王坚炯 陈旭 楼红侃

[摘要] 目的 探讨解剖列车理论下浮针在膝骨性关节炎的应用。 方法 本研究回顾性分析2017年7月至2018年6月宁波市中医院收治的60例膝骨性关节炎患者，其中30例对照组患者采用常规药物及物理治疗，30例观察组患者在上述基础上以解剖列车理论为指导进行浮针治疗。两组患者均完成随访，比较两组治疗后疼痛VAS评分、患膝关节Lysholm评分及患者满意度。 结果 治疗前两组患者一般资料、疼痛VAS评分、患膝关节Lysholm评分比较，差异无统计学意义（P>0.05）;治疗后两组患者疼痛VAS评分均较治疗前下降，观察组患者疼痛VAS评分治疗后24 h（4.6±0.5）分、7 d（3.1±0.6）分、14 d（1.9±0.4）分，较对照组术后24 h（4.9±0.4）分、7 d（4.2±0.9）分、14 d（2.7±1.0）分明显下降（P<0.05）;治疗后两组患者膝关節Lysholm评分均较治疗前上升，观察组患者膝关节Lysholm评分治疗后24 h（74.5±1.6 ）分、7 d（85.4±2.7）分、14 d（90.3±2.9）分，较对照组术后24 h（63.7±2.2）分、7 d（70.7±1.7）分、14 d（79.2±3.1）分明显上升（P<0.05）;观察组患者满意度（93.3%）较对照组（76.7%）升高，差异有统计学意义（P<0.05）。 结论 合理运用浮针治疗，可使疼痛感触明显减轻，功能和患者的满意度均显著提高。

[关键词] 解剖列车;浮针;骨性关节炎;Lysholm评分

[中图分类号] R684.3          [文献标识码] A          [文章编号] 1673-9701（2021）32-0018-04

[Abstract] Objective To explore the application of floating needles in knee osteoarthritis under the theory of anatomy trains. Methods A total of 60 patients with knee osteoarthritis in Ningbo Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were retrospectively analyzed in this study. Among them， 30 patients in the control group were treated with conventional medications and physical therapy， and 30 patients in the observation group were treated with floating needles under the theory of anatomy trains on the basis of the above-mentioned principles. Both groups of patients were completed follow-up. The pain （VAS score）， Lysholm score of the affected knee joint，and patient satisfaction were compared between the two groups after treatment. Results Before treatment， there was no statistically significant difference in general data， pain VAS score， and Lysholm score of the affected knee joint between the two groups（P>0.05）points;after treatment， the pain VAS scores in both groups were lower than those before treatment. The pain VAS scores in the observation group were （4.6±0.5）points，（3.1±0.6） points， and （1.9±0.4）points at 24 h，7 d and 14d after treatment， compared with those of （4.9±0.4）points，（4.2±0.9）points，and（2.7±1.0）points at 24 h， 7 d and 14 d after treatment in the control group，which were significantly decreased（P<0.05）; after treatment，the Lysholm scores of the affected knee joints in both groups of patients were increased compared with those before treatment.The Lysholm scores of the affected knee joint in the observation group were （74.5±1.6） points，（85.4±2.7） points， and （90.3±2.9） points at 24 h，7 d and 14 d after treatment，compared with those of （63.7±2.2） points，（70.7±1.7）points， and （79.2±3.1）points at 24 h，7 d and 14 d after treatment in the control group， which were increased significantly（P<0.05）; the patient satisfaction in the observation group （93.3%） was increased compared with that in the control group（76.7%）， and the difference was statistically significant（P<0.05）. Conclusion Reasonable use of floating needle therapy can significantly reduce the sense of pain and improve joint function and patient satisfaction.

[Key words] Anatomy trains; Floating needles; Knee osteroarthritis; Lysholm scores

骨关节炎（Osteoarthritis，OA）为骨科的常见退化性疾病，多发于中老年人，为关节的无菌性炎症反应，主要病理表现为包括关节软骨蜕变磨损甚至消失，软骨下骨在应力刺激后反应性増生等[1-2]。OA多发于负重的关节、较频繁活动的关节，如髋、膝、踝关节等，而临床上更以膝骨关节炎最为常见，致残率高[3]。浮针疗法是对中医整体局部相统一观点及辨证论治理念的良好阐述。浮针既作为针灸学的传统传承，又是一种明显的发扬创新，通过释放神经介质，促进局部血流，增强肌筋膜网絡的修复，故具有起效快速、经济安全、较少副作用等优点[4]。……