推拿配合功能锻炼治疗膝关节骨性关节炎的临床观察

谢洪波

推拿配合功能锻炼治疗膝关节骨性关节炎的临床观察

谢洪波

南京市中心医院康复科，江苏南京 210018

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出版历程
- 收稿日期: 2017-03-04
- 修回日期: 2017-04-12
- 刊出日期: 2017-07-10

Clinical Effectiveness Observation of the Combination of Tuina and Functional Exercise in the Treatment of Knee Osteoarthritis

XIE Hong-bo

摘要

摘要: 目的观察推拿配合功能锻炼治疗膝关节骨性关节炎（KOA）的临床效果。方法选取2016年1月-2016年12月我院收治的180例KOA患者，将其按照随机数字法随机分为观察组A、观察组B和对照组，每组60例，对照组给予规范化的功能锻炼，观察组A在对照组基础上给予中医特色的推拿手法进行治疗，2组均治疗2周，观察组B在对照组基础上给予硫酸氨基葡萄糖胶囊治疗。分别于治疗前后对膝关节肿胀、压痛、活动受限评分及Lysholm膝关节功能进行评分，且分别于治疗前后抽取患者膝关节关节液，检测基质金属蛋白酶-3（MMP-3)、基质金属蛋白酶组织抑制因子-1(TIMP-1)和肿瘤坏死因子-α（TNF-α），并对2组治疗后的临床疗效和治疗期间的安全性进行评价。结果治疗后3组膝关节肿胀、压痛、活动受限评分均显著降低（P<0.05），Lysholm膝关节功能评分均显著升高（P<0.05），但观察组A和观察组B膝关节肿胀、压痛、活动受限评分降低更为明显（P<0.05），Lysholm膝关节功能评分升高更为明显（P<0.05）。治疗后3组MMP-3、TIMP-1及TNF-α水平均显著降低（P<0.05），但观察组A和观察组B降低更为明显（P<0.05）。治疗后观察组A和观察组B的总有效率分别为95.00%和91.67%显著高于对照组的75.00%，差异具有统计学意义（SymbolcA@2=9.412、8.757，P<0.01）。3组患者均未出现明显不良反应，安全级别均为Ⅰ级。结论推拿配合功能锻炼治疗KOA临床疗效显著，安全性高，值得临床推广。
- 功能锻炼 /
- 推拿 /
- 膝关节骨性关节炎 /
- 硫酸氨基葡萄糖胶囊
Abstract: OBJECTIVE To observe the clinical effectiveness of the combination of Tuina and functional exercise in the treatment of knee osteoarthritis (KOA). METHODS 180 KOA patients admitted in our hospital from Jan. 2016 to Dec. 2106 were selected and randomly divided into the observation group A， B and the control group by random number， 60 cases in each group. The control group was intervened by normalized functional exercise， the observation A group was intervened by Tuina with Chinese medicines characteristics on the basis of the control group， and the observation group B was treated with glucosamine sulfate capsules on the basis of the control group. Scores of knee-joint swelling， tenderness， joint activity and Lysholm knee function were evaluated before and after treatment. Knee joint fluid was extracted from patients and Matrix metalloproteinase-3 (MMP3)， tissue inhibitor of metalloproteinase 1 (TIMP1) and tumor necrosis factor-α (TNF-α) were tested before and after treatment. The clinical efficacy after treatment and safety during treatment were evaluated in two groups. RESULTS Scores of knee-joint swelling， tenderness and joint activity in three groups significantly decreased after treatment (P<0.05)， and Lysholm knee function scores increased significantly (P<0.05)， but scores of knee-joint swelling， tenderness and joint activity in observation groups A and B decreased more significantly (P<0.05)， and Lysholm knee function scores increased more significantly (P<0.05). Levels of MMP3， TIMP1 and TNF-α in three groups decreased significantly after treatment(P<0.05)， but observation groups A and B decreased more significantly(P<0.05). Total effective rates in observation groups A and B were 95.00% and 1.67%， respectively， which were significantly higher than that in the control group (75.00%)， the differences were statistically significant (2=9.412、8.757， P<0.01). There were no obvious adverse reactions in three groups， and the safety was grade I. CONCLUSION The combination of Tuina and functional exercise has significant clinical effectiveness and high safety in the treatment of KOA， which is worthy of clinical promotion.
- functional exercise /
- Tuina /
- knee osteoarthritis /
- glucosamine sulfate capsules

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参考文献(18)

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