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1. 北京市西城区新街口社区卫生服务中心中医科
2. 北京中医药大学东直门医院针灸科
纸质出版日期:2019
移动端阅览
罗溪, 侯学思, 田紫煜, 等. 针刺干预早期膝关节骨性关节炎:随机对照试验[J]. 针刺研究, 2019,44(3):211-215.
LUO Xi, HOU Xue-si, TIAN Zi-yu, et al. Randomized controlled clinical trial of acupuncture treatment for knee osteoarthritis in the early stage[J]. Acupuncture research, 2019, 44(3): 211-215.
罗溪, 侯学思, 田紫煜, 等. 针刺干预早期膝关节骨性关节炎:随机对照试验[J]. 针刺研究, 2019,44(3):211-215. DOI: 10.13702/j.1000-0607.180677.
LUO Xi, HOU Xue-si, TIAN Zi-yu, et al. Randomized controlled clinical trial of acupuncture treatment for knee osteoarthritis in the early stage[J]. Acupuncture research, 2019, 44(3): 211-215. DOI: 10.13702/j.1000-0607.180677.
目的:观察对于早期膝关节骨性关节炎(KOA)针刺联合基础治疗与单纯基础治疗的临床疗效差异。方法:将60例单侧KOA患者按随机数字表法分为基础治疗组和针刺联合基础治疗组
每组30例。基础治疗组采用患者教育和患膝局部涂抹双氯芬酸二乙胺乳胶剂
每天涂抹3次
连续2周。针刺联合基础治疗组在基础治疗组的基础上
针刺患侧阿是穴、足三里、阳陵泉、阴陵泉、内膝眼和犊鼻
每次留针30min
每周一、三、五治疗1次
连续治疗2周。于治疗前后测评患者的视觉模拟量尺(VAS)评分及西安大略和麦克马斯特大学(WOMAC)骨关节炎量表评分
并在治疗后观察患者的临床疗效。结果:两组患者治疗后患膝VAS评分均低于治疗前(P<0.05)
且针刺联合基础治疗组治疗后评分低于基础治疗组(P<0.05)
治疗前后差值大于基础治疗组(P<0.05)。两组患者治疗后患膝WOMAC评分均低于治疗前(P<0.05)
且针刺联合基础治疗组治疗后评分低于基础治疗组(P<0.05)
治疗前后差值大于基础治疗组(P<0.05)。治疗后基础治疗组的愈显率为73.33%(22/30)
针刺联合基础治疗组的愈显率为83.33%(25/30)
两组比较差异无统计学意义(P>0.05)。结论:针刺联合基础治疗对于早期KOA比单纯基础治疗更能减轻患者疼痛
改善膝关节活动度
有潜在的临床疗效优势。
Objective To observe the therapeutic effect of acupuncture in the treatment of patients with knee osteoarthritis(KOA)in the early stage.Methods A total of 60 KOA patients were randomized into medication group and acupuncture combined with medication(acupuncture)group(n=30 in each group).Patients of the medication group were treated by external application of Diclofenac Diethylamine Emulgel around the affected joint
3 times a day for 2 successive weeks and reasonable exercising training.Patients of the acupuncture group received routine medication and reasonable exercising training and acupuncture of Ashi-points
Zusanli(ST36)
Yanglingquan(GB34)
Yinlingquan(SP9)
Neixiyan(EX-LE4)and Dubi(ST35)at affected side with filiform needles which were manipulated with uniform reinforcing-reducing method for a while
followed by retaining the needles for 30 min.The treatment was conducted once every other day for 2 weeks.The pain degree was assessed by using visual analog scale(VAS)and the Western Ontario McMaster Universities Osteoarthritis Index(WOMAC)scale(0-240 points)was used to evaluate the severity of KOA
and the"Diagnosis of Syndromes of Traditional Chinese Medicine"was used to assess the therapeutic effect after the treatment.Results After the treatment
the VAS and WOMAC scores of both medication and acupuncture groups were significantly and respectively decreased in comparison with their own pre-treatment(P<0.05)
and the scores of the two indexes of the acupuncture group were evidently lower than those of the medication group(P<0.05).Of the two 30 cases in the medication and acupuncture groups
5(16.67%)and 6(20.00%)were cured
17(56.67%)and 19(63.33%)experienced marked improvement
6(20.00%)and 4(13.33%)were effective
2(6.67%)and 1(3.33%)were ineffective
with the effective rate of cure plus marked effectiveness being 73.33% and 83.33%
respectively.No significant difference was found between the two groups in the therapeutic effect(P>0.05).Conclusion Acupuncture combined with medication has a better therapeutic effect in the treatment of KOA in the early stage than that of the simple medication.
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