摘要
目的观察石氏伤科推拿联合针刀松解治疗膝骨关节炎(KOA)痰瘀痹阻证的临床疗效。方法选取2022年5月—2025年5月河南省中医院收治的KOA痰瘀痹阻证患者132例作为研究对象,按信封法将其分为观察组和对照组各66例。两组均给予盐酸氨基葡萄糖片口服,对照组在此基础上给予针刺和传统推拿治疗,观察组给予石氏伤科推拿与针刀松解治疗。经治4周后,比较两组患者临床疗效,中医证候(主症、次症、总分)评分,膝关节活动度(屈伸度、伸直度),膝关节运动功能(稳定性、屈膝畸形、肌力、关节活动度、行走能力、疼痛),炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)]水平,及不良反应(局部红肿、瘙痒、恶心呕吐)发生情况。结果治疗过程中脱落10例患者,最终纳入研究122例,每组各61例。治疗后,观察组临床总有效率为98.36%(60/61),高于对照组的86.89%(53/61)(P<0.05);两组患者主症、次症评分及总分均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05);两组患者屈伸度、伸直度较治疗前均增高(P<0.05),且观察组均优于对照组(P<0.05);两组患者关节稳定性、屈膝畸形、肌力、关节活动度、行走能力、疼痛评分较治疗前均升高(P<0.05),且观察组均高于对照组(P<0.05);两组患者TNF-α、IL-6、IL-1水平均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05);治疗期间,观察组不良反应总发生率为6.56%(4/61),与对照组的3.28%(2/61)比较,差异无统计学意义(P>0.05)。结论石氏伤科推拿联合针刀松解治疗痰瘀痹阻型KOA,可有效改善患者临床症状、提高关节活动度和关节功能,减轻炎症反应,从而提升临床疗效。
Objective To observe the clinical efficacy of SHI's Traumatology Tuina combined with acupotomy release in the treatment of Knee Osteoarthritis(KOA)with phlegm-blood stasis syndrome.Methods A total of 132 patients with KOA and phlegm-blood stasis syndrome admitted to Henan Provincial Hospital of Traditional Chinese Medicine from May 2022 to May 2025 were selected as the study subjects and divided into an observation group and a control group,with 66 cases in each group,using the envelope method.Both groups were administered oral glucosamine hydrochloride tablets.The control group received acupuncture and traditional tuina treatment,while the observation group received SHI's Traumatology Tuina and acupotomy release treatment.After 4 weeks of treatment,the clinical efficacy,scores of traditional Chinese medicine symptoms(primary symptoms,secondary symptoms,and total score),range of motion(flexion-extension and extension),motor function of the knee joint(stability,flexion deformity,muscle strength,range of motion,walking ability,and pain),levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-1(IL-1)],and adverse reactions(local redness,itching,nausea,and vomiting)were compared between the two groups.Results Ten patients were dropped during the treatment process,and ultimately,122 cases were included in the study,with 61 cases in each group.After treatment,the total clinical efficacy rate in the observation group was 98.36%(60/61),which was higher than that in the control group[86.89%(53/61)(P<0.05)].The scores of primary and secondary symptoms and total score in both groups were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).The range of flexion-extension and extension in both groups increased compared to before treatment(P<0.05),and those in the observation group were superior to those in the control group(P<0.05).The scores of joint stability,flexion deformity,muscle strength,range of motion,walking ability,and pain in both groups increased compared to before treatment(P<0.05),and those in the observation group were higher than those in the control group(P<0.05).The levels of TNF-α,IL-6,and IL-1 in both groups were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).During the treatment period,the total incidence of adverse reactions in the observation group was 6.56%(4/61),which showed no significant difference compared to the control group[3.28%(2/61)](P>0.05).Conclusion The combined treatment of SHI's traumatological Tuina and acupotomy release for KOA of phlegm-blood stasis syndrome can effectively improve patients'clinical symptoms,enhance joint mobility and function,reduce inflammatory reactions,and thereby enhance clinical efficacy.
作者
陈玉琦
潘富伟
史鹏博
CHEN Yuqi;PAN Fuwei;SHI Pengbo(Henan Provincial Hospital of Traditional Chinese Medicine/Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000;First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000)
出处
《国医论坛》
2026年第2期41-46,共6页
Forum On Traditional Chinese Medicine
基金
河南省科技发展计划项目(252102310480,252300423161)。
关键词
膝骨关节炎
痰瘀痹阻证
石氏伤科推拿
针刀疗法
临床报道
knee osteoarthritis
phlegm-blood stasis syndrome
SHI's traumatology Tuina
acupotomy therapy
clinical report
