| 针刀松解术治疗膝骨关节炎的临床观察 |
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王翔 |
WANG Xiang |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 刘顺怡 |
LIU Shun-yi |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 石瑛 |
SHI Ying |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 张明才 |
ZHANG Ming-cai |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 陈元川 |
CHEN Yuan-chuan |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 张继伟 |
ZHANG Ji-wei |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 詹红生 |
ZHAN Hong-sheng |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
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| 陈东煜 |
CHEN Dong-yu |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai 201203, China |
dychen26603@126.com |
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| 期刊信息：《中国骨伤》2016年29卷，第4期，第345-349页 |
| DOI：10.3969/j.issn.1003-0034.2016.04.012 |
| 基金项目:国家重点学科"中医骨伤科学"项目(编号:100508);上海市科委科技创新行动计划及重点攻关项目(编号:11DZ1973402,13401903500);上海市中医药事业发展三年行动计划(重大研究)资助项目(编号:ZYSNXD-CC-ZDYJ047);上海市中医药领军人才建设项目(编号:2012-63-15) |
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目的:观察针刀松解术治疗膝骨关节炎的临床疗效.
方法:2010年3月至2013年3月上海曙光医院骨伤科门诊诊治的膝骨关节炎患者,按照纳入、排除标准筛选后,纳入230例患者,分针刀组和针灸组.针刀组115例,男43例,女72例,年龄43~70岁,平均(51.4±1.7)岁,病程0.25~12年,平均(1.2±0.3)年,治疗前WOMAC总评分43.75±11.35,针刀松解术治疗1次;针灸组115例,男40例,女75例,年龄41~78岁,平均(52.4±2.0)岁,病程0.25~15年,平均(1.1±0.3)年,治疗前WOMAC总评分41.51±13.07,采用传统针灸疗法,每日治疗1~2次,共治疗2周.两组患者在性别、年龄、病程及WOMAC总评分上差异均无统计学意义,具有可比性;治疗后采用通用的WOMAC评分问卷调查方式来评价两组患者膝关节功能改善情况.
结果:两组疗效比较结果采用秩和检验,差异有统计学意义(Z=-2.24,P=0.025),针刀组总体疗效优于针灸组.两组治疗前后WOMAC各项评分,针刀组:疼痛5.98±2.27及2.80±1.57,行走痛7.19±1.41及3.34±1.34,久坐站立痛5.54±1.91及2.31±1.40,僵硬6.57±1.40及3.11±1.44,上下楼梯7.24±1.12及3.70±1.22,下蹲屈膝5.44±1.81及2.45±1.63,日常活动5.79±1.44及2.76±1.32;针灸组:疼痛6.07±2.00及4.09±1.46,行走痛6.50±1.75及3.20±1.64,久坐站立痛5.23±2.88及3.65±1.84,僵硬6.06±1.38及2.97±1.01,上下楼梯6.74±1.16及3.41±0.62,下蹲屈膝5.79±1.97及3.65±1.62,日常活动5.12±1.93及3.30±0.00.两组组间比较,在疼痛、久坐站立痛、下蹲屈膝及日常活动改善方面,两组差异有统计学意义;在行走痛、僵硬及上下楼梯差异无统计学意义;两组组内比较,在疼痛、久坐站立痛、下蹲屈膝及日常活动改善方面,治疗后均优于治疗前.
结论:针刀及针灸对改善膝关节功能均有效;针刀松解术对于缓解整体疼痛和恢复关节活动的疗效优于针灸,但对于僵硬和行走痛方面,针刀与针灸疗效相差不大,两者疗效相当. |
| [关键词]:膝骨关节炎 针刀 针灸 病例对照研究 |
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| Clinical observation on acupotomy surgery for the treatment of knee osteoarthritis |
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Abstract:
Objective:To observe the clinical effect of acupotomy surgery in the treatment of knee osteoarthritis.
Methods: From March 2010 to March 2013,230 patients with knee osteoarthritis treated in the Shanghai Shuguang Hospital were selected according to inclusion and exclusion criteria. These patients were randomly divided into acupotomy group and acupuncture group. In acupotomy group,there were 115 cases including 43 males and and 72 females ranging in age from 43 to 70 years old with an average of(51.4±1.7) years old;the course of disease ranged from 0.25 to 12 years with an average of (1.2±0.3) years,and the average WOMAC total score was(43.75±11.35) before treatment;the patients in acupotomy group were treated with acupotomy release for 1 time. In acupuncture group,there were 115 cases including 40 males and and 75 females ranging in age from 41 to 78 years old with an average of (52.4±2.0) years old; the course of disease ranged from 0.25 to 15 years with an average of (1.1±0.3) years,and the average WOMAC total score was(41.51±13.07) before treatment; the patients in acupuncture group was treated with traditional acupuncture and moxibustion for 1 to 2 times a day,and a total of 2 weeks. There was no significant difference in gender,age,course of disease and WOMAC score between the two groups(P>0.05),and the ratio of the patients was comparable. After treatment,the knee joint function improvement was evaluated by using the general WOMAC score questionnaire.
Results:The curative effect comparison results of two groups using rank sum test,the difference was statistically significant(Z=-2.24,P=0.025<0.05),the overall effect of the acupotomy group was better than the acupuncture group. The WOMAC score of two groups before and after treatment,in acupotomy group: pain score (5.98±2.27,2.80±1.57),walking pain(7.19±1.41,3.34±1.34),sedentary stand pain(5.54±1.91,2.31±1.40) and stiffness (6.57±1.40,3.11±1.44),up and down the stairs (7.24±1.12,3.70±1.22) and squat knees (5.44±1.81,2.45±1.63) and activity of daily life(5.79±1.44,2.76±1.32). In acupuncture group:pain score(6.07±2.00,4.09±1.46),walking pain(6.50±1.75,3.20±1.64),sedentary stand pain (5.23±2.88,3.65±1.84) and stiffness(6.06±1.38,2.97±1.01),up and down the stairs(6.74±1.16,3.41±0.62),squat knees (5.79±1.97,3.65±1.62) and activity of daily life (5.12±1.93,3.30±0). Comparison in pain (t=3.308,P=0.002),sedentary stand pain(t=3.180,P=0.002),squat knees(t=2.845,P=0.006) and activity of daily life (t=2.227,P=0.034) improvement aspects between two groups has statistically significant difference(P<0.05). In walking pain(t=-0.362,P=0.718),stiffness(t=-0.442,P=0.661) and up and down the stairs(t=-1.133,P=0.263),there was a trend of improvement,but no significant difference(P>0.05). Comparison in pain,sedentary stand pain,squat knees and active improvement aspect between two groups had a significant difference(P<0.0001).
Conclusion:Acupuncture and acupotomy were effective to improve the function of knee joint. The overall effect to relieve pain and recovery of joint activities of acupotomy operation was significantly better than acupuncture,but for stiff and walking pain,curative effect of acupotomy and acupuncture had little difference,rather the two effects. |
| KEYWORDS:Osteoarthritis,knee Needle knife Acupuncture Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王翔,刘顺怡,石瑛,张明才,陈元川,张继伟,詹红生,陈东煜.针刀松解术治疗膝骨关节炎的临床观察[J].中国骨伤,2016,29(4):345~349 |
| 英文格式: | WANG Xiang,LIU Shun-yi,SHI Ying,ZHANG Ming-cai,CHEN Yuan-chuan,ZHANG Ji-wei,ZHAN Hong-sheng,CHEN Dong-yu.Clinical observation on acupotomy surgery for the treatment of knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):345~349 |
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