in knee scores between different time points,in other words,there was time effect(F = 1. 576, p = 0. 226). The knee scores were higher in the observation group compared to the control group,in other words,there was group effect(F =10. 835,p = 0. 034). Before the treatment,there was no statistical difference in knee scores between the two groups(56. 8 +/﹣ 10. 2 vs 55. 2+/﹣ 9. 5 points;t = 0. 629,p = 0. 532). The knee scores were higher in the observation group compared to the control group after 6-week treatment and at 3 and 6 months after the end of the treatment(80. 6 +/﹣ 8. 4 vs 75. 9 +/﹣ 9. 6 points;t = 2. 018,p = 0. 048;78. 2 +/﹣ 8. 6 vs 72. 5 +/﹣ 9. 5 points;t = 2. 436,p = 0. 018;75. 8 +/﹣ 8. 3 vs 70. 2 +/﹣ 9. 2 points;t = 2. 475,p = 0. 016). While 12 months after the end of the treatment,there was no statistical difference in knee scores between the two groups(69. 0 +/﹣ 8. 5 vs 66. 9 +/﹣ 8. 9 points;t = 0. 935, p = 0. 354). There was interaction between time factor and grouping factor(F = 0. 008,p = 0. 039). No complications such as broken nee-dles,stuck needles,acupuncture syncope and pinhole infection were found in both of the 2 groups. Conclusion:The acupuncture therapy by inserting needles in Dong’s extraordinary points can effectively relieve the knee pain and improve the knee function. It is safe and reliable for treatment of KOA,and its short-term curative effect is better than that of traditional acupuncture therapy.