[1]熊应宗 朱俊琛△ 王超 贺业霖 苏毅 李迎春 郑智文 马幸福.针刀联合塞来昔布治疗膝骨关节炎的临床疗效观察[J].中国中医骨伤科杂志,2020,28(02):19-23.
　XIONG Yingzong ZHU Junchen WANG Chao HE Yelin SU YiLI Yingchun ZHENG Zhiwen MA Xingfu.Clinical Efficacy of Needle-knife Combined withCelecoxib in Treating Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(02):19-23.
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针刀联合塞来昔布治疗膝骨关节炎的临床疗效观察
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年02期
页码:
19-23
栏目:
临床研究
出版日期:
2020-02-10

文章信息/Info

Title:
Clinical Efficacy of Needle-knife Combined withCelecoxib in Treating Knee Osteoarthritis
文章编号:
1005-0205(2020)02-0019-05
作者:
熊应宗1 朱俊琛1△ 王超1 贺业霖2 苏毅1 李迎春1 郑智文1 马幸福1
1安徽中医药大学第二附属医院(合肥,230061)2安徽中医药大学研究生部
Author(s):
XIONG Yingzong1 ZHU Junchen1△ WANG Chao1 HE Yelin2 SU Yi1LI Yingchun1 ZHENG Zhiwen1 MA Xingfu1
1The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230061,China; 2Anhui University of Traditional Chinese Medicine,Hefei 230038,China.
关键词:
针刀;  塞来昔布;  膝骨关节炎
Keywords:
needle-knife therapy;  celecoxib;  knee osteoarthritis
分类号:
R684.3
文献标志码:
A
摘要:
目的:观察针刀联合塞来昔布治疗膝骨关节炎的临床疗效。方法:选取符合膝骨关节炎纳入标准的患者90例,使用随机数字表法随机分为针刀组、药物组和联合组,每组30例,分别采用针刀治疗、口服塞来昔布治疗和针刀联合塞来昔布治疗,于治疗前、治疗3周和3个月随访时进行疼痛视觉模拟评分(VAS),西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及临床疗效评估。结果:在治疗3周和3个月随访时联合组VAS评分低于其余两组,差异有统计学意义(P<0.05); 塞来昔布组在治疗3周时评分低于针刀组,差异有统计学意义(P<0.05),3个月随访时高于针刀组,差异有统计学意义(P<0.05)。WOMAC评分中疼痛评分变化与VAS评分整体变化趋势相同,且差异均有统计学意义(P<0.05); 关节僵硬评分中,联合组与针刀组在治疗3周和3个月随访时评分较前均显著下降,差异有统计学意义(P<0.05),且评分低于塞来昔布组,差异有统计学意义(P<0.05); 关节功能评分中,联合组在治疗3周和3个月随访时降低最显著,针刀组次之,三组间差异均有统计学意义(P<0.05)。WOMAC评分总分中,联合组在治疗3周和3个月随访时评分显著低于其余两组,差异有统计学意义(P<0.05),且针刀组低于塞来昔布组,差异有统计学意义(P<0.05)。3个月随访时联合组临床疗效优于针刀组和塞来昔布组,差异有统计学意义(P<0.05)。结论:针刀联合塞来昔布治疗膝骨关节炎在短期和远期可明显缓解疼痛、改善关节活动度、促进关节功能恢复,且安全可行,值得临床推广应用。
Abstract:
Objective:To observe the clinical efficacy of needle-knife combined with celecoxib in the treatment of knee osteoarthritis.Methods:Ninety patients with knee osteoarthritis were randomly divided into needle-knife group,drug group and combination group by random number table.Each group had 30 patients who were respectively treated by needle-knife,celecoxib and needle-knife combined with celecoxib.Visual analogue scale(VAS)scores,Western Ontario McMaster University osteoarthritis index(WOMAC)and clinical efficacy were evaluated before treatment,3 weeks after treatment and 3 months follow-up.Results:The VAS scores of the combination group were lower than the other two groups at 3 weeks of treatment and 3 months of follow-up,and the difference was statistically significant(P<0.05).The celecoxib group scores was lower than the needle-knife group at 3 weeks of treatment(P<0.05),and higher than the needle-knife group at 3 months of follow-up(P<0.05).The change of pain score in WOMAC score was the same as the overall change trend of VAS score,and the difference was statistically significant(P<0.05).Among the joint stiffness scores,the combination group and the needle-knife group were significantly lower at 3 weeks of treatment and 3 months of follow-up(P<0.05),and the score was lower than the celecoxib group(P<0.05).Among the joint function scores,the combination group was the most significant at 3 weeks of treatment and 3 months of follow-up,followed by the needle-knife group,and the differences between the three groups were statistically significant(P<0.05); Among the total scores of WOMAC scores,the scores of the combination group were significantly lower than those of other groups at 3 weeks of treatment and 3 months of follow-up(P<0.05),and the needle-knife group was lower than the celecoxib group(P<0.05).The clinical efficacy of the combination group was better than that of the needle-knife group and the celecoxib group at the 3 months of follow-up,the difference was statistically significant(P<0.05).Conclusion:Needle-knife combined with celecoxib in the treatment of KOA can significantly relieve pain and improve joint mobility and promote joint function recovery in the short and long term,it is safe,feasible and worthy of clinical promotion.

参考文献/References:

[1] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].北京:人民军医出版社,2012:1676.
[2] 帖小佳,郑如庚,赵梦,等.中国中老年人膝关节骨关节炎患病率的Meta分析[J].中国组织工程研究,2018,22(4):650-656.
[3] 张前进,曹烈虎,李卓东,等.艾灸与塞来昔布治疗膝骨性关节炎临床效果及安全性观察[J].中国中医骨伤科杂志,2011,19(1):13-15.
[4] 曹振武,黄永明,田振江,等.针刀联合局部封闭治疗膝骨关节炎临床疗效观察[J].中国中医骨伤科杂志,2018,26(8):18-20.
[5] 王骥.中医药疗法治疗膝关节骨性关节炎研究进展[J].中国临床医生杂志,2015,43(3):36-39.
[6] 邱贵兴.骨关节炎诊治指南[J].中华骨科杂志,2007,27(10):793-796.
[7] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:48-49.
[8] 郭倩,杜朝晖,郭伟.经外奇穴温针灸治疗膝骨关节炎79例[J].中国中医骨伤科杂志,2019,27(4):64-66.
[9] 杨康,朱蜀云,成向东,等.推拿加独活寄生汤治疗膝关节骨性关节炎60例[J].中国中医骨伤科杂志,2019,27(1):69-71.
[10] 王翔,刘顺怡,石瑛,等.针刀松解术治疗膝骨关节炎的临床观察[J].中国骨伤,2016,29(4):345-349.
[11] 刘奕兵,王超.塞来昔布对老年膝骨性关节炎患者炎症因子、骨代谢和血液流变学指标的影响[J].中国老年学杂志,2018,38(19):4713-4715.
[12] 杨安忠,姚勇,吴昊,等.塞来昔布对骨关节炎患者相关炎性因子影响[J].中华实用诊断与治疗杂志,2018,32(4):382-384.
[13] 唐流刚,唐宏智,王芳.关于膝骨关节炎小针刀松解法疗法的疗效观察[J].成都中医药大学学报,2017,40(2):67-69.
[14] 冯文昌,王庆,马碧涛,等.针刀联合消瘀散外敷治疗膝骨关节炎的临床观察[J].上海中医药杂志,2018,52(8):54-57.
[15] 熊沛芳,陈世均.小针刀配合手法松解治疗膝骨关节炎疗效观察[J].山西中医,2018,34(1):45-47.

备注/Memo

备注/Memo:
基金项目:安徽省科技攻关项目(1704a0802168)△通信作者 E-mail:2006zhujc@163.com(收稿日期:2019-07-03)
更新日期/Last Update: 2020-02-10