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| 雷火灸结合电针治疗寒湿型膝骨性关节炎的随机对照试验* |
| A randomized controlled trial of thunder-fire moxibustion combined with electro-acupuncture in the treatment of cold-dampness knee osteoarthritis |
| 投稿时间：2019-09-04 录用日期：2019-09-30 |
| DOI： |
| 中文关键词: 膝骨性关节炎 雷火灸 电针 随机对照研究 疗效 |
| 英文关键词: knee osteoarthritis thunder-fire moxibustion electro-acupuncture randomized controlled study curative effect |
| 基金项目:国家自然科学基金 广西壮族自治区卫计委广西医疗卫生适宜技术开发与推广应用项目 |
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| 中文摘要: |
| 目的：观察雷火灸结合电针疗法与双氯芬酸钠双释放肠溶胶囊及附桂骨痛胶囊两种疗法之间治疗寒湿型膝骨性关节炎的临床疗效差异。方法：根据计算机软件生成的随机数将72例寒湿型膝骨性关节炎患者随机分为观察组和对照组各36例。观察组电针取穴以犊鼻、内膝眼、足三里、阳陵泉、阴陵泉、血海、梁丘、鹤顶为主要穴位,行针得气后连接电针治疗仪,选择连续波,留针30min,1次/d,并在电针治疗同时采用雷火灸以悬灸方式灸神阙、关元两穴,每次30min,1次/d；对照组口服双氯芬酸钠双释放肠溶胶囊75mg/次,1次/d,及附桂骨痛胶囊6粒/次,3次/d。2组均14d为一个疗程,连续治疗2个疗程。观察两组治疗前后VAS评分、WOMAC评分、Lequesne指数评分、中医证候疗效比较差异变化情况,并在治疗结束后第4个月进行随访评价远期疗效。结果：治疗后观察组总有效率为97.1%(34/35),高于对照组的78.8%(26/33),(P<0.05)；2组VAS评分、WOMAC(包括疼痛、僵硬、功能及总分)评分、Lequesne指数评分在治疗2个疗程后均显著改善(P<0.05),并且观察组在降低VAS评分、WOMAC(疼痛、功能及总分)评分、Lequesne指数评分等方面相较对照组更为显著(P<0.05),同时在治疗后第4个月的随访中观察组的3项评分仍低于同期对照组且与治疗前比较差异均有统计学意义(P<0.05)。而在WOMAC的僵硬项目评分中,2组对比未见明显差异(P>0.05),但观察组在降低该项评分的幅度仍大于对照组。2组的不良事件发生率分别为0%(0例)和8.3%(3例),比较2组不良事件情况未见明显统计学意义(P>0.05)。结论：雷火灸结合电针治疗寒湿型膝骨性关节炎的临床治疗效果明显且不良反应少,与药物组相比,雷火灸结合电针在疗效持久性方面更具优势。 |
| 英文摘要: |
| Objective: to observe the difference of clinical efficacy between thunder-fire moxibustion combined with electro-acupuncture therapy and diclofenac sodium double release enteric-coated capsule and Fugui Gutong capsule in the treatment of cold-dampness knee osteoarthritis. Methods: according to the random number generated by computer software, 72 patients with cold and wet knee osteoarthritis were randomly divided into observation group (n = 36) and control group (n = 36). In the observation group, the acupoints were treated with calving nose, inner knee eye, Zusanli, Yanglingquan, Yinlingquan, Xuehai, Liang Qiu and Heding as the main acupoints. After acupuncture, the acupuncture instrument was connected to each other. Continuous wave, retained needle for 30 minutes, once a day, and at the same time, lightning-fire moxibustion was used to moxibustion Shenque, Guanyuan two points, once a day. The control group was treated with diclofenac sodium double release enteric capsule 75mg/ once a day and Fugui Gutong capsule 6 times a time, 3 times a day for 14 days as a course of treatment. The changes of VAS score, WOMAC score, Lequesne index score and TCM syndrome curative effect were observed before and after treatment, and the long-term curative effect was evaluated at the 4th month after treatment. Results: after treatment, the total effective rate in the observation group was 97.1% (34/35), which was higher than that in the control group (78.8%) (26/33), (P < 0.05). The, WOMAC (score of VAS score, including pain, stiffness, function and total score, and the score of Lequesne index were significantly improved after two courses of treatment, and the scores of, WOMAC (pain, function and total score in the observation group were more significant than those in the control group (P < 0.05). At the same time, at the 4th month after treatment, the scores of the three items in the observation group were still lower than those in the control group at the same time, and the difference was statistically significant compared with that before treatment (P < 0.05). However, there was no significant difference in the score of stiffness items between the two groups, but the decrease of the score in the observation group was still larger than that in the control group. The incidence of adverse events in the two groups was 0% (0 cases) and 8.3% (3 cases), respectively, and there was no significant difference in the adverse events between the two groups (P > 0.05). Conclusion: the clinical effect of thunder-fire moxibustion combined with electro-acupuncture in the treatment of cold-dampness knee osteoarthritis is obvious and the adverse reactions are less. Compared with the drug group, thunder-fire moxibustion combined with electro-acupuncture has more advantages in curative effect persistence. |
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