摘要
目的:针刺可使膝关节骨性关节炎患者患膝局部的血液循环加速,组织代谢率增加,从而改善患膝的瘀血症状,促进局部炎症吸收等,最终达到缓解临床症状,改善患肢功能的目的。文章分析近5年针灸治疗膝关节骨性关节炎的方法、作用机制、疗效及疗效评价标准。方法:应用计算机检索CHKD期刊全文数据库2002-01/2006-12与针灸治疗膝关节骨性关节炎相关的文章,检索词为"针灸,膝骨关节炎,治疗,探讨",并限定文章语言种类为中文。对资料进行初审,选取包含处理组和对照组的文献,筛除非随机研究,查找全文,并查看每篇文献后的引文。纳入标准:①检索时间在2002-01/2006-12范围。②随机对照研究。③符合按疗法数量分类。④中医保守治疗为主。排除理由:①重复研究。②不典型报道。共收集到102篇关于针刺、艾灸、电针、中药内服外敷、推拿等治疗膝关节骨性关节炎的随机和非随机研究文章,37篇临床观察报道符合纳入标准。排除的65篇文章为实验研究、重复性研究或无对照组。结果:从针灸治疗膝骨关节炎的临床报道可见,针灸治疗该病的疗效确切、简便、易行,且选取穴位多在膝关节及以下部位。在众多治疗方法中,温针、电针使用较多,常配合推拿、中药内服外用等以提高疗效。临床报道中均采用了对照组进行治疗方法的比较,这较早期的论文有明显不同。但是临床疗效的评价方面,标准稍显混乱,只有少数学者对患者临床症状、体征、日常生活能力进行分值上的评估,或采用疼痛评分量表、骨关节炎调查量表等。故建立统一的主观、客观的疗效评价标准是很有必要的,从而有助于疗法的筛选,并提高疗效。此外,针灸治疗膝骨关节炎的实验报道不多,今后可加强这方面的研究,通过实验数据来支持临床疗效,提高说服力。结论:针灸治疗膝关节骨性关节炎方法多样、疗效确切,但疗效评价标准应统一,实验研究也应加强。
AIM： Acupuncture could accelerate the local blood circulation of knee, increase tissue metabolic rate, improve the blood stasis of affected knee, and promote inflammation absorption, finally relieve clinical symptoms of patients with osteoarthritis of knee joint. In this study, the procedure, mechanism, curative effect and evaluation criterion of acupuncture and moxibustion for knee osteoarthritis in recent 5 years were investigated.
METHODS： CHKD full text database was searched for Chinese articles about acupuncture for osteoarthritis dated from January 2002 to December 2006 with the keywords of ＂acupuncture and moxibustion, knee osteoarthritis, treatment, explore＂. The articles including control group and treatment group were selected to look up the full texts, and the non-randomized studies were excluded. Inclusive criteria： ①elated articles published between January 2002 and December 2006; ②randomized controlled research; ③ classified by quantity of treatment; ④conservative treatment first. Exclusive criteria： ①epetitive studies; ②untypical case report. Totally 102 randomized and non-randomized articles on treatment of osteoarthritis with acupuncture, moxibustion, electroacupuncture, traditional Chinese herbs for external and internal use, and massage were collected, and 37 clinical case reports met the inclusive criteria. Sixty-five empirical and duplicated studies or no control group were excluded.
RESULTS： The clinical reports about the treatment of osteoarthritis with acupuncture suggest that acupuncture therapy is simple with precise curative effect and most of the acupoints are located at knee or below. Among the various therapies, acupuncture with warmed needle or electricity are used a lot, assisted with massage, traditional Chinese herbs to enhance the curative effect. The control group is set up to compare the curative effect with treatment group. This is an obvious difference in present articles from former ones. However, the evaluation criteria for clinical effect are still uncertain, only few evaluations on the clinical symptoms. signs, ability of daily life, or those with pain score scale and osteoarthritis sacle. It is necessary to establish uniform and objective criteria, which are conducive to the screening of treatment and improvement of curative effect. In addition, there are few reports about the research of acupuncture for treatment of knee osteoarthritis.
CONCLUSION： Many conservative treatments such as acupuncture and moxibustion could be utilized to cure knee osteoarthritis and have received certain effect. However, unified standard to evaluate curative effect should be established and experimental work should be reinforced.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第7期1337-1340,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
