摘要
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。
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.
出处
《中医正骨》
2014年第11期12-14,共3页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
骨关节炎
膝
针刺疗法
穴位
经外奇
Osteoarthritis,knee
Acupuncture therapy
Points,extraordinary
