摘要
目的:比较耳穴电针加隔灵仙药饼灸(简称耳穴电针加灸)与电针、TDP照射3种疗法治疗膝骨关节炎(KOA)的疗效差异。方法:将89例患者随机分成3组,耳穴电针加灸组30例,采用耳穴电针刺加隔灵仙药饼灸治疗,耳穴取膝、皮质下、神门,隔药饼灸阳陵泉、犊鼻、足三里、内膝眼、鹤顶、阿是穴;电针组29例,采用与上述隔药饼灸相同的腧穴电针治疗;TDP组30例,采用患膝TDP照射治疗。3组均每天治疗1次,10次为一疗程,疗程间休息1周,共治疗3个疗程。观察各组患者治疗前及治疗后1周KOA临床症状体征评分和Lequesne指数疼痛症状单项评分情况,并比较3组疗效。结果:治疗后1周各组患者症状体征总积分与治疗前比较显著降低(均P<0.05),且耳穴电针加灸组在改善症状体征方面优于另两组(1.50±1.57vs 2.52±1.82、2.63±1.97,均P<0.05);对疼痛评分的改善耳穴电针加灸组亦优于其他两组(2.37±0.81vs 2.83±0.92,P<0.05;2.37±0.81vs 3.03±0.77,P<0.01);耳穴电针加灸组治愈率为40.0%(12/30),高于电针组的17.2%(5/29)与TDP组的20.0%(6/30,均P<0.01);耳穴电针加灸组在总疗效方面优于另两组(P<0.05)。结论:耳穴电针加隔灵仙药饼灸在改善膝骨关节炎患者症状体征总积分以及总疗效方面优于电针局部穴和TDP局部照射。
Objective To observe the difference in the therapeutic effects on knee osteoarthritis （KOA） among auricular electroacupuncture therapy plus isolated moxibustion with Lingxian herbal paste （combined therapy）, electroacupuncture （EA） and TDP irradiation. Methods Eighty-nine cases were randomized into three groups. In the combined therapy group （30 cases）, the auricular electroacupuncture therapy was adopted together with the isolated moxibustion with Lingxian herbal paste. The auricular points were xi （AH4）, pizhixia （AT4）, shenmen （TF4）, etc. The Lingxian herbal paste was applied at Yanglingquan （GB 34）, Dubi （ST 35）, Zusanli （ST 36）, Neixiyan （EX-LE 4）, Heding （EX-LE 2） and Ashi points. In EA group （29 cases）, EA was applied at the acu- points that were same as those in the isolated moxibustion with Lingxian herbal paste. In TDP group （30 cases）, TDP irradiation was given at the affected knee. The treatment was given once every day, 10 treatments made one session and there was 1 week at the interval among sessions. Totally, 3 sessions of treatment were required. KOA clinical symptom and physical sign score and the single item pain symptom score of Lequesne index were observed before treatment and 1 week after treatment in the patients of each group separately. The efficacies were compared among the three groups. Results One week after treatment, the total score of symptoms and physical signs of the patients in each group was reduced significantly as compared with that before treatment （all P〈0.05）. The im- provements in the symptoms and physical signs in the combined therapy group were better than those in the other two groups （1.50±1.57 vs 2.52±1.82, 2.63±1.97, both P〈0.05）. The improvement in pain in the combined therapy group was also better than that in the other two groups （2.37±0.81 vs 2.83±0. 92, P〈0.05, 2.37± 0.81 vs 3.03±0.77, P〈0.01）. The curative rate in the combined therapy group was 40.0% （12/30）, which was higher than 17.2% （5/29） in EA group and 20.0% （6/30） in TDP group separately （both P〈0.01）. The overall efficacy in the combined therapy group was superior to the other two groups （P〈0.05）. Conclusion The auricu- lar electroacupuncture therapy plus isolated moxibustion with Lingxian herbal paste is advantageous at the tota lscore of the symptoms and physical signs and the overall efficacy in the patients of KOA as compared with EA at the local acupoints and local TDP irradiation.
出处
《中国针灸》
CAS
CSCD
北大核心
2014年第3期230-234,共5页
Chinese Acupuncture & Moxibustion
关键词
膝骨关节炎
耳穴
电针
隔物灸
随机对照试验
knee osteoarthritis
auricular points
electroacupuncture
isolated moxibustion
randomized con-trolled trial（RCT）
作者简介
第一作者：成钢（1958-），男，副主任医师、副教授。研究方向：针刺镇痛和中医痿、痹、瘫类病证的临床针灸康复技术。E-mail：847581838@qq．com
