[1]尹煜辉,陈明,李玲慧,等.松筋调膝手法联合经皮神经电刺激治疗膝骨关节炎的临床研究[J].中国中医骨伤科杂志,2025,33(04):27-32.[doi:10.20085/j.cnki.issn1005-0205.250406 ]
　YIN Yuhui,CHEN Ming,LI Linghui,et al.Clinical Study on the Treatment of Knee Osteoarthritis by Songjintiaoxi Manipulation Combined with Transdermal Electrical Nerve Stimulation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(04):27-32.[doi:10.20085/j.cnki.issn1005-0205.250406 ]
点击复制

松筋调膝手法联合经皮神经电刺激治疗膝骨关节炎的临床研究()
分享到：

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

卷:
第33卷
期数:
2025年04期
页码:
27-32
栏目:
临床研究
出版日期:
2025-04-10

文章信息/Info

Title:
Clinical Study on the Treatment of Knee Osteoarthritis by Songjintiaoxi Manipulation Combined with Transdermal Electrical Nerve Stimulation
文章编号:
1005-0205(2025)04-0027-06
作者:
尹煜辉1; 陈明1; 李玲慧1; 魏戌1; 王尚全1△
1中国中医科学院望京医院(北京,100102)
Author(s):
YIN Yuhui1; CHEN Ming1; LI Linghui1; WEI Xu1; WANG Shangquan1△
1Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
关键词:
膝骨关节炎;  松筋调膝手法;  经皮神经电刺激;  疼痛改善;  平衡功能
Keywords:
knee osteoarthritis;  Songjintiaoxi manipulation;  transdermal electrical nerve stimulation;  pain improvement;  balance function
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.250406
文献标志码:
A
摘要:
目的:观察松筋调膝手法联合经皮神经电刺激(TENS)治疗膝骨关节炎(KOA)患者的临床疗效。方法:选择2022年1月至2024年1月治疗的膝骨关节炎患者90例,按随机数字表法分为对照组和观察组,每组各45例。两组均接受常规基础治疗,对照组在常规基础治疗基础上接受经皮神经电刺激治疗,约20 min/次,3次/周,连续治疗4周; 观察组在对照组的基础上接受松筋调膝手法治疗,约20 min/次,3次/周,连续治疗4周。分别于治疗前后采用疼痛视觉模拟量表(VAS)评分和膝关节压痛值主客观相结合综合评价膝骨关节炎患者疼痛程度; 采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分评价患者膝关节功能; 采用通用量角器测量膝骨关节炎患者屈膝、伸膝时的膝关节活动度; 采用Berg平衡量表(BBS)评分评价膝骨关节炎患者平衡功能。结果:治疗过程中共有2例患者脱落,其中对照组和观察组各1例,最终纳入88例,每组各44例。与治疗前相比,两组患者治疗后VAS评分及WOMAC评分均明显降低,膝关节压痛值、活动度及BBS评分均明显升高,差异有统计学意义(P<0.05)。与对照组相比,观察组治疗后VAS评分及WOMAC评分均明显更低,膝关节压痛值、活动度及BBS评分均明显更高,差异有统计学意义(P<0.05)。结论:松筋调膝手法联合经皮神经电刺激可以明显缓解膝骨关节炎患者膝关节疼痛,改善膝关节运动及日常生活功能,提高平衡功能。
Abstract:
Objective:To observe the clinical effect of the combination of Songjintiaoxi manipulation and transdermal electrical nerve stimulation(TENS)on patients with knee osteoarthritis(KOA).Methods:A total of 90 KOA patients treated from January 2022 to January 2024 were selected and divided into control group and observation group according to random number table method,with 45 cases in each group.Both groups received conventional basic treatment.The control group received transdermal electrical nerve stimulation therapy on the basis of conventional basic treatment,about 20 min/times,3 times/week,continuous treatment for 4 weeks.On the basis of the control group,the observation group was treated with Songjintiaoxi manipulation,about 20 min/times,3 times/week,for 4 weeks.The pain degree of KOA patients was evaluated by pain visual analogue scale(VAS)and knee tenderness before and after treatment.The osteoarthritis index(WOMAC)score of Western Ontario and McMaster University was used to evaluate the knee function of the patients.A universal protractor was used to measure the knee motion of KOA patients when they bent and extended their knees.Berg balance scale(BBS)was used to evaluate the balance function of KOA patients.Results:In the course of treatment,a total of 2 cases fell off,including 1 case in the control group and 1 case in the observation group.88 cases were included in the final treatment,44 cases in each group.Compared with before treatment,VAS score and WOMAC score of the two groups were significantly decreased after treatment,knee tenderness value,range of motion and BBS score were significantly increased,the difference was statistically significant(P<0.05).Compared with control group,VAS score and WOMAC score of observation group were significantly lower after treatment,knee tenderness value,range of motion and BBS score were significantly higher,and the differences were statistically significant(P<0.05).Conclusion:The combination of Songjintiaoxi manipulation and transdermal electrical nerve stimulation can effectively relieve knee pain,improve knee movement,daily living function and balance function in patients with KOA.

参考文献/References:

[1] 修忠标,陈长贤,张建新,等.膝骨关节炎针刀临床诊疗指南[J].康复学报,2023,33(3):193-201.
[2] 展嘉文,王尚全,朱立国,等.经皮穴位电刺激治疗膝骨关节炎的临床研究[J].中国中医骨伤科杂志,2019,27(8):28-31.
[3] 李凯明,王尚全,李玲慧,等.经皮电刺激治疗膝骨关节炎的有效性与安全性评价[J].康复学报,2021,31(1):83-88.
[4] 孙树椿.清宫正骨手法图谱[M].北京:中国中医药出版社,2012:41-42.
[5] 中华中医药学会.膝骨关节炎中西医结合诊疗指南(2023年版)[J].中医正骨,2023,35(6):1-10.
[6] 中华医学会骨科分会关节外科学组,吴阶平医学基金会骨科学专家委员会.膝骨关节炎阶梯治疗专家共识(2018年版)[J].中华关节外科杂志(电子版),2019,13(1):124-130.
[7] MO L,JIANG B,MEI T,et al.Exercise therapy for knee osteoarthritis:a systematic review and network meta-analysis[J].Orthop J Sports Med,2023,11(5):232596712311 72773.
[8] 朱立国,于杰,高景华,等.颈肩部压痛的测定及其在神经根型颈椎病诊疗过程中的意义[J].颈腰痛杂志,2008(1):6-9.
[9] GANDEK B.Measurement properties of the Western Ontario and McMaster Universities Osteoarthritis Index:a systematic review[J].Arthritis Care Res(Hoboken),2015,67(2):216-229.
[10] 叶海霞,谭波涛,虞乐华.膝骨关节炎的康复评定进展[J].中国康复理论与实践,2019,25(12):1408-1413.
[11] 中国医师协会风湿免疫科医师分会骨关节炎学组.中国膝骨关节炎临床药物治疗专家共识(2023)[J].中华内科杂志,2024,63(6):560-578.
[12] 莫坚,叶森涛,章晓云.中药单体及复方在膝骨关节炎中的治疗进展[J].中国组织工程研究,2024,28(11):1756-1761.
[13] 邱峰,周爱珍,过琳,等.膝骨关节炎经筋辨证的研究进展[J].中医正骨,2022,34(11):62-64.
[14] 谭春霞,屠建峰,马欣,等.针刺缓解膝骨关节炎疼痛机制的研究进展[J].中国疼痛医学杂志,2024,30(3):215-219.
[15] 章晓云,曾浩,孟林.膝骨关节炎疼痛机制及治疗研究进展[J].中国疼痛医学杂志,2023,29(1):50-58.
[16] 中华医学会物理医学与康复学分会,四川大学华西医院.中国膝骨关节炎康复治疗指南(2023版)[J].中国循证医学杂志,2024,24(1):1-14.
[17] 邓程远,周桂娟,王甜甜,等.膝骨关节炎的物理治疗进展[J].中国老年学杂志,2021,41(8):1756-1760.
[18] JOHNSON M I,PALEY C A,JONES G,et al.Efficacy and safety of transcutaneous electrical nerve stimulation(TENS)for acute and chronic pain in adults:a systematic review and meta-analysis of 381 studies(the meta-TENS study)[J].BMJ Open,2022,12(2):e051073.
[19] PENG W W,TANG Z Y,ZHANG F R,et al.Neurobiological mechanisms of TENS-induced analgesia[J].Neuroimage,2019,195:396-408.
[20] 赵夏洁,尹金玲,李航兵,等.经皮神经电刺激的镇痛作用机制及最新研究进展[J].实用医学杂志,2015,31(21):3480-3482.
[21] 周航,许辉,周运峰,等.推拿治疗膝骨关节炎作用机制研究进展[J].中华中医药杂志,2024,39(8):4257-4260.
[22] CHERIAN J J,HARRISON P E,BENJAMIN S A,et al.Do the effects of transcutaneous electrical nerve stimulation on knee osteoarthritis pain and function last?[J].J Knee Surg,2016,29(6):497-501.
[23] 吴毅,俞晓杰,胡永善,等.膝关节骨关节炎患者的本体感觉及其与疼痛和功能障碍间的相关性研究[J].中华物理医学与康复杂志,2007,29(5):334-338.
[24] 中国中医药研究促进会骨伤科分会.膝骨关节炎中医诊疗指南(2020年版)[J].中医正骨,2020,32(10):1-14.

备注/Memo

备注/Memo:
△通信作者 E-mail:13901147122@163.com
更新日期/Last Update: 2025-04-10