针刺足运感区为主治疗膝骨性关节炎的临床疗效观察

发布时间：2018-11-04 17:21

【摘要】：目的:观察针刺足运感区、巨毼穴和情感区治疗膝骨性关节炎的临床疗效,寻求更简练、有效的治疗方法。方法:本课题采用随机数字表法将符合纳入标准的96例患者分为治疗组与对照组,每组48例,治疗组针刺对侧足运感区、情感区、同侧巨毼穴,上述二区行针快速捻转约3分钟,频率200转/分以上,留针30分钟,留针期间每10分钟捻转1次;巨毼穴行毫针常规针刺,行针后嘱患者活动膝关节,以患者能接受为度。留针30分钟。对照组取膝眼、梁丘、阳陵泉、血海等穴直刺0.5-1.2寸,行毫针常规针刺,留针30分钟。两组每日针刺治疗1次,每周进行6天,休息1天,共治疗5周。将骨关节炎指数(WOMAC)评分、视觉模拟(VAS)评分、膝关节屈伸活动度、焦虑自评量表(SAS)以及抑郁自评量表(SDS)作为评价指标,观察并总结两组的治疗效果,将所得数据进行统计学分析。结果:1.两组视觉模拟评分法(VAS)评分比较:治疗后两组经过组内及组间比较,均有显著性差异(p0.05)。提示两组治疗方案对膝骨性关节炎患者疼痛的减轻均有疗效,且治疗组效果优于对照组。2.两组骨关节炎指数(WOMAC)评分比较:治疗组中,治疗前与治疗后疼痛、僵硬、进行日常活动的难度及总分相比,均具有极显著性差异(p0.01),说明治疗组在改善疼痛及其他症状有明显疗效;对照组中,与治疗前相比,治疗后疼痛、进行日常活动的难度、总分具有显著性差异(p0.05),说明对照组可以缓解疼痛,降低进行日常生活的难度;对照组中,治疗前与治疗后僵硬对比,无显著性差异(p0.05),说明对照组在改善关节僵硬方面效果不明显。治疗后两组疼痛、僵硬、进行日常活动的难度有显著性差异(p0.05),说明两组治疗均有效。3.两组膝关节屈伸活动度比较:治疗后,与对照组相比,治疗组在改善膝关节活动度方面,有显著性差异(p0.05),说明治疗组优于对照组。4.两组焦虑自评表(SAS)比较:治疗后两组经过组内及组间比较,均有显著性差异(p0.05)。提示两组治疗方案对缓解膝骨性关节炎患者焦虑情绪均有疗效,且治疗组效果优于对照组。5.两组抑郁自评表(SDS)比较:治疗后两组经过组内及组间比较,均有显著性差异(p0.05)。提示两组治疗方案对缓解膝骨性关节炎患者抑郁情绪均有疗效,且治疗组效果优于对照组。6.两组临床疗效比较:治疗组总有效率为97.91%,对照组总有效率为91.67%,两组对比差异具有统计学意义(p0.05),说明治疗组治疗膝骨性关节炎的临床疗效优于对照组。结论:1.针刺足运感区、情感区、巨毼穴配合动法与传统方法治疗膝骨性关节炎均有疗效,且针刺足运感区、情感区、巨毼穴配合动法更有显著性。2.针刺足运感区、情感区、巨毼穴配合动法治疗膝骨性关节炎能够有效改善患者膝关节疼痛、僵硬症状,提高膝关节活动度,缓解焦虑抑郁心情。
[Abstract]:Objective: to observe the clinical curative effect of acupuncture on knee osteoarthritis (OA) in the area of sensation of foot operation, acupoint Juzhang and emotional area, and to seek more concise and effective treatment methods. Methods: 96 patients were randomly divided into treatment group (n = 48) and control group (n = 48). The above two areas are twirled for about 3 minutes with a frequency of more than 200 rpm and a needle for 30 minutes, twirling once every 10 minutes during the needle retention period; After routine acupuncture, the patient was told to move the knee joint so that the patient could accept it. Keep the needle for 30 minutes. In the control group, the knee eyes, Liang Qiu, Yanglingquan and Xuehai points were pricked 0.5-1.2 inches. Two groups were treated with acupuncture once a day, 6 days a week, rest 1 day, a total of 5 weeks. Osteoarthritis index (WOMAC), visual analog (VAS) (VAS), knee flexion and extension activity, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used as evaluation indexes to observe and summarize the therapeutic effects of the two groups. The data were analyzed statistically. The result is 1: 1. Comparison of visual analogue score (VAS) between the two groups: there was significant difference between the two groups after treatment (p0.05). It is suggested that the two treatment groups have curative effect on pain relief of patients with knee osteoarthritis, and the effect of the treatment group is better than that of the control group. 2. Comparison of (WOMAC) score of osteoarthritis index between the two groups: in the treatment group, there were significant differences in pain, stiffness, difficulty in daily activities and total score before and after treatment (p0.01). The results showed that the treatment group had obvious curative effect in improving pain and other symptoms. In the control group, compared with before treatment, pain after treatment, the difficulty of daily activities, the total score has significant difference (p0.05), indicating that the control group can alleviate the pain, reduce the difficulty of daily life; In the control group, there was no significant difference in stiffness before and after treatment (p0.05), indicating that the effect of the control group in improving joint stiffness was not obvious. There were significant differences in pain, stiffness and difficulty of daily activities between the two groups after treatment (p0.05), indicating that the two groups were effective. Comparison of knee flexion and extension activity between the two groups: after treatment, there were significant differences in improving knee joint motion between the treatment group and the control group (p0.05), which indicated that the treatment group was better than the control group. Comparison of (SAS) between the two groups: there were significant differences between the two groups after treatment (p0. 05). The results suggest that the two groups are effective in relieving anxiety in patients with knee osteoarthritis, and the effect of the treatment group is better than that of the control group (5. 5%). Comparison of (SDS) between the two groups: after treatment, there were significant differences between the two groups after treatment (p0. 05). The results suggest that the two groups are effective in relieving depression in patients with knee osteoarthritis, and the effect of the treatment group is better than that of the control group (6. 6%). Comparison of clinical efficacy between the two groups: the total effective rate in the treatment group was 97.91, and the total effective rate in the control group was 91.67. The difference between the two groups was statistically significant (p0.05). The results showed that the treatment group was superior to the control group in the treatment of knee osteoarthritis. Conclusion: 1. Acupuncture has curative effect on knee osteoarthritis by acupuncture in the area of feeling of movement of foot, emotional area, combined method of acupoint Gudu and traditional method, and acupuncture of the area of feeling of movement of foot, emotional area, and acupoint Giu are more significant. 2. Acupuncture can effectively improve the pain and stiffness of knee joint, improve the movement of knee joint and relieve anxiety and depression.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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