膝骨关节炎“从筋治”的临床研究 hhj.docVIP

膝骨关节炎“从筋论治”的临床研究 何海军 王荣田 陈志伟 刘道兵 谢斌 王均玉 陈卫衡 (中国中医科学院望京医院骨关节三科,北京,100102 ) 基金项目：“十二五”国家科技支撑计划项目(2015BAI04B03) ；中国中医科学院特色诊疗技术与方法研究项目( ZZ070864) 通讯作者：陈卫衡E-mail: drchenweiheng@163.com 摘 要 目的：通过观察针刀联合玻璃酸钠关节腔治疗膝骨关节炎有效性及其优势，为膝骨关节炎“从筋论治”提供理论依据。方法：将120例膝骨关节炎患随机分为治疗组和对照组，每组各60例，治疗组给予针刀联合玻璃酸钠关节腔治疗，对照组给予玻璃酸钠关节腔注射治疗，并以治疗5周、治疗后3月VAS评分、HSS评分为疗效评价指标。数据统计运用两组间计数资料采用X2检验、Fisher精确检验，计量资料采用t检验、Willcoxon秩和检验，治疗组组内比较采用配对t检验。结果：治疗5周、治疗后3月，治疗组VAS评分均低于对照组（P0.001）,HSS总体评分治疗组均高于对照组（p0.001）。HSS评分系统中，治疗5周时，其中疼痛及功能方面评分治疗组均高于对照组（p0.05），治疗后3月，其中疼痛、功能及关节活动度方面评分治疗组均高于对照组（p0.05）。治疗组治疗5周和治疗后3月HSS系统评分中，除稳定性评分外（稳定性评分治疗前后均为10分），其他各个方面评分均高于治疗前（P0.001）。结论：“从筋论治”的思想指导下的针刀联合玻璃酸钠关节腔治疗膝骨关节炎，可有效缓解疼痛，改善日常活动能力，是一种治疗早中期膝骨关节炎的一种简单、有效、可行方法，值得推广。 关键词：膝骨关节炎；从筋论治；临床疗效 Clinical study on treatment based on tendons of patients with knee osteoarthritis HE Hai-jun WANG Rong-tian CHEN Zhi-wei LIU Dao-bing XIE Bin WANG Jun-yu CHEN Wei-heng Wangjing Hospital of China Academy Of Chinese Medical Sciences，Beijing 100102，China ABSRTACT Objective: to provide a theoretical basis for treating knee osteoarthritis by treatment based on tendons through observing effectiveness and advantage of acupotomology combined with articular sodium hyaluronate injection. Methods: 120 patients suffered from knee osteoarthritis were randomly divided into treatment group received acupotomology combined with articular sodium hyaluronate injection and control group treated with articular sodium hyaluronate injection, with 60 cases in each. VAS score and HSS score were recorded for efficacy evaluation after 5-week and 3-month treatment. The data was analyzed with Software SPSS17.0,count data using X2 test and Fishers exact test, measurement data using t test and Wilcoxon rank sum test between the two groups. The results were compared using paired t test within group. Results: The VAS score of the treatment group was lower than that of the control group (P0.001), and the total score of HSS was significantly higher than the control group (p0.001) a