电针配合辨证取穴治疗膝关节骨性关节炎的随机对照试验

Treating knee osteoarthritis with dialectical acupoint selection and electro-acupuncture: a randomized controlled study

关键词:  电针疗法  针刺治疗  膝关节炎  随机对照研究

Key words:  electro-acupuncture therapy  needle therapy  knee osteoarthritis  randomized controlled study

摘要:

[目的] 探讨电针灸治疗膝关节骨性关节炎的有效方法.[方法] 将符合纳入标准的210例患者随机分为电针组、针刺组、西药组,每组各70例.西药组口服布洛芬缓释胶囊,针刺采用辨证取穴针刺法,电针组在辨证取穴的基础上配合低频脉冲电流治疗.运用"膝关节骨性关节炎自评量表"(WOMAC)及中文版"简明健康状况调查表"(SF-36)在治疗前、治疗4周后、9周后随访时进行疗效评估.[结果] 治疗4周后电针组总有效率为91.4%、针刺组85.3%、西药组81.4%,3组疗效差异无统计学意义(P>0.05).9周后随访时电针组总有效率为87.1%优于针刺组77.9%、西药组的58.6%(P<0.05).3组治疗4周WOMAC和SF-36评分比较差异均无统计学意义(P>0.05),9周后随访时电针组WOMAC和SF-36评分改善优于针刺组和西药组(P<0.05).[结论] 电针配合辨证取穴治疗膝关节骨性关节炎与针刺组、西药组比较,近期疗效效果相当,而远期疗效明显优于针刺组和西药组.

Abstract:

[Objective] To discuss the effective method in acupuncture therapy on knee osteoarthritis. [Methods] The 210 patients were randomly divided into electro-acupuncture group, acupuncture group, acupuncture group plus Western medicine(WM) group with 70 cases in each group. The WM group was treated with oral administration of Glucosamine Hydrochloride capsules;the needle group was treated with dialectical acupoint selection;electroacupuncture group with dialectical acupoint selection based on a low frequency pulse current. Western Ontario and McMaster University Osteoarthritis Index(WOMAC) and Chinese version of SF-16 were used to assess the therapeutic effect before treatment,4 and 9 weeks after treatment. [Results] Four weeks after treatment the total effective rate was 91.4% in the electro acupuncture group,85.3% in the needle group,81.4% in the WM group without significant difference(P>0.05) among the three groups. At 9 weeks after treatment,the total effective rate(87.1%) in the electro acupuncture group was better than that in the needle group(77.9%) and in the WM group(58.6%),P<0.05. There were no significant differences in comparison of WOMAC and SF-16 scores 4 weeks after treatment among three groups. Nine weeks after treatment these patients were followed up and found that the electro needle group in improving these scores was superior than the needle group and WM group(P<0.05). [Conclusion] The therapeutic effect in the early atage of electro acupuncture combined with differentiated acupoint acupuncture in treating knee osteoarthritis is similar to acupuncture group and the WM group, while the long-term efficacy of the electro-acupuncture group is much better than the acupuncture group and WM group.