摘要
目的 基于影像学指标评价理筋动髌手法治疗髌股关节骨关节炎的临床疗效和作用机制。方法 招募126例髌股关节骨关节炎患者,按照随机数字表法分为治疗组和对照组。对照组给予常规玻璃酸钠单侧注射治疗,每周1次,共治疗5次。治疗组给予理筋动髌手法治疗,每周3次,治疗4周。比较两组治疗前与治疗结束1周后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟量表(VAS)评分及影像学指标(包括髌骨外移距离、髌股适合角、外侧髌股角、髌股指数),并比较两组临床疗效。结果 治疗组总有效率(45/54,83.33%)明显优于对照组(36/54,66.67%),差异具有统计学意义(P<0.05)。治疗结束1周后,两组VAS评分及WOMAC评分均低于本组治疗前(P<0.01),且治疗组髌股指数、髌股适合角较对照组减小(P<0.05)。与本组治疗前比较,治疗组治疗结束1周后髌骨外移距离、髌股指数、髌股适合角均减小,对照组髌股适合角均减小(P<0.05)。结论 理筋动髌手法通过调筋理筋纠正髌骨外翻程度,缓解患者的关节疼痛症状,改善关节功能,达到治疗髌股关节骨关节炎的目的。
Objective To evaluate the therapeutic effect and mechanism of tendon-management and patellamovement therapeutic manipulation in the treatment of patellofemoral arthritis based on imaging evaluation.Methods Totally 126 patients with patellofemoral arthritis were recruited and divided into a treatment group and a control group according to a randomised numerical table.The control group received routine sodium hyaluronate injection once a week for a total of 5 times;the treatment group received tendon-management and patella-movement therapeutic manipulation three times a week for four weeks.We compared the Western Ontario and McMaster University osteoarthritis index score(WOMAC),visual analogue scale(VAS),imaging indicators including patellar external displacement distance,patellofemoral fit angle,lateral patellofemoral angle,and patellofemoral index,and overall effectiveness evaluation between the two groups before and one week after treatment.Results The total effective rate of the treatment group(45/54,83.33%)was significantly higher than that of the control group(36/54,66.67%,P<0.05).One week after the end of treatment,the VAS scores and WOMAC scores of both groups were lower than those before treatment in the same group(P<0.01),and the patellofemoral index and patellofemoral fit angle of the treatment group decreased compared with that of the control group(P<0.05).Compared with the pre-treatment,the distance of patellar external displacement,patellofemoral index,and patellofemoral fit angle decreased in the treatment group 1 week after the end of treatment,and the patellofemoral fit angle decreased in the control group(P<0.05).Conclusion The therapeutic manipulation of tendon-management and patella-movement can correct the degree of patellar external displacement,alleviate joint pain symptoms,improve joint function,and achieve the goal of treating patellofemoral arthritis.
作者
顾金光
魏光成
赵勇
董永丽
卓泽川
孙奥林
秦伟凯
GU Jinguang;WEI Guangcheng;ZHAO Yong;DONG Yongli;ZHUO Zechuan;SUN Aolin;QIN Weikai(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing,100102;Suzhou Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine)
出处
《中医杂志》
北大核心
2025年第13期1350-1356,共7页
Journal of Traditional Chinese Medicine
基金
中国中医科学院科技创新工程项目(CI2021A03604)。
关键词
髌股关节骨关节炎
筋束骨
理筋动髌手法
关节功能
随机对照研究
patellofemoral arthritis
tendon fettering bones
tendon-management and patella-movement therapeutic manipulation
joint function
randomised controlled trial
作者简介
通讯作者:秦伟凯,qinvkai@163.com。
