摘要
目的:观察隔附子饼灸、艾灸以及针刺治疗肾虚髓亏型膝关节骨性关节炎(KOA)患者的临床疗效差异,探索隔附子饼灸自行居家治疗的可行性。方法:将90例患者随机分为隔附子饼灸组、艾灸组和针刺组,每组30例。各组均穴取患侧内膝眼、犊鼻,双侧血海、梁丘、鹤顶、肾俞、足三里,每天治疗1次,10次为一疗程,疗程间休息2~3 d,共观察3个疗程。隔附子饼灸组前2个疗程在医院完成,后续则在主管医师的指导下居家治疗。观察3组患者治疗前后及治疗结束后6个月随访时症状、体征分级量化评分和生存质量(行走时疼痛、下蹲弯腰膝疼痛、上下楼梯膝部不适、日常生活不适)评分,并评价临床疗效。结果:各组患者治疗后及随访时症状、体征分级量化评分均低于治疗前(P<0.01,P<0.05),且隔附子饼灸组评分低于艾灸组和针刺组(均P<0.01)。各组患者治疗后及随访时行走时疼痛、下蹲弯腰膝疼痛、上下楼梯膝部不适、日常生活不适评分均低于治疗前(P<0.01,P<0.05),且隔附子饼灸组行走时疼痛和日常生活不适评分均低于艾灸组和针刺组(P<0.01,P<0.05)。治疗后,隔附子饼灸组愈显率为63.3%(19/30),艾灸组为50.0%(15/30),针刺组为43.3%(13/30),隔附子饼灸组愈显率均优于艾灸组和针刺组(均P<0.05)。随访时,隔附子饼灸组愈显率为56.7%(17/30),艾灸组为36.7%(11/30),针刺组为40.0%(12/30),隔附子饼灸组愈显率均优于其他两组(均P<0.05)。结论:隔附子饼可以治疗肾虚髓亏型膝关节骨性关节炎,提高患者生活质量,疗效优于艾灸和针刺,可考虑居家治疗。
Objective To observe the effects among aconite cake-separated moxibustion, moxibustion and acupuncture for knee osteoarthritis （KOA） with kidney-marrow deficiency and to explore the feasibility of cake-separated moxibustion as a home remedy solution. Methods Ninety patients were randomized into an aconite cake-separated moxibustion group, a moxibustion group and an acupuncture group, 30 cases in each one. The acupoints in the three groups were Neixiyan （EX-LE 4）, Dubi （ST 35） in the affected side, and bilateral Xuehai （SP 10）, Liangqiu （ST 34）, Heding （EX-LE 2）, Shenshu （BL 23） and Zusanli （ST 36）. All the treatment was given for 3 sessions, 10 days as a session with 2 to 3 days between 2 sessions, and once a day. The first 2 courses of aconite cake-separated moxibustion was applied in the hospital and the other 1 session was used at home guided by officer physician. Symptoms and physical signs classification score and life quality scores were recorded before and after treatment and 6 months after treatment, including walking pain, knee pain in stoop and squat, knee discomfort in stair activity and daily discomfort. The effects were evaluated. Results The symptoms and physical signs classification scores in the three groups after treatment and at follow-up were lower than those before treatment （P〈0.01, P〈0.05）, and the scores in the aconite cake-separated moxibustion group were better than those in the moxibustion group and acupuncture group （all P〈0.01）. The scores of walking pain, knee pain in stoop and squat, knee discomfort in stair activity and daily discomfort were lower in the three groups after treatment and 6 months after treatment （P〈0.01, P〈0.05）, and the scores of walking pain and daily discomfort in the aconite cake-separated moxibustion group were lower than those inthe moxibustion group and acupuncture group （P〈0.01, P〈0.05）. After treatments, the cured and markedly effective rate in the aconite cake-separated moxibustion group was 63.3
出处
《中国针灸》
CAS
CSCD
北大核心
2018年第1期45-49,共5页
Chinese Acupuncture & Moxibustion
基金
湖南省中医药管理局基金资助项目:201475
关键词
膝关节骨性关节炎
肾虚髓亏
隔附子饼灸
居家治疗
knee osteoarthritis
kidney-marrow deficiency
aconite cake-separated moxibustion
home remedy solution
