不同壮数温针灸对膝骨性关节炎疗效及关节腔积液的影响

发布时间：2018-05-11 03:11

本文选题：膝骨性关节炎 + 温针灸　；参考：《中华中医药杂志》2017年09期

【摘要】：目的:探讨不同壮数温针灸对阳虚寒凝型膝骨性关节炎(KOA)疗效及关节腔积液的影响。方法:选取96例确诊为合并有关节积液的阳虚寒凝型KOA患者作为研究对象,按患者的就诊次序随机分为3组,每组各32例。3组均予温针灸治疗,穴位均取患侧内膝眼(EX-LE4)、外膝眼(ST35)和足三里(ST36),针刺后一壮组、两壮组、三壮组各施温针灸1壮、2壮、3壮后起针。3组均予治疗1次/d,40min/次,15d为1个疗程,疗程间休息2d,共治疗2个疗程。对比观察治疗前、治疗后及随访2个月时3组间的临床疗效、症状积分、疼痛评分、关节运动功能及积液含量。结果:(1)总疗效评价:2个疗程后,3组均取得明显疗效,其中一壮组有效率为76.67%;两壮组有效率为87.10%,三壮组的有效率为90.00%。两壮组和三壮组的有效率均明显优于一壮组(P0.05),而两壮组和三壮组的有效率比较,差异无统计学意义。(2)结局指标评价:在症状积分、膝关节运动功能、疼痛评分、关节积液含量变化等方面,治疗后3组与各自治疗前比较均有所改善(P0.05,P0.01),且治疗后两壮组、三壮组的改善情况也均明显优于一壮组(P0.05,P0.01),而两壮组与三壮组比较,差异均无统计学意义。(3)安全性评价:治疗过程中3组均未产生其他并发症或不良反应。结论:(1)温针灸治疗阳虚寒凝型KOA有明显疗效,且能有效促进关节积液吸收。(2)温针灸壮数不同对KOA的临床疗效有一定影响,2壮温针灸是治疗阳虚寒凝型KOA的优选壮数,2壮温针灸在改善症状、镇痛、恢复关节功能,促进积液吸等方面具有相对优势,值得临床推广应用。
[Abstract]:Objective: to investigate the effect of acupuncture and moxibustion on Yang deficiency and cold coagulation type knee osteoarthritis (KOAA) and the effusion of articular cavity. Methods: 96 cases of KOA with joint effusion were selected and randomly divided into 3 groups. 32 cases in each group were treated with warm acupuncture and moxibustion. Acupoints were taken from the inner knee eye of the affected side (EX-LE4N), the outer knee eye (ST35) and Zusanli (ST36D), the first Zhuang group after acupuncture, the two groups, and the third group were treated with acupuncture and moxibustion (1 Zhuang, 2 Zhuang, 3 Zhuang, 3 Zhuang) after acupuncture for 40 min / every 15 days as a course of treatment. Two courses of treatment were treated for 2 days. The clinical efficacy, symptom score, pain score, articular motor function and accumulation of fluid were compared between the three groups before, after and 2 months follow-up. Results: the total curative effect evaluation: after two courses of treatment, the effective rate of the first Zhuang group was 76.677.The effective rate of the two groups was 87.100.The effective rate of the Sanzhuang group was 90.00. The effective rate of the two groups was significantly better than that of the first group (P 0.05), while the effective rate of the two groups was not significantly different from that of the Sanzhuang group (P < 0.05). The evaluation of the outcome indexes: the score of symptoms, the motor function of the knee joint, the score of pain, the difference between the two groups was not statistically significant. The changes of joint effusion content in the three groups were improved after treatment compared with those before treatment, and the improvement of the two groups and the Sanzhuang group were significantly better than that of the first group, and the comparison between the two groups and the Sanzhuang group after treatment, and the difference between the two groups and the Sanzhuang group was also significant, while that of the two groups was significantly higher than that of the control group, and the difference between the two groups was better than that in the other two groups. There was no significant difference in safety evaluation: no other complications or adverse reactions occurred in the three groups. Conclusion warming acupuncture and moxibustion has obvious curative effect on KOA with Yang deficiency and cold coagulation. And it can effectively promote the absorption of joint effusion. 2) warming acupuncture and moxibustion has certain influence on the clinical efficacy of KOA. It is a good choice of acupuncture and moxibustion in treating KOA with Yang deficiency and cold coagulation. It can improve symptoms, analgesia and restore joint function. It is worth popularizing clinical application because of its relative advantages in promoting effusion absorption and so on.
【作者单位】：福建中医药大学针灸学院;厦门市湖里区江头街道社区卫生服务中心;福建中医药大学附属第二人民医院针灸科;
【基金】：国家自然科学基金面上项目(No.81373719)~~
【分类号】：R246.9

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