摘要
目的观察运气学说指导下的杵针疗法治疗气滞血瘀型膝骨关节炎的临床疗效。方法将108例气滞血瘀型膝骨关节炎患者随机分为常规组、杵针组和运气杵针组,每组36例。常规组采用膝骨关节炎常规治疗和护理,杵针组在常规组基础上行杵针治疗,运气杵针组在常规组基础上采用运气学说指导的杵针治疗。比较治疗前后及随访时3组疼痛视觉模拟量表(visual analog scale,VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and Mc Master University osteoarthritis index,WOMAC)评分、中医证候积分及生活质量评价简明量表(12-item short-form health survey,SF-12)中躯体健康总测量(physical component summary,PCS)和精神健康总测量(mental component summary,MCS)评分的变化,并比较3组临床疗效。结果3组治疗1个疗程后、治疗后及随访时VAS评分、WOMAC评分和中医证候积分较治疗前降低(P<0.05),3组治疗后VAS评分、WOMAC评分和中医证候积分较治疗1个疗程后降低(P<0.05),常规组和杵针组随访时VAS评分、WOMAC评分和中医证候积分较治疗后升高(P<0.05)。3组治疗1个疗程后VAS评分比较,差异无统计学意义(P>0.05);杵针组与运气杵针组治疗后VAS评分低于常规组(P<0.05);杵针组与运气杵针组治疗1个疗程后和治疗后WOMAC评分和中医证候积分低于常规组(P<0.05);运气杵针组随访时VAS评分、WOMAC评分和中医证候积分低于杵针组和常规组,杵针组低于常规组,差异均有统计学意义(P<0.05)。3组治疗后和随访时PCS和MCS评分较治疗前升高(P<0.05)。杵针组与运气杵针组治疗后PCS和MCS评分高于常规组(P<0.05);运气杵针组随访时PCS评分高于常规组(P<0.05);运气杵针组随访时MCS评分高于杵针组和常规组,杵针组高于常规组,差异均有统计学意义(P<0.05)。常规组总有效率为83.3%,杵针组总有效率为94.4%,运气杵针组总有效率为97.1%,杵针组和运气杵针组总有效率高于常规组(P<0.05)。结论运气学说指导下杵针疗法治疗气滞血瘀型膝骨关节炎,可以减轻膝关节疼痛,改善膝关节功能,提高生活质量,疗效优于常规治疗和杵针治疗,且疗效更持久。
Objective To observe the clinical efficacy of pestle needle therapy based on the theory of five circuits and six qi for knee osteoarthritis of qi stagnation and blood stasis type.Method One hundred and eight patients with knee osteoarthritis of qi stagnation and blood stasis type were randomized to conventional,pestle needle and five circuits and six qi-based pestle needle groups,with 36 cases in each group.The conventional group received conventional treatment and nursing;the pestle needle group,pestle needle therapy plus conventional treatment and nursing;the five circuits and six qi-based pestle needle group,pestle needle therapy based on the theory of five circuits and six qi plus conventional treatment and nursing.The visual analog scale(VAS)score,the Western Ontario and McMaster University osteoarthritis index(WOMAC)score,the TCM symptom score and the physical component summary(PCS)and mental component summary(MCS)scores in the 12-item short-form health survey(SF-12)were compared between the three groups before and after treatment and at the follow-up.The clinical therapeutic effects were compared between the three groups.Result The VAS score,the WOMAC score and the TCM symptom score decreased in the three groups after one course and the completion of treatment and at the follow-up compared with before(P<0.05)and after the completion of treatment compared with after one course(P<0.05)and increased in the conventional and pestle needle groups at the follow-up compared with after the completion of treatment(P<0.05).The VAS score had no statistically significant difference between the three groups after one course of treatment(P>0.05)and was lower in the pestle needle and five circuits and six qi-based pestle needle groups than in the conventional group after the completion of treatment(P<0.05).The WOMAC score and the TCM symptom score were lower in the pestle needle and five circuits and six qi-based pestle needle groups than in the conventional group after one course of and the completion of treatment(P<0.05).The VAS score,the WOMAC score and the TCM symptom score were lower in the five circuits and six qi-based pestle needle group than in the pestle needle and conventional groups and were lower in the pestle needle group than in the conventional group at the follow-up with statistically significant differences in all(P<0.05).The PCS and MCS scores increased in the three groups after the completion of treatment and at the follow-up compared with before treatment(P<0.05).The PCS and MCS scores were higher in the pestle needle and five circuits and six qi-based pestle needle groups than in the conventional group after the completion of treatment(P<0.05);the PCS score was higher in the five circuits and six qi-based pestle needle group than in the conventional group at the follow-up(P<0.05);the MCS score was higher in the five circuits and six qi-based pestle needle group than in the pestle needle and conventional groups and in the pestle needle than in the conventional group at the follow-up with statistically significant differences in all(P<0.05).The total efficacy rate was 83.3%in the conventional group,94.4%in the pestle needle group and 97.1%in the five circuits and six qi-based pestle needle group;it was higher in the pestle needle and five circuits and six qi-based pestle needle groups than in the conventional group(P<0.05).Conclusion Pestle needle therapy based on the theory of five circuits and six qi can relieve knee joint pains,improve knee joint function and raise the quality of life in treating knee osteoarthritis of qi stagnation and blood stasis type.It is more effective than pestle needle therapy and conventional treatment and produces a longer-lasting therapeutic effect.
作者
杨春枝
姚洁
董博
邓楠
种文强
赵军
范洪伟
武霜
赵琛
YANG Chunzhi;YAO Jie;DONG Bo;DENG Nan;CHONG Wenqiang;ZHAO Jun;FAN Hongwei;WU Shuang;ZHAO Chen(Shaanxi University of Traditional Chinese Medicine School of Nursing,Xianyang 712046,China;Xi’an Honghui Hospital,Xi’an 710000,China;Xi’an Hospital of Traditional Chinese Medicine,Xi’an 710021,China)
出处
《上海针灸杂志》
2025年第3期283-289,共7页
Shanghai Journal of Acupuncture and Moxibustion
基金
陕西中医药大学优势特色与交叉学科支持计划项目(2022XKZC05)。
关键词
杵针疗法
气滞血瘀型
骨关节炎
膝
五运六气
随机对照试验
Pestle needle therapy
Qi stagnation and blood stasis type
Osteoarthritis,Knee
Five circuits and six qi
Randomized controlled trial
作者简介
杨春枝(1980-),女,主管护师,硕士,Email:chunzhiyang@126.com;通信作者:姚洁(1979-),女,教授,博士,Email:344246303@qq.com。
