摘要
目的观察腕踝针联合肌内效贴治疗早中期寒湿痹阻型膝骨关节炎(KOA)的临床效果,为KOA患者提供更有效的治疗选择。方法选择早中期寒湿痹阻型KOA患者120例,按照随机数字表法分为对照组、腕踝针组、肌内效贴组及联合组各30例。对照组采用基础治疗联合常规护理,腕踝针组在对照组的基础上予以腕踝针治疗,肌内效贴组在对照组的基础上予以肌内效贴治疗,联合组在对照组的基础上采用腕踝针联合肌内效贴治疗。于干预前、干预后1周、干预后2周,采用中医症候积分评价患者病情严重程度,根据中医症候积分的变化评价临床疗效,计算总有效率。于干预前、干预后1周、干预后2周,采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分评估各组膝关节结构和功能;疼痛视觉模拟量表(VAS)评分评估各组膝关节疼痛程度并记录疼痛缓解时间,膝骨关节炎严重指数(ISOA)评分评价各组KOA严重程度;采集各组静脉血,魏氏法检测红细胞沉降率(ESR)、免疫比浊法检测C反应蛋白(CRP)。干预期间,密切监测患者的不良反应并记录。结果各组干预前中医症候积分比较差异均无统计学意义(P均>0.05);与同组干预前比较,各组干预后中医症候积分均降低,且干预后2周均低于干预后1周(P均<0.05);与同时点对照组比较,腕踝针组、肌内效贴组及联合组中医症候积分均降低,且联合组中医症候积分均低于同时点腕踝针组、肌内效贴组(P均<0.05)。总有效率联合组>腕踝针组、肌内效贴组>对照组(P均<0.05)。各组干预前WOMAC、VAS、ISOA评分及炎症指标血ESR、CRP水平比较差异均无统计学意义(P均>0.05);与同组干预前比较,各组干预后WOMAC、VAS、ISOA评分及血ESR、CRP水平均降低,且干预后2周均低于干预后1周(P均<0.05);与同时点对照组比较,腕踝针组、肌内效贴组及联合组WOMAC、VAS、ISOA评分及血ESR、CRP水平均降低,且联合组各指标均低于同时点腕踝针组、肌内效贴组(P均<0.05)。关节疼痛缓解时间联合组<腕踝针组、肌内效贴组<对照组(P均<0.05),各组干预期间均未出现不良反应。结论腕踝针联合肌内效贴可安全减轻早中期寒湿痹阻型KOA患者的疼痛与炎症,改善关节功能,疗效优于单一疗法。
Objective To observe the clinical effect of wrist-ankle acupuncture combined with Kinesio taping in the treatment of early and middle stage cold-dampness obstruction type knee osteoarthritis(KOA),and to provide more effective treatment options for KOA patients.Methods Totally 120 patients with early and middle stage cold-dampness obstruction type KOA were selected and randomly divided into control group,wrist-ankle acupuncture group,Kinesio taping group and combined group,with 30 cases in each group.Patients in the control group received basic treatment and routine care.Patients in the wrist-ankle acupuncture group were treated with wrist-ankle acupuncture on the basis of treatment of the control group.Patients in the Kinesio taping group were treated with Kinesio taping on the basis of treatment of the control group.Patients in the combined group were treated with wrist-ankle acupuncture combined with Kinesio taping on the basis of the treatment of the control group.Before intervention,1 and 2 weeks after intervention,the severity of the disease was evaluated by TCM syndrome score.The clinical efficacy was evaluated according to the changes in TCM syndrome score,and the total effective rate was calculated.Before intervention,1 and 2 weeks after intervention,the structure and function of the knee joint were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC).The degree of knee joint pain was evaluated by the visual analogue scale(VAS),and the pain relief time was recorded.The severity of KOA was evaluated by the Index of Severity of Osteoarthritis(ISOA).Venous blood was collected from each group,and erythrocyte sedimentation rate(ESR)was detected by the Westergren method and C-reactive protein(CRP)was detected by immunoturbidimetry.During the intervention period,adverse reactions of patients were closely monitored and recorded.Results There was no statistically significant difference in TCM syndrome score among the groups before intervention(P>0.05).Compared with that before intervention,the TCM syndrome score of each group decreased after intervention,and the score at 2 weeks after intervention was lower than that at 1 week after intervention(all P<0.05).Compared with the control group at the same time point,the TCM syndrome score of the wrist-ankle acupuncture group,Kinesio taping group and combined group decreased,and the score of the combined group was lower than that of the wrist-ankle acupuncture group and Kinesio taping group at the same time point(all P<0.05).The clinical effective rate was higher in the combined group than in the wrist-ankle acupuncture group and Kinesio taping group,and was higher in the wrist-ankle acupuncture group and Kinesio taping group than in the control group(all P<0.05).There were no statistically significant differences in WOMAC score,VAS score,ISOA score or inflammatory indicators ESR and CRP among the groups before intervention(all P>0.05).Compared with those before intervention,the WOMAC score,VAS score,ISOA score and ESR and CRP levels of each group decreased after intervention,and the score at 2 weeks after intervention was lower than that at 1 week after intervention(all P<0.05).Compared with the control group at the same time point,the WOMAC score,VAS score,ISOA score and ESR and CRP levels of the wrist-ankle acupuncture group,Kinesio taping group and combined group decreased,and the score of the combined group was lower than that of the wrist-ankle acupuncture group and Kinesio taping group at the same time point(all P<0.05).Joint pain relief duration was as follows:combined group<wrist-ankle acupuncture group,Kinesio taping group<control group(all P<0.05).No adverse reactions occurred in each group during the intervention period.Conclusion Wrist-ankle acupuncture combined with Kinesio taping can safely relieve pain and inflammation in patients with early and middle stage cold-dampness obstruction type KOA,improve joint function,and the therapeutic effect is superior to that of single therapy.
作者
韩珊
周静
马武开
刘佳
詹永佳
杨政宇
李足梅
陈敏
HAN Shan;ZHOU Jing;MA Wukai;LIU Jia;ZHAN Yongjia;YANG Zhengyu;LI Zumei;CHEN Min(Department of Rheumatology and Immunology,The Second Affiliated Hospital of Guizhou University of Chinese Medicine,Guiyang 550001,China;不详)
出处
《山东医药》
2025年第8期57-62,共6页
Shandong Medical Journal
基金
贵州省中医药(民族医药)科学技术研究专项课题项目(QZYY-2024-145)
贵州省中医风湿免疫病临床研究中心项目[黔科合平台人才(2020)2202号]。
关键词
膝骨关节炎
寒湿痹阻型
腕踝针
肌内效贴
knee osteoarthritis
cold-dampness obstruction type
wrist-ankle acupuncture
Kinesio taping
