经筋辨证手法治疗膝骨关节炎临床疗效的初步探讨

Preliminary study on clinical effect of means of tendon differentiation treating knee osteoarthritis

关键词:  膝骨关节炎  经筋  辨证论治  手法

Key words:  knee osteoarthritis  meridian tendons  treatment based on syndrome differentiation  method

摘要:

[目的] 观察应用经筋辨证手法治疗膝骨关节炎的临床疗效。[方法] 将2022年1—11月单侧膝骨关节炎患者60例随机分成对照组和观察组。对照组采用常规手法，观察组以经筋辨证手法治疗。观察两组患者治疗前及治疗2周后西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估膝关节功能恢复情况、SF-36生活量表评分、步态分析（步长、步速及双支撑相）和股四头肌、腓肠肌肌张力位移值测试。[结果] 两组患者治疗前WOMAC、SF-36评分、步长、双支撑相及股四头肌、腓肠肌肌张力位移值比较差异无统计学意义（P＞0.05），治疗后WOMAC、SF-36评分、步长、双支撑相及股四头肌、腓肠肌肌张力位移值均较治疗前有明显改善（P<0.05）。其中观察组治疗后WOMAC评分（30.48±2.38）分和SF-36评分（69.03±3.42）分，改善情况相较于对照组（38.04±3.88）分和（64.78±4.96）分更为明显（P<0.05）。治疗后观察组步长（97.83±6.34） cm及双支撑相16.89%±1.59%较对照组（93.46±7.15） cm、19.32%±2.59%改善情况更为明显（P<0.05）。治疗2周后观察组的股四头肌肌张力位移值（6.89±0.48） mm及腓肠肌肌张力位移值（7.42±0.48） mm相比对照组（6.51±0.47） mm和（7.13±0.32） mm改善情况更为明显（P<0.05）。[结论] 应用经筋辨证手法治疗膝骨关节炎能有效改善膝关节功能和软组织张力，提高步行能力，进而改善患者生活质量。

Abstract:

[Objective] To observe the clinical effect of meridian tendon differentiation technique in treating knee osteoarthritis. [Methods] The 60 patients with unilateral knee osteoarthritis from January 2022 to November 2022 were randomly divided into control group and observation group. The control group was treated by conventional manipulation，and the observation group was treated by meridian tendon differentiation. Knee functional recovery assessed by Western Ontario and McMaster University Osteoarthritis Index （WOMAC），SF-36 Life scale score，gait analysis（stride length，stride speed，and double brace phase），and quadriceps muscle and gastrocnemius muscle tension displacement values were observed in both groups before and 2 weeks after treatment. [Results] There were no significant differences in WOMAC，SF-36 score，step length，double brace phase，quadriceps muscle and gastrocnemius muscle tension displacement between the two groups before treatment（P>0.05）. After treatment，WOMAC score，SF-36 score，step length，double brace phase，quadriceps muscle and gastrocnemius muscle tension displacement were significantly improved compared with before treatment （P<0.05）. The improvement of WOMAC score （30.48±2.38） and SF-36 score （69.03±3.42） in the observation group was more significant than that in the control group （38.04±3.88） and （64.78±4.96） after treatment （P<0.05）. After treatment，the improvement of step length （97.83±6.34） cm and double support phase 16.89%±1.59% in the observation group was more obvious than that in the control group （93.46±7.15） cm and 19.32%±2.59% （P<0.05）. After 2 weeks of treatment，the quadriceps muscle tension displacement values（6.89±0.48） mm and gastrocnemius muscle tension displacement values（7.42±0.48） mm in the observation group were more significantly improved than those in the control group （6.51±0.47） mm and （7.13±0.32） mm （P<0.05）. [Conclusion] The treatment of knee osteoarthritis can effectively improve the function of knee joint and soft tissue tension，improve the walking ability，and improve the quality of life of patients.