CAJ | 학술논문

针刀疗法改善膝骨关节炎早期疼痛症状的疗效评价
침도요법개선슬골관절염조기동통증상적료효평개
LIANG Zhao1,CAI Jingyi1,YAN Li1,DONG Fuhui1,WEN Jianmin1,YU Zhiyong2,HUANG Dapeng3

万方数据

中医正骨中醫正骨 중의정골
The Journal of Traditional Chinese Orthopedics and Traumatology
2015年 9期 9-14 ,共6页

梁朝%蔡静怡%闫立%董福慧%温建民%余志勇%黄大鹏

량조%채정이%염립%동복혜%온건민%여지용%황대붕

骨关节炎,膝%小刀针%电针%治疗,临床研究性骨關節炎,膝%小刀針%電針%治療,臨床研究性
골관절염,슬%소도침%전침%치료,림상연구성
osteoarthritis,knee%small knife needle%electroacupuncture%therapies,investigational

目的：评价针刀疗法改善膝骨关节炎早期疼痛症状的疗效。方法：将60例早期膝骨关节炎患者随机分为2组，每组30例，分别采用针刀、电针治疗。分别记录并比较治疗前、治疗结束后和治疗结束后6个月2组患者的日常生活活动能力（activities of daily living，ADL）评分。并分别于治疗前和治疗结束后6个月记录并比较2组患者双足支撑期时间、支撑期各阶段时间积分比，其中支撑期各阶段时间包括触地初期（initial contact phase，ICP）、前足触地阶段（forefoot contact phase，FFCP）、全足支撑阶段（foot flat phase，FFP）、前足蹬离阶段（forefoot push off phase，FFPOP）。结果：①ADL 评分。不同时间点间患膝 ADL 评分的差异有统计学意义（F ＝58．212，P ＝0．000）。2组患膝 ADL 评分的组间差异总体上有统计学意义（F ＝15．623，P ＝0．001）。进一步比较显示，治疗前2组患膝 ADL 评分的差异无统计学意义[（27．28±4．89）分，（26．04±5．65）分，t ＝0．054，P ＝0．971]；治疗结束后及治疗结束后6个月，2组患膝 ADL 评分比较，组间差异均有统计学意义[（48．26±7．51）分，（43．94±6．72）分，t ＝7．976，P ＝0．001；（49．23±6．11）分，（44．32±8．25）分，t ＝9．015，P ＝0．000]。时间因素与分组因素存在交互效应（F ＝53．201，P ＝0．000）。②步态测试指标。治疗结束后6个月针刀组和电针组左、右足支撑期时间均小于治疗前[（791．35±135．76）分，（952．61±156．52）分，t ＝7．154，P ＝0．001；（801．24±151．88）分，（937．49±176．14）分，t ＝6．521，P ＝0．001；（808．43±136．80）分，（939．00±190．67）分，t ＝4．274，P ＝0．005；（818．81±161．01）分，（928．93±147．33）分，t ＝3．585，P ＝0．014]。治疗结束后6个月，针刀组左、右足 ICP、FFCP、FFP、FFPOP 的百分比与治疗前比较，差异均无统计学意义[（9．45±5．36）％，（6．73±3．56）％，t ＝1．446，P ＝0．081；（9．89±4．53）％，（7．98±4．49）％，t ＝1．475，P ＝0．076；（21．01±13．06）％，（19．59±12．31）％，t ＝0．986，P ＝0．335；（20．83±11．54）％，（18．27±10．38）％，t ＝1．006，P ＝0．319；（33．29±15．93）％，（37．47±19．31）％，t ＝0．846，P ＝0．358；（34．91±18．43）％，（39．06±14．77）％，t ＝0．696，P ＝0．494；（35．14±11．36）％，（36．63±10．81）％，t ＝1．104，P ＝0．214；（35．12±11．79）％，（34．60±10．54）％，t ＝0．856，P ＝0．349]；电针组左、右足 ICP、FFCP、FFP、FFPOP 的百分比与治疗前比较，差异均无统计学意义[（8．58±5．10）％，（11．77±7．23）％，t ＝1．214，P ＝0．095；（7．88±6．11）％，（8．48±6．39）％，t ＝1．024，P ＝0．314；（18．64±10．40）％，（20．55±15．02）％，t ＝0．753，P ＝0．427；（20．90±16．44）％，（19．76±17．47）％，t ＝0．987，P ＝0．334；（40．16±19．23）％，（35．63±20．25）％，t ＝0．812，P ＝0．363；（38．78±22．60）％，（39．25±22．08）％，t ＝0．631，P ＝0．527；（32．60±10．93）％，（32．03±12．65）％，t ＝0．742，P ＝0．449；（32．42±8．74）％，（32．49±7．33）％，t ＝1．005，P ＝0．320]。结论：针刀疗法对改善膝骨关节炎早期疼痛症状确切有效。
목적：평개침도요법개선슬골관절염조기동통증상적료효。방법：장60례조기슬골관절염환자수궤분위2조，매조30례，분별채용침도、전침치료。분별기록병비교치료전、치료결속후화치료결속후6개월2조환자적일상생활활동능력（activities of daily living，ADL）평분。병분별우치료전화치료결속후6개월기록병비교2조환자쌍족지탱기시간、지탱기각계단시간적분비，기중지탱기각계단시간포괄촉지초기（initial contact phase，ICP）、전족촉지계단（forefoot contact phase，FFCP）、전족지탱계단（foot flat phase，FFP）、전족등리계단（forefoot push off phase，FFPOP）。결과：①ADL 평분。불동시간점간환슬 ADL 평분적차이유통계학의의（F ＝58．212，P ＝0．000）。2조환슬 ADL 평분적조간차이총체상유통계학의의（F ＝15．623，P ＝0．001）。진일보비교현시，치료전2조환슬 ADL 평분적차이무통계학의의[（27．28±4．89）분，（26．04±5．65）분，t ＝0．054，P ＝0．971]；치료결속후급치료결속후6개월，2조환슬 ADL 평분비교，조간차이균유통계학의의[（48．26±7．51）분，（43．94±6．72）분，t ＝7．976，P ＝0．001；（49．23±6．11）분，（44．32±8．25）분，t ＝9．015，P ＝0．000]。시간인소여분조인소존재교호효응（F ＝53．201，P ＝0．000）。②보태측시지표。치료결속후6개월침도조화전침조좌、우족지탱기시간균소우치료전[（791．35±135．76）분，（952．61±156．52）분，t ＝7．154，P ＝0．001；（801．24±151．88）분，（937．49±176．14）분，t ＝6．521，P ＝0．001；（808．43±136．80）분，（939．00±190．67）분，t ＝4．274，P ＝0．005；（818．81±161．01）분，（928．93±147．33）분，t ＝3．585，P ＝0．014]。치료결속후6개월，침도조좌、우족 ICP、FFCP、FFP、FFPOP 적백분비여치료전비교，차이균무통계학의의[（9．45±5．36）％，（6．73±3．56）％，t ＝1．446，P ＝0．081；（9．89±4．53）％，（7．98±4．49）％，t ＝1．475，P ＝0．076；（21．01±13．06）％，（19．59±12．31）％，t ＝0．986，P ＝0．335；（20．83±11．54）％，（18．27±10．38）％，t ＝1．006，P ＝0．319；（33．29±15．93）％，（37．47±19．31）％，t ＝0．846，P ＝0．358；（34．91±18．43）％，（39．06±14．77）％，t ＝0．696，P ＝0．494；（35．14±11．36）％，（36．63±10．81）％，t ＝1．104，P ＝0．214；（35．12±11．79）％，（34．60±10．54）％，t ＝0．856，P ＝0．349]；전침조좌、우족 ICP、FFCP、FFP、FFPOP 적백분비여치료전비교，차이균무통계학의의[（8．58±5．10）％，（11．77±7．23）％，t ＝1．214，P ＝0．095；（7．88±6．11）％，（8．48±6．39）％，t ＝1．024，P ＝0．314；（18．64±10．40）％，（20．55±15．02）％，t ＝0．753，P ＝0．427；（20．90±16．44）％，（19．76±17．47）％，t ＝0．987，P ＝0．334；（40．16±19．23）％，（35．63±20．25）％，t ＝0．812，P ＝0．363；（38．78±22．60）％，（39．25±22．08）％，t ＝0．631，P ＝0．527；（32．60±10．93）％，（32．03±12．65）％，t ＝0．742，P ＝0．449；（32．42±8．74）％，（32．49±7．33）％，t ＝1．005，P ＝0．320]。결론：침도요법대개선슬골관절염조기동통증상학절유효。
Objective:To evaluate the curative effect of needle -knife therapy for relieving knee pain in patients with early knee osteo-arthritis(KOA).Methods:Sixty patients with early KOA were randomly divided into 2 groups,30 cases in each group,and the patients were treated with needle -knife therapy(needle -knife group)and electroacupuncture therapy(electroacupuncture group)respectively.The activ-ities of daily living(ADL)were recorded and compared between the 2 groups before treatment,after treatment and at 6 months after the end of the treatment respectively.The support phase time of both feet and integral ratio of each phase were recorded and compared between the 2 groups before treatment and at 6 months after the end of the treatment respectively.The support phases included initial contact phase (ICP),forefoot contact phase(FFCP),foot flat phase(FFP)and forefoot push off phase(FFPOP).Results:There was statistical difference in the knee ADL scores between different time points(F =58.21 2,P =0.000).In general,there was statistical difference in the knee ADL scores between the 2 groups(F =1 5.623,P =0.001 ).Further comparison showed that there was no statistical difference in the knee ADL scores between the 2 groups before treatment(27.28 +/-4.89 vs 26.04 +/-5.65 points,t =0.054,P =0.971 ),and there was statistical difference in the knee ADL scores between the 2 groups after treatment and at 6 months after the end of the treatment(48.26 +/-7.51 vs 43.94 +/-6.72 points,t =7.976,P =0.001 ;49.23 +/-6.1 1 vs 44.32 +/-8.25 points,t =9.01 5,P =0.000).There was interaction be-tween time factor and grouping factor(F =53.201 ,P =0.000).The support phase time of left foot and right foot of needle -knife group and electroacupuncture group at 6 months after the end of the treatment were less than that of pre -treatment (791 .35 +/-1 35.76 vs 952.61 +/-1 56.52 points,t =7.1 54,P =0.001 ;801 .24 +/-1 51 .88 vs 937.49 +/-1 76.1 4 points,t =6.521 ,P =0.001 ;808.43 +/-1 36.80 vs 939.00 +/-1 90.67 points,t =4.274,P =0.005;81 8.81 +/-1 61 .01 vs 928.93 +/-1 47.33 points,t =3.585,P =0.01 4). There was no statistical difference in the time percentage of ICP,FFCP,FFP and FFPOP of left foot and right foot of needle -knife group between pretreatment and 6 -month -post -treatment(9.45 +/-5.36% vs 6.73 +/-3.56%,t =1 .446,P =0.081 ;9.89 +/-4.53% vs 7.98 +/-4.49%,t =1 .475,P =0.076;21 .01 +/-1 3.06% vs 1 9.59 +/-1 2.31 %,t =0.986,P =0.335;20.83 +/-1 1 .54% vs 1 8.27 +/-1 0.38%,t =1 .006,P =0.31 9;33.29 +/-1 5.93% vs 37.47 +/-1 9.31 %,t =0.846,P =0.358;34.91 +/-1 8.43% vs 39.06 +/-1 4.77%,t =0.696,P =0.494;35.1 4 +/-1 1 .36% vs 36.63 +/-1 0.81 %,t =1 .1 04,P =0.21 4;35.1 2 +/-1 1 .79% vs 34.60 +/-1 0.54%,t =0.856,P =0.349).There was no statistical difference in the time percentage of ICP,FFCP,FFP and FFPOP of left foot and right foot of electroacupuncture group between pretreatment and 6 -month -post -treatment(8.58 +/-5.1 0% vs 1 1 .77 +/-7.23%,t =1 .21 4,P =0.095;7.88 +/-6.1 1 % vs 8.48 +/-6.39%,t =1 .024,P =0.31 4;1 8.64 +/-1 0.40% vs 20.55 +/-1 5.02%,t=0.753,P =0.427;20.90 +/-1 6.44% vs 1 9.76 +/-1 7.47%,t =0.987,P =0.334;40.1 6 +/-1 9.23% vs 35.63 +/-20.25%,t =0.81 2,P =0.363;38.78 +/-22.60% vs 39.25 +/-22.08%,t =0.631 ,P =0.527;32.60 +/-1 0.93% vs 32.03 +/-1 2.65%,t =0.742,P =0.449;32.42 +/-8.74 vs 32.49 +/-7.33%,t =1 .005,P =0.320).Conclusion:The needle -knife therapy does be effective for relieving knee pain in patients with early KOA.