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(P<0.05),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(P<0.05,P<0.01),且治疗后两壮组、三壮组的改善情况也均明显优于一壮组(P<0.05,P<0.01),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。
Objective: To study the effect of different number of warming needle moxibution to arthroedema of knee osteoarthritis(KOA) with yang deficiency and coagulated cold type, and evaluate its curative effect. Methods: Ninty-six patients with KOA who diagnosed as KOA with yang deficiency and coagulated cold type were selected and randomly divided into 3 groups based on patient's treatment orders, 32 cases in each group. All groups received warming needle moxibution, and the acupoints were Neixiyan(EX-LE4), Waixiyan(ST35) and Zusanli(ST36), with drawal of needle in 3 groups was performed after moxibution for 1 time, 2 times and 3 times. The treatment in 3 groups was once-daily, 40 minutes for each time, 15 days as a course of treatment, 2 days off between courses, and treated for 2 courses. The clinical curative effect, symptom score, pain score, joint movement function and joint effusion content were observed before and after treatment as well as follow-up for 2 months. Results:(1)The total curative effect evaluation: The 3 groups had achieved obvious curative effect after 2 courses, the effective rate of 1 time group was 76.67%; the effective rate of 2 times group was 87.10%, the effective rate of 3 times group was 90.00%. The effective rate of 2 times group and 3 times group was significantly better than that of 1 time group(P<0.05), and there was no significant difference between 2 times group and 3 times group.(2)Index evaluation: The clinical curative effect, symptom score, pain score, joint movement function and fluid content of 3 groups decreased after treatment(P<0.05, P<0.01), and the improvement of 2 times group or 3 times group were significantly better than 1 time group(P<0.05, P<0.01), and there was no significant difference between 2 times group and 3 times group.(3)Safety evaluation: In the course of the treatment, complications or adverse reactions were not found in 3 groups. Conclusion:(1)Warming needle moxibution has obvious effect in treating knee osteoarthritis with yang deficiency and coagulated cold type by effectively promoting the absorption of joint effusion.(2)Different number of warming needle moxibution has effects on the clinical curative effect to knee osteoarthritis, 2 times of warming needle moxibution is the optimization number for knee osteoarthritis with yang deficiency and coagulated cold type, it has great advantages in improving symptoms, relieving pain, joint function recovery, promoting the absorption of joint effusion, and it is worthy of clinical popularization and application.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2017年第9期4312-4316,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金面上项目(No.81373719)~~
关键词
膝骨性关节炎
温针灸
不同壮数
疗效
积液
Knee osteoarthritis
Warming needle moxibustion
Different number of times
Curative effect
Effusion
