摘要
目的:探讨阶梯疗法对膝骨关节炎临床疗效的影响。方法:应用计算机网络随机数字法将入组的96例患者随机分为两组,阶梯组采用定点平衡力学手法、外敷中药制剂与银质针刀松解配合几丁糖注射治疗,对照组给予传统推拿治疗。监测两组治疗前后及随访时膝关节运动功能、关节腔内积液量、实验室检查指标、炎症因子及临床疗效和安全性评价,并进行统计分析。结果:治疗6周及1个月随访时阶梯组Lysholm功能评分及关节积液量改善情况明显优于对照组(P<0.05或P<0.01);炎性因子包括IL-6、TNF-α、HA与IL-1β水平均低于对照组,差异有统计学意义(P<0.05);阶梯组治疗6周后实验室检查指标明显低于治疗前(P<0.05),对照组无明显改善,差异无统计学意义(P>0.05);阶梯组愈显率为72.92%(35/48),显著高于对照组的37.50%(18/48)。结论:阶梯疗法在改善膝骨关节炎症状、镇痛、恢复关节功能和促进积液吸收等方面具有相对优势,疗效优于传统推拿治疗,且安全有效。
Objective:To explore the clinical efficacy of ladder therapy in treating knee osteoarthritis(KOA).Methods:96 patients with KOA were randomly divided into the control group and the ladder group by using the computer network random number method.The ladder group was treated with fixed-point balance mechanics,external application of Chinese medicine preparations,silver needle acupotomy relaxation and chitosan injection.The control group was treated with traditional Tuina therapy.The knee joint motor function,intra-articular fluid accumulation,laboratory test indicators,inflammatory factors,clinical efficacy and safety evaluation were monitored before the treatment,after the treatment and during the follow-up.Statistical analysis was performed finally.Results:The improvement of Lysholm function score and joint effusion volume were significantly better in the ladder group than those in the control group after 6 weeks of the treatment and during the one-month follow-up(P<0.05);the levels of inflammatory factors including IL-6,TNF-α,HA and IL-1βwere all lower in the ladder group than those in the control group(P<0.05).The laboratory test indexes were significantly lower after 6 weeks of the treatment than those before the treatment in the ladder group(P<0.05);which showed no significant improvements in the control group(P>0.05).The total significant efficiency rate was 72.92%(35/48)in the ladder group,which was significantly higher than 37.50%(18/48)in the control group(P<0.05).Conclusion:Ladder therapy has comparative advantages in improving KOA symptoms,increasing analgesia,restoring joint function and promoting fluid absorption in treatment of KOA.The curative effect is better than traditional Tuina therapy.
作者
师浩钧
谢良玉
许文昌
师彬
SHI Haojun;XIE Liangyu;XU Wenchang;SHI Bin(The Second Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China;Bone Biomechanics Engineering Laboratory of Shandong Province,Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University,Jinan 250014,China)
出处
《针灸临床杂志》
2023年第1期10-14,共5页
Journal of Clinical Acupuncture and Moxibustion
基金
山东省中央引导地方科技发展资金项目,编号:YDZX20203700002055
齐鲁医派中医学术流派传承项目,编号:鲁卫函《2021》45号
山东第一医科大学学术提升计划,编号:2019QL003。
关键词
阶梯疗法
推拿疗法
膝骨关节炎
Ladder therapy
Tuina therapy
Knee osteoarthritis
作者简介
师浩钧(1998-),男,2017级中医学专业本科生,研究方向:脊柱及脊柱相关疾病临床及基础研究;通讯作者:师彬(1969-),男,主任医师,博士,研究方向:脊柱及脊柱相关疾病临床及基础研究。
