法对膝骨性关节炎患者股四头肌肌张力影响.docVIP

(扌衮)法对膝骨性关节炎患者股四头肌肌张力的影响 　　[摘要] 目的 探讨（扌衮）法对早中期膝骨性关节炎（KOA）患者股四头肌肌张力的影响。 方法 选择2012年6月～2014年5月上海中医药大学附属岳阳中西医结合医院推拿科收治的早中期KOA患者60例，采用随机数字表法将其分为两组，各30例。治疗组接受（扌衮）法治疗，对照组采用按揉手法治疗，每次20 min，每周3次，疗程4周。治疗前及治疗4周后对两组进行健康状况调查问卷（SF-36）评分；治疗前、治疗2周后及治疗4周后对两组进行视觉模拟评分（VAS）、骨关节炎指数（WOMAC）评分及股直肌、股外侧肌肌张力的测定。 结果 治疗4周后两组SF-36总分及躯体功能、躯体角色、身体疼痛、情感角色、活力、精神健康、社会功能、总体健康等维度评分均较治疗前显著升高（P 0.05）。两组治疗2周与4周后VAS、WOMAC疼痛积分、股直肌、股外侧肌位移均较治疗前明显改善（P 0.05）；治疗组治疗4周后VAS、WOMAC疼痛积分、股直肌位移、股外侧肌位移与治疗2周后比较，差异均有统计学意义（P 0.05）。治疗组治疗前后VAS差值与股直肌位移前后差值呈正相关（r = 0.524，P = 0.001）。 结论 单位时间内对膝关节股四头肌肌群行大面积（扌衮）法能有效改善早中期KOA患者膝关节疼痛与股直肌肌张力，提高患者的生活质量，且单位时间内膝关节疼痛改善程度与股直肌肌张力变化具有明显相关性。 　　[关键词] 手法；（扌衮）法；膝骨性关节炎；疼痛；股四头肌；肌张力 　　[中图分类号] R684.3 [文献标识码] A [文章编号] 1673-7210（2016）09（a）-0118-04 　　[Abstract] Objective To discuss the clinical effect of rolling tuina on quadriceps muscle tension of patients with knee osteoarthritis （KOA） in early and middle stage. Methods Sixty patients with early and middle stage of KOA admitted to Yueyang Hospital of Integrated Traditional Chinese and Western Medicine， Shanghai University of Traditional Chinese Medicine from June 2012 to May 2014 were collected and divided into two groups by random number table， with 30 cases in each group The treatment group was treated with rolling tuina， the control group was treated with pressing-kneading tuina， 20 minutes each time， three times a week， the course was 4 weeks. Before treatment and after treatment for 4 weeks， short form 36 health survey （SF-36） was taken in two groups； before treatment and after treatment for 2， 4 weeks， the visual analogue scale （VAS）， the Western Ontario and McMaster Universities arthritis index （WOMAC）， tension of rectus femoris， vastus lateralis of the patients in the two groups were recorded. Results After treatment for 4 weeks， SF-36 scores， physical function， physical role， physical pain， emotional role， social function， vitality energy， mental health， social function and overall health of patients in two groups were obviously inc