[1]赵勇,班林强,韦俊余,等.理筋提髌手法治疗髌股关节炎的临床研究[J].中国中医骨伤科杂志,2022,30(01):30-34.
　ZHAO Yong,BAN Linqiang,WEI Junyu,et al.Clinical Study on the Treatment of Patellofemoral Arthritis with Relieving Tendons and Moving Patella[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(01):30-34.
点击复制

理筋提髌手法治疗髌股关节炎的临床研究()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年01期
页码:
30-34
栏目:
临床研究
出版日期:
2022-01-15

文章信息/Info

Title:
Clinical Study on the Treatment of Patellofemoral Arthritis with Relieving Tendons and Moving Patella
文章编号:
1005-0205(2022)01-0030-05
作者:
赵勇1; 班林强2; 韦俊余1; 魏光成2; 张宽1; 秦伟凯1△
1中国中医科学院望京医院骨伤综合科(北京,100102) 2北京中医药大学
Author(s):
ZHAO Yong1; BAN Linqiang2; WEI Junyu1; WEI Guangcheng2; ZHANG Kuan1; QIN Weikai1△
1Department of Orthopedics,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China; 2Beijing University of Chinese Medicine,Beijing 100029,China.
关键词:
髌股关节炎;  手法;  玻璃酸钠;  疼痛;  随机对照试验
Keywords:
patellofemoral arthritis;  massotherapy;  sodium hyaluronate;  pain;  randomized controlled trial(RCT)
分类号:
R684.3
文献标志码:
A
摘要:
目的:评价理筋提髌手法治疗早中期髌股关节炎的临床效果。方法:于2018年1月至2020年12月共收治190例早中期髌股关节炎患者,将患者随机分为对照组与观察组,对照组采用关节腔注射玻璃酸钠(治疗5次),观察组采用理筋提髌手法(每周治疗2次),治疗时间为4周。分别记录治疗前、治疗3周后和治疗结束1周后患者膝关节的VAS评分、压痛指数、关节活动度、Lysholm膝关节评分、总体疗效评价等数据。结果:与治疗前比较,在治疗3周后和治疗结束1周后两组患者的VAS评分、Lysholm膝关节评分、压痛指数方面差异均有统计学意义(P<0.05),治疗3周后、治疗结束1周后观察组VAS评分、Lysholm膝关节评分、压痛指数与对照组比较差异有统计学意义(P<0.05); 在关节活动度方面,组间及组内比较差异均无统计学意义(P>0.05); 两组优良率比较,观察组为90%,对照组为58%,差异有统计学意义(P<0.05)。结论:理筋提髌手法治疗早中期髌股关节炎在缓解疼痛、改善功能方面均优于关节腔注射玻璃酸钠。
Abstract:
Objective:To evaluate the clinical efficacy of relieving tendons and moving patella under the guidance of tendon bundle bone theory on the treatment of early and middle patellofemoral arthritis.Methods:A total of 190 patients with patellofemoral arthritis in early and middle stage from January 2018 to December 2020 were treated.They were randomly divided into control group and observation group.The control group was treated with intraarticular injection of sodium hyaluronate(5 treatments for 4 weeks),and the observation group was treated with tendon lifting manipulation(twice a week).The treatment time was 4 weeks and the observation period was 5 weeks.VAS score,tenderness index,ranges of motion of the knee,Lysholm score and the overall curative efficacy evaluation were recorded before,at 3 weeks later and 1 week after the end of treatment.Results:Compared with before treatment,VAS score,tenderness index and Lysholm score in two groups were improved after 3 weeks and 5 weeks of treatment(P<0.05).Compared with control group,VAS score,tenderness index and Lysholm score in observation group were improved significantly after 3 weeks and 5 weeks of treatment(P<0.05).But there were no statistical differences of ranges of motion of the knee(P>0.05).The excellent-effective rate of observation group was higher than that in control group.Conclusion:Relieving tendons and moving patella combined with sodium hyaluronate on the treatment of early and middle patellofemoral arthritis is better than sodium hyaluronate injection in relieving pain and improving knee function.

参考文献/References:

[1] 宋娜,蒋金金,马琪,等.从生物力学角度探讨髌股关节炎的病因[J].中华物理医学与康复杂志,2020,42(5):477-480.
[2] 陈黎明,许根荣,陈兆军,等.髌骨不稳的诊疗现状[J].中国中医骨伤科杂志,2021,29(2):83-88.
[3] 岳强,王大麟,蒋维海.髌股关节炎的治疗研究进展[J].中华骨与关节外科杂志,2020,13(11):959-963.
[4] 姚俊丞,杜红根.推拿联合本体感觉训练治疗髌股关节炎的临床效果分析[J].中国医药,2021,16(1):102-105.
[5] 中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中国矫形外科杂志,2014,22(3):287-288.
[6] 李元浩,陈彦飞,秦伟凯,等.中医“筋”的解剖实质探析[J].陕西中医,2019,40(3):374-377.
[7] 陈彦飞,赵勇,李元浩,等.基于“筋骨关系”探讨铍针治疗膝骨关节炎[J].中国中医药信息杂志,2018,25(8):118-120.
[8] 邵开超,查和萍,范志勇,等.从筋束骨理论探讨腰椎间盘突出动物模型的构建[J].河南中医,2014,34(5):871-872.
[9] 欧阳振,杨斌辉,张波,等.关节镜下髌骨去神经化处理联合微骨折术治疗髌股关节炎[J].中国骨伤,2019,32(5):407-411.
[10] 石杰,刘刚,朱斌,等.髌股关节不稳研究进展[J].国际骨科学杂志,2020,41(6):352-355.
[11] 陈彦飞,鲁超,赵勇,等.基于筋束骨理论铍针松解髌骨外侧支持带改善髌股关节应力集中的有限元分析[J].中国骨伤,2021,34(2):126-130.
[12] 孙琪,勾禹,刘光源,等.髌股关节炎病因及发病机制的相关研究进展[J].华北理工大学学报(医学版),2018,20(3):246-252.
[13] 史晨辉,王永明,董金波,等.髌股关节骨性关节炎的病因探讨及关节镜诊治[J].中国矫形外科杂志,2003,11(22):67-69.
[14] 秦伟凯,张宽,吴林,等.针刀松解股四头肌筋结点治疗髌股关节炎的临床研究[J].中国中医骨伤科杂志,2019,27(10):26-30.
[15] FRANSEN M,MCCONNELL S,HARMER A R,et al.Exercise for osteoarthritis of the knee:a cochrane systematic review[J].Br J Sports Med,2015,49(24):1554-1557.
[16] 赵明宇,刘益兵,王凯,等.动态拔伸手法松解股四头肌治疗膝骨关节炎的临床研究[J].中医学报,2012,27(11):1417-1418.
[17] 黎丹东,李琳琳,张旭辉.髌骨内推法在髌股关节炎治疗中的疗效探讨[J].颈腰痛杂志,2017,38(4):385.
[18] 赵勇,韦俊余,秦伟凯,等.理筋提髌手法治疗髌股关节炎力学机制的有限元分析[J].中国中医骨伤科杂志,2021,29(8):25-28.
[19] 龚龙,张立新,刘义辉,等.手法配合玻璃酸钠治疗膝骨关节炎52例[J].中国中医骨伤科杂志,2020,28(5):42-44.
[20] 张华金,张化东,王焕勤.玻璃酸钠治疗骨关节炎的机制[J].中国生化药物杂志,2005(3):190-191.
[21] 周影,潘卫民,孙雯,等.云克和玻璃酸钠治疗膝骨关节炎合并滑膜炎的疗效观察[J].中国现代医学杂志,2019,29(5):103-107.
[22] 曾超,王昊晨,吴紫莺,等.《中国髌股关节骨关节炎诊疗指南(2020年版)》要点解读[J].中华骨科杂志,2021,41(2):129-132.

备注/Memo

备注/Memo:
基金项目:中国中医科学院基本科研业务费自主选题项目院内联合创新专项(ZZ11-034)北京中医药科技发展资金项目(JJ2016-67)
△通信作者 E-mail:qinvkai@163.com
更新日期/Last Update: 2022-01-18