摘要
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。
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.
出处
《中医正骨》
2015年第9期9-14,共6页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
骨关节炎
膝
小刀针
电针
治疗
临床研究性
osteoarthritis,knee
small knife needle
electroacupuncture
therapies,investigational
