[1]贾海光,李健,谷金玉,等.经筋理论指导下体外冲击波治疗早中期膝骨关节炎的临床研究[J].中国中医骨伤科杂志,2023,31(03):38-47.[doi:10.20085/j.cnki.issn1005-0205.230308]
　JIA Haiguang,LI Jian,GU Jinyu,et al.Clinical Investigation on the Application of Extracorporeal Shock Wave on the Treatment of Early and Mid-Stage Knee Osteoarthritis Based on the Meridian-Sinew Theory[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(03):38-47.[doi:10.20085/j.cnki.issn1005-0205.230308]
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经筋理论指导下体外冲击波治疗早中期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03期
页码:
38-47
栏目:
临床研究
出版日期:
2023-03-15

文章信息/Info

Title:
Clinical Investigation on the Application of Extracorporeal Shock Wave on the Treatment of Early and Mid-Stage Knee Osteoarthritis Based on the Meridian-Sinew Theory
文章编号:
1005-0205(2023)03-0038-10
作者:
贾海光1; 2; 李健1; 谷金玉2; 林承宇2; 李凯明2; 闫秀杰1; 赵喆3; 朱俊宇1; 肖健1; 邢更彦1△; 张清2△
1中国人民解放军总医院第三医学中心(北京,100039)
2中国中医科学院望京医院
3中国人民解放军总医院第四医学中心
Author(s):
JIA Haiguang1; 2; LI Jian1; GU Jinyu2; LIN Chengyu2; LI Kaiming2; YAN Xiujie1; ZHAO Zhe3; ZHU Junyu1; XIAO Jian1; XING Gengyan1△; ZHANG Qing2
1The Third Medical Center, General Hospital of CPLA, Beijing 100039,China;
2Wangjing Hospital of China Academy of Chinese Medical Scinences, Beijing 100102,China;
3The Fourth Medical Center, General Hospital of CPLA, Beijing 100048,China.
关键词:
膝骨关节炎;  经筋理论;  发散式体外冲击波;  软骨损伤
Keywords:
knee osteoarthritis;  meridian-sinew theory;  radial extracorporeal shock wave therapy;  cartilage lesions
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.230308
文献标志码:
A
摘要:
目的:在中医经筋理论指导下观察发散式体外冲击波治疗早中期膝骨关节炎的疗效及安全性。方法:60例早中期膝骨关节炎患者被随机分为对照组和试验组,对照组应用体外冲击波治疗患膝疼痛及软骨损伤区域,试验组通过经筋辨证分型后,针对患膝分布的结筋病灶点进行体外冲击波治疗。每组均治疗2次/周,共治疗8次。分别比较两组治疗前和治疗结束后第1天、第4周、第12周时的西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分和视觉模拟量表(VAS)评分以及治疗前和治疗后第12周的关节软骨T2-mapping值,同时记录治疗及随访期间可能出现的不良反应。结果:两组患者在治疗前后各随访时间点的VAS和WOMAC评分均有所改善,差异有统计学意义(P<0.05),同时试验组VAS和WOMAC评分在治疗后第1天和第4周时均明显优于对照组,差异有统计学意义(P<0.05); 在治疗后第12周时,两组间比较差异无统计学意义(P>0.05)。试验组治疗后第12周的T2-mapping值与治疗前比较差异无统计学意义(P>0.05),同时与对照组治疗后第12周比较差异无统计学意义(P>0.05)。在治疗过程中两组均未出现严重不良反应,发生频次差异无统计学意义(P>0.05)。结论:经筋理论指导下体外冲击波治疗较常规冲击波治疗能更快速缓解早中期膝骨关节炎患者膝痛症状,改善关节活动功能,同时在治疗过程中不会损伤关节软骨,其临床疗效安全可靠。
Abstract:
Objective:To observe the efficacy and safety of radial extracorporeal shock wave therapy in patients with early and mid-stage osteoarthritis of the knee based on the Meridian-Sinew theory of traditional Chinese medicine. Methods:60 patients with early and mid-stage knee osteoarthritis were randomly divided into control group and trial group. The control group was treated with extracorporeal shock wave for areas of pain and cartilage lesion in the affected knee, and the trial group was treated with extracorporeal shock wave targeting funicular nodules as the treatment points of the affected knee via syndrome differentiation of Meridian-Sinew and several different types. Both groups were treated twice weekly for a total of 8 sessions. Visual analogue scale(VAS)scores and The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores between the two groups before treatment and at day 1, 4 weeks and 12 weeks after the end of treatment as well as T2-mapping values of articular cartilage between the two groups before and 12 weeks after treatment were compared, respectively. Meanwhile, possible adverse efficacy during treatment and follow-up are also recorded. Results:Both groups showed improvement in the VAS and WOMAC scores at each time points of the pre-treatment and post-treatment follow-up(P<0.05). Meanwhile, the VAS and WOMAC scores of the trail group were statistically better than those of the control group at day 1 and 4 weeks after treatment(P<0.05). At 12 weeks post-treatment, there were no statistically differences between the two groups. There were no statistically differences regarding the T2-mapping values of the trail group at 12 weeks after treatment compared with those before treatment(P>0.05), and also no statistically differences compared with the control group at 12 weeks after treatment(P>0.05). There were no serious adverse efficacy in both groups during treatment, and there were no significant differences in the frequency of occurrence(P>0.05). Conclusion:Compared with the routine extracorporeal shock wave therapy, the meridian-sinew extracorporeal shock wave therapy can provide quicker and more effective relief from the symptoms of knee pain and improve joint mobility in early and mid-stage knee osteoarthritis patients without damaging the articular cartilage during the treatment process, and its clinical efficacy is safe and reliable.

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备注/Memo

备注/Memo:
基金项目:首都临床特色应用研究项目(Z181100001718018)
国家自然科学基金面上项目(81873914)
△通信作者 E-mail:xgy1350138@163.com(邢更彦)
zhangqinggys@163.com(张清)
更新日期/Last Update: 2023-03-10