Application of combing thumbtack needle with ear point pressing beans in knee osteoarthritis patients with syndrome of qi and blood weakness
-
摘要:
目的 观察揿针联合耳穴压豆在轻中度气血虚弱证膝骨关节炎患者中的临床应用效果。 方法 选取温州市中医院骨科2019年3月—2020年3月收治的112例轻中度气血虚弱证膝骨关节炎患者,按照随机数字表法分为2组,且2组各脱落6例,最终2组各50例。对照组予常规康复治疗,研究组在对照组的基础上应用揿针联合耳穴压豆。观察2组治疗前后膝关节肿胀、压痛、活动度体征评分、血清C反应蛋白、西安大略和麦克马斯特骨关节炎指数(WOMAC)功能、疼痛、僵硬等指标。 结果 治疗4周后研究组膝关节肿胀[(1.43±0.32)分]、压痛[(1.01±0.13)分]、活动度评分[(1.06±0.24)分]、血清C反应蛋白[(5.32±1.68)mg/L]、WOMAC评分功能[(18.13±6.45)分]、疼痛[(7.35±2.19)分]、僵硬[(2.43±1.03)分]及总分[(26.43±9.51)分]均低于对照组[(2.68±0.75)分、(1.98±0.77)分、(2.34±0.98)分、(10.67±2.93)mg/L、(24.32±5.17)分、(14.15±4.38)分、(3.69±1.15)分、(48.19±8.43)分],差异有统计学意义(均P<0.05)。 结论 揿针联合耳穴压豆可缓解轻中度气血虚弱证膝骨关节炎患者肿胀、疼痛、关节僵硬等症状,降低血清C反应蛋白,提高膝关节功能和生活质量。 Abstract:Objective To observe the application of combing thumbtack needle with ear point pressing beans in mild-to-moderate knee osteoarthritis patients with syndrome of qi and blood weakness. Methods A total of 112 mild-to-moderate knee osteoarthritis patients with syndrome of qi and blood weakness admitted from March 2019 to March 2020 were recruited and randomly divided into two groups using the random number table, six cases were shed in each group and 50 cases were included in each group for study. The control group was given routine rehabilitation treatment, whereas the research group was given thumbtack needle and ear point pressing beans. Knee joint swelling, tenderness, activity, serum C-reactive protein (CRP), function, pain and stiffness of WOMAC indicators were compared between the two groups before and after treatment. Results After treatment for 4 weeks, the knee joint swelling [(1.43±0.32) points], tenderness [(1.01±0.13) points], activity [(1.06±0.24) points], CRP [(5.32±1.68) mg/L], WOMAC function [(18.13±6.45) points], pain [(7.35±2.19) points], stiffness [(2.43±1.03) points] and total score [(26.43±9.51) points] in the research group were lower than those in the control group [knee joint swelling (2.68±0.75) points, tenderness (1.98±0.77) points, activity (2.34±0.98) points, CRP (10.67±2.93) mg/L, WOMAC function (24.32±5.17) points, pain (14.15±4.38) points, stiffness (3.69±1.15) points and total score (48.19±8.43) points]. The differences were statistically significant (all P < 0.05). Conclusion Combing thumbtack needle with ear point pressing beans can ease swelling, pain, tenderness and symptom, reduce the CRP level and improve knee joint function and quality of life of mild-to-moderate knee osteoarthritis patients with syndrome of qi and blood weakness. -
表 1 2组轻中度气血虚弱证KOA患者临床资料比较
组别 例数 性别(例) 年龄
(x±s, 岁)WOMAC总分
(x±s, 分)Kellgren分级(例) 男性 女性 Ⅱ级 Ⅲ级 研究组 50 21 29 69.25±5.32 75.31±6.52 23 27 对照组 50 23 27 67.31±5.19 74.18±7.05 24 26 统计量 0.162a 1.846b 0.832b 0.040a P值 0.687 0.068 0.407 0.841 注:a为χ2值,b为t值。 表 2 2组轻中度气血虚弱证KOA患者治疗前后膝关节体征评分、CRP比较(x±s)
组别 例数 肿胀(分) 压痛(分) 活动度(分) CRP(mg/L) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 研究组 50 3.06±0.42 1.43±0.32a 2.75±0.21 1.01±0.13a 2.98±0.11 1.06±0.24a 8.59±2.47 5.32±1.68a 对照组 50 3.01±0.35 2.68±0.75 2.68±0.32 1.98±0.77 2.93±0.19 2.34±0.98 17.83±2.71 10.67±2.93a t值 0.647 10.840 1.293 8.783 1.610 8.971 1.466 11.201 P值 0.519 < 0.001 0.202 < 0.001 0.114 < 0.001 0.146 < 0.001 注:与同组治疗前比较,aP<0.05。 表 3 2组轻中度气血虚弱证KOA患者治疗前后WOMAC评分比较(x±s, 分)
组别 例数 功能 疼痛 僵硬 总分 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 研究组 50 46.29±4.35 18.13±6.45a 22.19±2.73 7.35±2.19a 5.24±1.06 2.43±1.03a 5.31±6.52 26.43±9.51a 对照组 50 45.73±3.62 24.32±5.17a 22.35±3.65 14.15±4.38a 5.08±1.14 3.69±1.15a 74.18±7.05 48.19±8.43a t值 0.700 5.295 0.248 9.819 0.727 5.771 0.832 12.107 P值 0.486 < 0.001 0.805 < 0.001 0.469 < 0.001 0.407 < 0.001 注:与同组治疗前比较,aP<0.05。 -
[1] GIWNEWER U, RUBIN G, ORBACH H, et al. Treatment for osteoarthritis of the knee[J]. Harefuah, 2016, 155(7): 403-406. [2] 柏林, 杨洋, 吕姝婷. 揿针疗法的临床应用[J]. 中国实用医药, 2019, 14(10): 192-193. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201910105.htm [3] 黄利刚, 肖鲁伟. 耳穴疗法减轻膝骨性关节炎疼痛的临床效果观察[J]. 黑龙江中医药, 2015, 44(1): 43-45. https://www.cnki.com.cn/Article/CJFDTOTAL-HLZY201501029.htm [4] 中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南(2018年版)[J]. 中华骨科杂志, 2018, 38(12): 705-715. doi: 10.3760/cma.j.issn.0253-2352.2018.12.001 [5] DILEKÇI E, ÖZKUK K, KAKI B, et al. Effect of balneotherapy on pain and fatigue in elderly with knee osteoarthritis receiving physical therapy: A randomized trial[J]. Int J Biometeorol, 2019, 63(12): 1555-1568. doi: 10.1007/s00484-019-01768-0 [6] BRAUNSCHWEIG R, SPAHN G, REGIER M, et al. Osteoarthritis classifications: Modification proposal for the criteria of Kellgren and Vallotton[J]. Radiologe, 2019, 59(11): 1010-1018. doi: 10.1007/s00117-019-00587-z [7] 中华中医药学会骨伤科分会膝痹病(膝骨关节炎)临床诊疗指南制定工作组. 中医骨伤科临床诊疗指南·膝痹病(膝骨关节炎)[J]. 康复学报, 2019, 29(3): 1-7. https://www.cnki.com.cn/Article/CJFDTOTAL-FYXB201903002.htm [8] 关雪峰, 杨永菊, 吕世伟, 等. 中西医结合综合康复疗法治疗膝骨关节炎的疗效观察[J]. 中华中医药学刊, 2016, 34(8): 1980-1982. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201608054.htm [9] 徐纬, 孙丹, 陈娜, 等. 揿针埋针镇痛联合康复训练对膝关节骨性关节炎功能障碍的疗效影响[J]. 中华全科医学, 2017, 15(12): 2141-2144. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201712044.htm [10] 王军, 王帅, 王艳君. 耳穴压豆联合中药方剂、针灸治疗膝骨关节炎临床观察[J]. 光明中医, 2019, 34(6): 917-919. doi: 10.3969/j.issn.1003-8914.2019.06.043 [11] 中国中医药研究促进会骨科专业委员会, 中国中西医结合学会骨伤科专业委员会关节工作委员会. 膝骨关节炎中医诊疗专家共识(2015年版)[J]. 中医正骨, 2015, 27(7): 4-5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG201507002.htm [12] 周帅琪, 梁龙, 于杰, 等. 最新膝骨关节炎循证国际指南纵览[J]. 海南医学院学报, 2020, 26(5): 388-391. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYY202005016.htm [13] 武永彪, 石晓兵. 膝骨性关节炎中医治疗现状研究[J]. 陕西中医, 2019, 40(4): 543-545. doi: 10.3969/j.issn.1000-7369.2019.04.043 [14] 古楠, 袁宏伟, 赵宪明, 等. 温针电针联合新型揿针治疗膝骨关节炎疗效观察[J]. 世界中西医结合杂志, 2018, 13(7): 981-983, 988. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX201807026.htm [15] 刘舒力. 耳穴贴压减轻膝关节术后疼痛的临床观察[J]. 医药前沿, 2018, 8(3): 355-356. doi: 10.3969/j.issn.2095-1752.2018.03.309 [16] 高慧, 杨连招. 揿针联合耳穴压豆的研究现状与发展[J]. 全科护理, 2015, 36(13): 3653-3656. [17] GAO H, ZHAO X D, MA G J, et al. Acupuncture combined with pyonex for xerophthalmia[J]. World J Acupunct-Mox, 2016, 26(2): 37-42. doi: 10.1016/S1003-5257(17)30008-9 [18] 郭长允. 揿针联合耳穴压豆在骨科护理中的应用效果研究[J]. 中国医药指南, 2016, 14(23): 279-280. [19] 喻兰, 宋晓霞, 吕欣畔. 揿针联合耳穴压豆在骨外科护理管理中的应用效果观察[J]. 中国继续医学教育, 2017, 15(9): 218-220. doi: 10.3969/j.issn.1674-9308.2017.09.119 [20] 饶亚妮. 揿针联合耳穴压豆在骨折患者术后康复中的应用[J]. 中国实用医药, 2016, 22(11): 229-230. -

计量
- 文章访问数: 348
- HTML全文浏览量: 132
- PDF下载量: 6
- 被引次数: 0