[1]刘晨,詹强△,杜红根.膝关节平衡整复法治疗膝骨关节炎的临床研究[J].中国中医骨伤科杂志,2023,31(01):30-35.
　LIU Chen,ZHAN Qiang,DU Honggen.Clinical Research on the Treatment of Knee Osteoarthritis with Balanced Bonesetting of Knee Joint[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(01):30-35.
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膝关节平衡整复法治疗膝骨关节炎的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年01期
页码:
30-35
栏目:
临床研究
出版日期:
2023-01-15

文章信息/Info

Title:
Clinical Research on the Treatment of Knee Osteoarthritis with Balanced Bonesetting of Knee Joint
文章编号:
1005-0205(2023)01-0030-06
作者:
刘晨1; 詹强2△; 杜红根1
1浙江中医药大学附属第一医院(浙江省中医院)(杭州,310003) 2浙江省中西医结合医院
Author(s):
LIU Chen1; ZHAN Qiang2△; DU Honggen1
1The First Affiliated Hospital of Zhejiang Chinses Medical University, Hangzhou 310003,China; 2Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou 310014,China.
关键词:
膝骨关节炎;  膝关节平衡整复法;  临床症状;  膝关节间隙;  推拿
Keywords:
knee osteoarthritis;  balanced bonesetting of knee joint;  clinical symptoms;  knee space;  tuina
分类号:
R684.3
文献标志码:
A
摘要:
目的:研究膝关节平衡整复法治疗膝骨关节炎的临床疗效。方法:选取膝骨关节炎患者80例,采用随机数字表法随机分为两组,治疗组和对照组各40例。治疗组采用膝关节平衡整复法,对照组采用常规推拿手法治疗,比较两组治疗前后WOMAC评分、膝关节间隙及间隙角、中西医临床疗效评价差异。结果:治疗后两组患者WOMAC评分、膝关节间隙及间隙角均较前改善,差异有统计学意义(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05); 治疗组西医总有效率为85.0%,对照组为65.0%,中医总有效率为82.5%,对照组为55.0%,两组差异有统计学意义(P<0.05),治疗组优于对照组。结论:膝关节平衡整复法对膝骨关节炎患者的疼痛、僵硬、关节功能等临床症状及对骨关节间隙具有改善作用,且疗效优于常规推拿治疗,值得进一步推广及探讨。
Abstract:
Objective:To study the clinical efficacy of balanced bonesetting of knee joint in treating knee osteoarthritis. Methods:80 patients with knee osteoarthritis were randomly divided into two groups with 40 in the treatment group and 40 in the control group. The treatment group was treated with balanced bonesetting of knee joint and the control group was treated with conventional massage. The WOMAC score, knee space and knee space angle, and the clinical efficacy evaluation of traditional Chinese and Western medicine were compared between the two groups before and after treatment.Results:The WOMAC score, knee joint space and knee joint space angle of the two groups after treatment were improved compared with those before, and the difference was statistically significant(P<0.05), and the treatment group was better than the control group(P<0.05). The total effective rate was 85.0% in the treatment group and 65.0% in the control group according to the evaluation of Western medicine.The total effective rate was 82.5% in the treatment group and 55.0% in the control group according to the evaluation of traditional Chinese medicine. The difference between the two groups was statistically significant(P<0.05), and the treatment group was superior to the control group.Conclusion:Balanced bonesetting of knee joint can improve the clinical symptoms such as pain, stiffness and joint function of patients with knee osteoarthritis and improve the bone joint space, and the curative efficacy is better than conventional massage treatment, which is worthy of further promotion and discussion.

参考文献/References:

[1] HUNTER D J,BIERMA-ZEINSTRA S.Osteoarthritis[J].Lancet,2019,393(10182):1745-1750.
[2] WALLACE I J,WORTHINGTON S,FELSON D T,et al.Knee osteoarthritis has doubled in prevalence since the mid-20th century[J].Proc Natl Acad Sci USA,2017,114(35):9332-9336.
[3] 王斌,邢丹,董圣杰,等.中国膝骨关节炎流行病学和疾病负担的系统评价[J].中国循证医学杂志,2018,18(2):134-142.
[4] DE ROOIJ M,MARIKE V D L,HEYMANS M W,et al.Prognosis of pain and physical functioning in patients with knee osteoarthritis:a systematic review and meta-analysis[J].Arthritis Care & Research,2016,68(4):481-492.
[5] 王锴,董雪,林剑浩.膝关节骨关节炎患者疾病医疗费用的调查[J].中华医学杂志,2017,97(1):29-32.
[6] 中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南(2018年版)[J].中华骨科杂志,2018,38(12):705-715.
[7] 骨痹的诊断依据、证候分类、疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.1-94)[J].辽宁中医药大学学报,2017,19(1):224.
[8] 寇智君,詹强,崔太松,等.詹强“经痹点”理论浅析[J].中华中医药杂志,2018,33(9):109-111.
[9] 詹强,罗华送,何嘉莹.夹胫推肘牵膝法为主推拿治疗退行性膝关节病180例[J].中国中医药科技,2009,16(4):319.
[10] 范炳华.推拿治疗学[M].北京:中国中医药出版社,2016:165-167.
[11] 王凯,宋永嘉,董万涛,等.经筋推拿手法治疗早中期膝骨关节炎临床疗效观察[J].陕西中医药大学学报,2019,42(3):77-81.
[12] 邢华,邵盛,储宇舟,等.影像学方法在膝骨关节炎诊断及手法治疗中的应用[J].北京中医药,2019,38(10):1047-1050.
[13] 褚立希,王锋.膝骨关节炎X线片生物力学及形态学测量分析[J].中西医结合学报,2004,2(6):3.
[14] 甘浩然,程楷,赵文胜,等.膝骨关节炎中骨性力线改变的影像学及临床研究[J].实用骨科杂志,2019,25(8):709-712.
[15] 艾健,房敏,孙武权,等.“筋骨失衡,以筋为先”理论在膝关节病中的应用探讨[J].中华中医药杂志,2014,29(8):2404-2406.
[16] 赵明宇,廉杰,鲍铁周,等.平乐正骨“筋滞骨错”理论再析[J].中医正骨,2015,27(4):74-75.
[17] 贾良良,许丽梅,陈达,等.筋骨失衡与膝骨关节炎疼痛的相关性探讨[J].风湿病与关节炎,2017,6(12):54-57.
[18] 赵永阳,修忠标.从“筋骨并重”理念论治膝关节骨性关节炎[J].亚太传统医药,2017,13(14):41-42.
[19] 寇赵淅,赵明宇,张向东,等.“以筋为先,以衡为用”理念在膝骨关节炎中的应用探讨[J].中医学报,2020,35(3):520-523.
[20] 戴大城,龚利,邵盛,等.手法治疗膝骨关节炎研究进展[J].中医学报,2020,35(4):792-796.
[21] 程露露,陈朝晖.推拿手法治疗膝骨性关节炎的作用机制探讨[J].广西医学,2020,42(23):3110-3112.
[22] 唐君,詹强.夹胫推肘牵膝推拿法对膝骨性关节炎实验兔膝关节间隙的影响[J].中国医药导报,2013,10(30):20-23.
[23] 詹强,唐君.“夹胫推肘牵膝推拿法”对膝骨性关节炎实验兔胫股角的影响[J].中国中医药科技,2012,19(3):289.
[24] 梁红广,姜淑云,李建华,等.坐位调膝法治疗膝骨关节炎的疗效与步态分析研究[J].北京中医药,2018,37(2):135-138.
[25] 陈张,詹强,寇智君,等.詹强教授“三部三层”理论治疗脊柱相关疾病经验[J].浙江中西医结合杂志,2017,27(3):198.
[26] 唐君,韩金生.夹胫推肘牵膝手法治疗膝关节骨性关节炎临床疗效观察[J].浙江医学,2020,42(14):1539-1542.
[27] 韩金生,唐君.肌骨超声下“夹胫推肘牵膝推拿法”治疗膝骨关节炎的临床疗效观察[J].中国现代医生,2019,57(6):107-111
[28] 邵盛,龚利,孙武权,等.法结合坐位调膝法治疗膝骨关节炎的效果[J].中国医药导报,2020,17(34):134-137.
[29] 康知然,龚利,邢华,等.坐位调膝法治疗膝骨关节炎的治疗理念与原理初探[J].上海中医药大学学报,2020,34(4):98-102.
[30] 曹龙军,章礼勤,周石,等.膝关节骨性关节炎患者股四头肌动员能力和肌力储备改变的研究[J].中国康复医学杂志,2012,27(1):30-34.
[31] 俞晓杰,吴毅,胡永善,等.膝关节骨关节炎患者膝屈伸肌的表面肌电信号研究[J].中华物理医学与康复杂志,2006,28(6):402-405.
[32] GROUIN J M,LEWIS J.Erratum:committee for proprietary medicinal products(CPMP):points to consider on adjustment for baseline covariates[J].Statistics in Medicine,2004,23(5):701-709.
[33] TEICHTAHL A J,CICUTTINI F M,JANAKIRAMANAN N,et al.Static knee alignment and its association with radiographic knee osteoarthritis[J].Osteoarthritis Cartilage,2006,14(9):958-962.
[34] KELLGREN J H,LAWRENCE J S.Radiological assessment of osteoarthrosis[J].Annals of the Rheumatic Diseases,1957,16(4):494-502.
[35] 王强,苟海昕,曹月龙,等.膝骨关节炎X线分级与疼痛程度的相关性分析[J].中国中医骨伤科杂志,2015,23(6):18-21.
[36] OAK S R,GHODADRA A,WINALSKI C S,et al.Radiographic joint space width is correlated with 4-years clinical outcomes in patients with knee osteoarthritis:data from the osteoarthritis initiative[J].Osteoarthr Cartil,2013,21(9):1185-1190.

备注/Memo

备注/Memo:
基金项目:2020年度浙江省中医药科技计划(2020ZT002)
詹强浙江省名老中医专家传承工作室项目(浙中医药〔2017〕12号)
△通信作者 E-mail:zqtow@163.com
更新日期/Last Update: 2023-01-10