【摘要】：目的探討針刀聯合中藥熱敷治療寒濕痹阻型膝骨關節炎的臨床療效及安全性。方法采用前瞻性、區組隨機、平行對照的研究方法,選取2016年1月至2017年1月于北京市宣武中醫醫院診斷為膝骨關節炎的60例患者,采用區組隨機,信封法隱藏,將其分為治療組和對照組,每組各30例。治療組患者根據中醫辨證論治理論和寒者熱之的治療原則,采用針刀療法配合傷筋痹痛散熱敷,對照組患者單純采用針刀療法。兩組患者治療周期均為2周,治療前、治療末(第15天)及療程結束后1個月共3次隨訪,進行療效評價,癥狀評分采用西安大略和曼特考斯特大學骨性關節炎(WOMAC)指數量表(2015OARS指南)進行判定。結果兩組患者在治療末的治療有效率分別為針刀組93. 33%(28/30)、針刀聯合中藥熱敷組96. 67%(29/30)(χ~2=0. 351,P=0. 554),治療1個月后兩組的治療有效率分別為針刀組93. 33%(28/30)、針刀聯合中藥熱敷組96. 67%(29/30)(χ~2=0. 351,P=0. 554),差異均無統計學意義。兩組患者治療后療效的優良程度比較,治療組療效優良程度在治療末和治療后1個月均好于對照組(治療末P=0. 033,治療1個月后P=0. 037),差異具有統計學意義。結論兩組患者治療后與治療前相比,各項指標改善顯著,均取得了一定的近期效果,但有效率差異無統計學意義。而療效的優良程度與治療方法有關,針刀聯合中藥熱敷療法優良程度顯著好于單純針刀療法。
[Abstract]:Objective to investigate the clinical efficacy and safety of acupuncture and knife combined with hot compress of traditional Chinese medicine in the treatment of knee osteoarthritis with cold dampness arthralgia. Methods A prospective, random, parallel control study was conducted to select 60 patients with knee osteoarthritis diagnosed in Xuanwu Hospital of traditional Chinese Medicine from January 2016 to January 2017. The patients were randomly divided into treatment group (n = 30) and control group (n = 30). According to the theory of syndrome differentiation and treatment of cold people in the treatment group, the patients in the treatment group were treated with needle knife therapy combined with the heat dissipation of injury tendons and pain, while the patients in the control group were treated with needle knife therapy alone. The treatment cycle of the two groups was 2 weeks. Before treatment, at the end of treatment (15th day) and one month after treatment, the curative effect was evaluated. The symptom scores were evaluated by Xi'an Dailuo and Mandcoster University osteoarthritis (WOMAC) Index scale (2015OARS Guide). Results the effective rates of the two groups at the end of treatment were 93. 3% in the acupuncture and knife group, respectively. 33% (28 / 30), acupuncture and knife combined with traditional Chinese medicine hot dressing group 96. 5% (28 / 30). 67% (29 鈮，

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