摘要
目的:观察夹胫推肘牵膝推拿法联合针灸治疗膝骨关节炎(KOA)继发滑膜炎的临床疗效。方法:选取90例KOA继发滑膜炎患者,按随机数字表法分为观察组和对照组,每组45例。对照组给予针灸治疗,观察组给予夹胫推肘牵膝推拿法联合针灸治疗,每周3次,10次为1个疗程,连续治疗2个疗程。比较2组治疗前后视觉模拟评分法(VAS)评分、Lysholm膝关节功能评分、Barthel指数、骨代谢指标及积液指数、滑膜厚度。结果:治疗后,2组VAS评分、Ⅰ型前胶原氨基端前肽(PINP)水平均较治疗前降低(P<0.05),观察组VAS评分、PINP水平均低于对照组(P<0.05);2组Barthel指数、Lysholm膝关节功能评分、骨保护素(OPG)及骨钙素(OC)水平均较治疗前升高(P<0.05),观察组Barthel指数、Lysholm膝关节功能评分、OPG及OC水平均高于对照组(P<0.05);2组滑膜厚度、积液指数均较治疗前减小(P<0.05),观察组滑膜厚度、积液指数均小于对照组(P<0.05)。结论:夹胫推肘牵膝推拿法联合针灸治疗KOA继发滑膜炎,可有效减轻患者膝关节疼痛,改善骨代谢水平,减少膝关节积液,从而提高其膝关节功能。
Objective:To observe the clinical effect of tibial-clipping,elbow-pushing and knee-pulling tuina method combined with acupuncture and moxibustion for synovitis secondary to knee osteoarthritis(KOA).Methods:A total of90 cases of patients with synovitis secondary to KOA were selected and divided into the observation group and the control group according to the random number table method,45 cases in each group.The control group was treated with acupuncture and moxibustion,and the observation group was treated with tibial-clipping,elbow-pushing and knee-pulling tuina method combined with acupuncture and moxibustion.Both groups were treated for two courses,with ten times being a course and three times in a week.Before and after treatment,the scores of Visual Analogue Scale(VAS)and Lysholm knee joint function,Barthel indexes,bone metabolism indexes,effusion indexes and synovial thickness in the two groups were compared.Results:After treatment,VAS scores and the levels of type I procollagen N-terminal propeptide(PINP)in the two groups were decreased when compared with those before treatment(P<0.05),and VAS score and PINP level in the observation group were lower than those in the control group(P<0.05);Barthel indexes,Lysholm knee joint function scores,osteoprotegerin(OPG)levels and osteocalcin(OC)levels in the two groups were increased when compared with those before treatment(P<0.05);Barthel indexes,Lysholm knee joint function scores,OPG levels and OC levels in the observation group were higher than those in the control group(P<0.05);synovial thickness and effusion indexes in the two groups were decreased when compared with those before treatment(P<0.05),and synovial thickness and effusion index in the observation group were lower than those in the control group(P<0.05).Conclusion:The therapy of tibial-clipping,elbow-pushing and knee-pulling tuina method combined with acupuncture and moxibustion for synovitis secondary to KOA can effectively relieve the knee pain of patients,improve bone metabolism levels,reduce knee joint effusion,thus improving the knee joint function.
作者
雷言坤
韩金生
LEI Yankun;HAN Jinsheng
出处
《新中医》
CAS
2021年第18期145-149,共5页
New Chinese Medicine
基金
杭州市科技发展计划项目(20180533B57)。
关键词
膝骨关节炎
夹胫推肘牵膝推拿
针灸
疼痛
膝关节功能
骨代谢
Knee osteoarthritis
Tibial-clipping
elbow-pushing and knee-pulling tuina
Acupuncture and moxibustion
Pain
Knee joint function
Bone metabolism
