摘要
目的:评价温针灸治疗膝骨关节炎的临床疗效,探讨其对患者下肢等速肌力的影响。方法:将50例膝骨关节炎患者随机分为观察组和对照组,观察组25例,对照组21例(脱落4例)。观察组穴取犊鼻、内膝眼、血海、梁丘、阴陵泉、阳陵泉、委中、合阳、风市,行温针灸治疗,每次约40min,前6次治疗每日1次,后6次治疗隔日1次,12次为一疗程,共3周。对照组未给予治疗,仅观察3周。观察治疗前后两组患者膝关节屈伸肌最大等速向心力量指标(总功、屈伸肌绝对和相对峰力矩、相对峰力矩屈伸比),西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表积分和综合疗效等。结果:与治疗前相比,观察组患者总功、屈伸肌绝对和相对峰力矩均高于治疗前(P<0.01,P<0.05),屈肌/伸肌比值降低(P<0.05),对照组屈肌绝对和相对峰力矩降低(P<0.05,P<0.01);观察组治疗后总功、伸肌绝对和相对峰力矩较对照组升高明显(P<0.05,P<0.01),屈肌/伸肌比值降低更显著(P<0.05);观察组治疗后WOMAC量表各项积分及总分均降低(均P<0.01),对照组WOMAC量表各项积分降低不明显(均P>0.05);观察组治疗后WOMAC量表的疼痛、僵硬评分及总分较对照组降低更明显(P<0.01,P<0.05),观察组日常生活难度评分虽有降低趋势,但两组比较差异无统计学意义(P>0.05)。观察组总有效率为88.0%(22/25)。结论:温针治疗膝骨关节炎能够减轻疼痛、改善功能、提高伸屈肌力量(尤其是伸肌)和肌力平衡,临床疗效较好。
Objective To evaluate the clinical efficacy of warm-needling moxibustion for knee osteoarthritis （KOA）, and to explore its effects on isokinetic strength of lower limb muscle.Methods Fifty cases of KOA were randomly divided into an observation group （25 cases） and a control group （21 cases）, but 4 cases lost contact.The observation group was treated with warm-needling moxibustion at Dubi （ST 35）, Neixiyan （EX-LE 4）, Xuehai （SP 10）, Liangqiu （ST 34）, Yinlingquan （SP 9）, Yanglingquan （GB 34）, Weizhong （BL 40）, Heyang （BL 55） and Fengshi （GB 31） for 40 min per treatment.The first 6 treatments were given once a day, and the last 6 treatments were given once every other day.12 treatments were taken as one course, and totally 3-week treatment was given.No treatment was given in the control group for 3 weeks.The isokinetic strength of extensor muscle and flexor muscle, including the total work, absolute peak torque （aPT） and relative peak torque （rPT）, and Western Ontario and McMaster Universities Arthritis Index （WOMAC）, and comprehensive efficacy were observed and compared in the two groups.Results Compared before treatment, the total work, aPT and rPT of the extensor and flexor muscle increased significantly after treatment in the observation group （P〈0.01, P〈0.05）, but the flextion/extention ratio was lowered （P〈0.05）.In the control group, aPT and rPT of flexor muscle were reduced after treatment （P〈0.05, P〈0.01）.The total work, aPT and rPT of the extensor muscle in the observation group were higher than those in the control group after treatment （P〈0.05, P〈0.01）, but the flextion/extention ratio was lowered （P〈0.05）.The item score and total score of WOMAC were reduced in the observation group after treatment （all P〈0.01）, but no significant change was observed in the control group （all P〉0.05）.The pain score, stiffness scores and total score of WOMAC in the observation group were lower than those in the control group （P〈0.01, P〈0.05）;the score of daily function activities was declined in the observation group, but not significantly different from that in the control group （P〉0.05）.The total effective rate was 88.0% （22/25） in the observation group.Conclusion Warm-needling moxibustion could relieve pain, improve function and muscle balance, strengthen extensor and flexor muscle power, especially extensor, which has superior clinical efficacy.
作者
王晓玲
王芗斌
侯美金
王华华
纪峰
WANG Xiaoling WANG Xiangbin HOU Meijin WANG Huahua JI Feng(College of Rehabiliration Medicine, Fujian University of TCM, Fuzhou 350122, China Fujian Provincial Rehabilitation Industrial Institute, Fuzhou 350122 Fujian Key Laboratory of Rehabilitation Technology, Fuzhou 350122 Rehabilitation Hospital of Fujian University of TCM College of Acupuncture and Moxibustion, Fujian University of TCM)
出处
《中国针灸》
CAS
CSCD
北大核心
2017年第5期457-462,共6页
Chinese Acupuncture & Moxibustion
基金
福建省自然科学基金项目:2016J01383
福建省科技厅科技平台建设项目:2015Y2001-05
福建中医药大学2014年重点学科专项校管课题项目:X 2014075-学科
关键词
膝骨关节炎
温针灸
等速肌力
随机对照试验
knee osteoarthritis
warm-needling moxibustion
isokinetic strength of muscle
randomized controlled trial （RCT）
