张利献

【摘 要】目的：观察加味通痹壮骨汤联合苍龟探穴法针刺治疗膝骨关节炎的临床疗效。方法：将98例膝骨关节炎患者按照随机数字表法分为治疗组和对照组，每组49例。对照组给予加味通痹壮骨汤治疗，治疗组在对照组基础上联合苍龟探穴法针刺治疗。观察2组临床疗效，以及治疗前后视觉模拟评分法（VAS）评分、生活质量评分。结果：治疗组临床控制38例，显效9例，有效1例，无效1例，总有效率为97.96%；对照组临床控制27例，显效8例，有效9例，无效5例，总有效率为89.80%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组VAS评分和生活质量评分均较治疗前改善（P < 0.05）；且治疗组VAS评分低于对照组，生活质量评分高于对照组，差异有统计学意义（P < 0.05）。结论：加味通痹壮骨汤联合苍龟探穴法针刺治疗膝骨关节炎疗效显著，有利于缓解疼痛、提高生活质量。

【关键词】 骨关节炎，膝；加味通痹壮骨汤；苍龟探穴法针刺；VAS评分；生活质量

【ABSTRACT】Objective：To observe the clinical efficacy of modified Tongbi Zhuanggu Tang（加味通痹壮骨汤）combined with Canggui Tanxue Acupuncture（苍龟探穴法针刺）on VAS and quality of life in treating patients with knee osteoarthritis.Methods：Ninety eight cases of knee osteoarthritis were randomly divided into a treatment group and a control group，49 cases in each group.The control group was treated with modified Tongbi Zhuanggu Tang，while the treatment was treated with Canggui Tanxue Acupuncture base on the treatment for the control group.The clinical effects of the two groups were observed，as well as the VAS scores and the quality of life scores before and after the treatment.Results：In the treatment group，38 cases were clinically controlled，9 cases were markedly effective，1 case was effective，1 case was invalid，and the total effective rate was 97.96%.In the control group，27 cases were clinically controlled，8 cases were markedly effective，9 cases were effective，5 cases were ineffective，and the total effective rate was 89.80%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，the score of VAS and quality of life score of the two groups were improved（P < 0.05），and the score of VAS of the treatment group was lower than that of the control group，while the quality of life score was higher than that of the control group，and the difference was statistically significant（P < 0.05）.Conclusion：Modified Tongbi Zhuanggu Tang combined with Canggui Tanxue Acupuncture has a good effect in the treatment of knee osteoarthritis，significantly helping alleviate pain and improve the quality of life.

【Keywords】 osteoarthritis，knee；modified Tongbi Zhuanggu Tang（加味通痹壮骨汤）；Canggui Tanxue Acupuncture（苍龟探穴法针刺）；VAS score；quality of life

膝骨关节炎（knee osteoarthritis，KOA）为临床骨科常见疾病，是一种缓慢的病理发展过程，多发于中老年群体，且女性多于男性。中医学认为，膝为筋之府，KOA属“骨痹”“痹證”等范畴，为本虚标实之证，肝肾亏虚、气血不足，风寒湿邪趁机侵入机体所致经络瘀阻、运行失畅为本病的主要病因病机，所谓不通则痛，故治疗应以通痹壮骨、活血祛痛、温阳散寒为原则[1]。针刺在我国已有数千年历史，主要通过刺入人体一定穴位以达治疗的目的。苍龟探穴是针刺的一种，相比常规针刺，该法具有刺激面广、刺激量强等显著特点，可更好地缓解关节疼痛，促进组织修复[2]。本研究探讨加味通痹壮骨汤联合苍龟探穴法针刺对KOA患者视觉模拟评分法（VAS）评分及生活质量的影响，现总结报告如下。……