易罐运动拉伸疗法治疗膝骨关节炎的临床效果及机制探讨(1)
【摘要】 目的：探讨易罐运动拉伸疗法治疗膝骨关节炎(knee osteoarthritis，KOA)的临床效果及机制。方法：选取2018年7月-2019年7月本院60例KOA患者，按随机数字表法分对照组与治疗组，各30例。对照组采取传统针刺治疗，治疗组采取易罐运动拉伸疗法治疗。比较两组治疗前后WOMAC评分、视觉模拟评分法(visual analogue score，VAS)及现有痛强度(present pain intensity，PPI)评分，并比较两组临床效果。结果：治疗后，治疗组WOMAC、VAS及PPI评分均低于对照组(P<0.05)。治疗组临床疗效优于对照组(P<0.05)。结论：易罐运动拉伸疗法治疗KOA临床效果确切，可有效改善患者症状，减轻疼痛程度，值得临床推广及应用。
【关键词】 膝骨关节炎 易罐运动拉伸疗法 WOMAC评分
[Abstract] Objective： To explore the clinical effect and mechanism of easy cupping exercise stretching therapy in the treatment of knee osteoarthritis (KOA). Method： A total of 60 KOA patients from July 2018 to July 2019 in our hospital were selected. They were divided into control group and treatment group according to the random number table method， 30 cases in each group. The control group was treated with traditional acupuncture， while the treatment group was treated with easy cupping exercise stretching therapy. WOMAC score， visual analogue score (VAS) and present pain intensity (PPI) score were compared between the two groups before and after treatment， and the clinical effects of the two groups was compared. Result： After treatment， WOMAC， VAS and PPI scores of the treatment group were lower than those of the control group (P<0.05). The clinical efficacy of the treatment group was better than that of the control group (P<0.05). Conclusion： Easy cupping exercise stretching therapy has a definite clinical effect on KOA， it can effectively improve the symptoms of patients and reduce the degree of pain， which is worthy of clinical promotion and application.
[Key words] Knee osteoarthritis Easy cupping exercise stretching therapy WOMAC score
First-author’s address： Guangzhou Liwan Orthopedics Hospital， Guangzhou 510140， China
doi：10.3969/j.issn.1674-4985.2020.21.031
膝骨關节炎(knee osteoarthritis，KOA)是一种常见的中老年慢性退行性骨关节疾病，临床以膝关节的疼痛、肿胀、变形及活动障碍等症状为主，主要特点为关节内软骨变性破坏、关节边缘骨质增生、间隙不均衡，日久刺激滑膜炎症反应、半月板损伤、游离体形成等病变[1-2]。目前多认为该病与生物学因素(年龄、遗传、炎症等)、机械性损伤及力线改变有关，据国内统计资料表明，我国60岁以上人群X线有KOA表现者约50%，75岁以上的老年人80%有KOA的症状[3]。目前，KOA的中医治疗方法主要包括以针灸、针刀、推拿、中药熏洗、中药内服、膏药外敷等，本研究对照观察了易罐运动拉伸疗法与传统针刺治疗KOA的效果，现报道如下。
1 资料与方法
1.1 一般资料 选取2018年7月-2019年7月本院60例KOA患者。诊断标准：诊断标准参照2007版《骨关节炎诊治指南》标准，(1)近1月内膝关节反复出现疼痛;(2)站立位X线示关节间隙狭窄、软骨下骨质硬化或出现囊性变、关节边缘有骨赘形成;(3)关节液检查(>2次)显示黏稠、清亮，白细胞<2 000个/mL;(4)≥40岁的患者;(5)晨僵≤30 min;(6)关节活动闻及骨擦音(感)，结合临床症状、实验室及X线检查，符合(1)+(2)或者(1)+(3)+(5)+(6)或者(1)+(4)+(5)+(6)即可诊断为KOA[2]。纳入标准：(1)符合上述诊断标准;(2)年龄40～70岁，病程在3年内，能结合治疗，骨性关节炎Kellgren-Lawrence(K-L)分级为Ⅰ～Ⅲ级。排除标准：(1)妊娠;(2)有明显膝部外伤史;膝关节肿瘤;(3)有严重肝、心、肾及血液系统疾病;(4)皮肤破损或过敏;(5)金属过敏或严重惧针;(6)关节大量积液;(7)对本研究操作不耐受或不结合。剔除标准：(1)未按时接受治疗;(2)采取本法以外疗法，不能客观地评价疗效;(3)发生严重不良事件或并发症。按随机数字表法分为治疗组与对照组，各30例。所有患者及家属均知情同意并签署知情同意书，本研究已经医院伦理委员会批准。, 百拇医药(何挺 凌翠敏 沈庆亮 罗玉明 李盛琳)
【关键词】 膝骨关节炎 易罐运动拉伸疗法 WOMAC评分
[Abstract] Objective： To explore the clinical effect and mechanism of easy cupping exercise stretching therapy in the treatment of knee osteoarthritis (KOA). Method： A total of 60 KOA patients from July 2018 to July 2019 in our hospital were selected. They were divided into control group and treatment group according to the random number table method， 30 cases in each group. The control group was treated with traditional acupuncture， while the treatment group was treated with easy cupping exercise stretching therapy. WOMAC score， visual analogue score (VAS) and present pain intensity (PPI) score were compared between the two groups before and after treatment， and the clinical effects of the two groups was compared. Result： After treatment， WOMAC， VAS and PPI scores of the treatment group were lower than those of the control group (P<0.05). The clinical efficacy of the treatment group was better than that of the control group (P<0.05). Conclusion： Easy cupping exercise stretching therapy has a definite clinical effect on KOA， it can effectively improve the symptoms of patients and reduce the degree of pain， which is worthy of clinical promotion and application.
[Key words] Knee osteoarthritis Easy cupping exercise stretching therapy WOMAC score
First-author’s address： Guangzhou Liwan Orthopedics Hospital， Guangzhou 510140， China
doi：10.3969/j.issn.1674-4985.2020.21.031
膝骨關节炎(knee osteoarthritis，KOA)是一种常见的中老年慢性退行性骨关节疾病，临床以膝关节的疼痛、肿胀、变形及活动障碍等症状为主，主要特点为关节内软骨变性破坏、关节边缘骨质增生、间隙不均衡，日久刺激滑膜炎症反应、半月板损伤、游离体形成等病变[1-2]。目前多认为该病与生物学因素(年龄、遗传、炎症等)、机械性损伤及力线改变有关，据国内统计资料表明，我国60岁以上人群X线有KOA表现者约50%，75岁以上的老年人80%有KOA的症状[3]。目前，KOA的中医治疗方法主要包括以针灸、针刀、推拿、中药熏洗、中药内服、膏药外敷等，本研究对照观察了易罐运动拉伸疗法与传统针刺治疗KOA的效果，现报道如下。
1 资料与方法
1.1 一般资料 选取2018年7月-2019年7月本院60例KOA患者。诊断标准：诊断标准参照2007版《骨关节炎诊治指南》标准，(1)近1月内膝关节反复出现疼痛;(2)站立位X线示关节间隙狭窄、软骨下骨质硬化或出现囊性变、关节边缘有骨赘形成;(3)关节液检查(>2次)显示黏稠、清亮，白细胞<2 000个/mL;(4)≥40岁的患者;(5)晨僵≤30 min;(6)关节活动闻及骨擦音(感)，结合临床症状、实验室及X线检查，符合(1)+(2)或者(1)+(3)+(5)+(6)或者(1)+(4)+(5)+(6)即可诊断为KOA[2]。纳入标准：(1)符合上述诊断标准;(2)年龄40～70岁，病程在3年内，能结合治疗，骨性关节炎Kellgren-Lawrence(K-L)分级为Ⅰ～Ⅲ级。排除标准：(1)妊娠;(2)有明显膝部外伤史;膝关节肿瘤;(3)有严重肝、心、肾及血液系统疾病;(4)皮肤破损或过敏;(5)金属过敏或严重惧针;(6)关节大量积液;(7)对本研究操作不耐受或不结合。剔除标准：(1)未按时接受治疗;(2)采取本法以外疗法，不能客观地评价疗效;(3)发生严重不良事件或并发症。按随机数字表法分为治疗组与对照组，各30例。所有患者及家属均知情同意并签署知情同意书，本研究已经医院伦理委员会批准。, 百拇医药(何挺 凌翠敏 沈庆亮 罗玉明 李盛琳)