朱慧梅 俞坤强 吴李秀

[摘要] 目的 观察筋针联合康复训练治疗早中期膝骨关节炎的临床疗效。 方法 选取2017年8月至2019年1月本院治疗的早中期膝骨关节炎患者80例，随机分为治疗组和对照组，每组各40例。治疗组采用筋针联合康复训练治疗，对照组采用口服艾瑞昔布片联合康复训练治疗。观察两组治疗前后西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟评分法（VAS）、血清白细胞（WBC）和C反应蛋白（CRP）的变化情况，并比较两组临床疗效。 结果 两组治疗后WOMAC和VAS评分、WBC和CRP水平均较治疗前降低（P<0.05），且治疗组低于对照组（P<0.05）。治疗组总有效率为95.00%，明显高于对照组的77.50%，差异有统计学意义（P<0.05）。 结论 与艾瑞昔布联合康复训练相比，筋针联合康复训练可以更好地改善早中期膝骨关节炎患者的临床症状，减轻患者的炎症反应，临床疗效更优，值得临床推广应用。

[关键词] 筋针;康复训练;艾瑞昔布;早中期膝骨关节炎

[Abstract] Objective To observe the clinical effect of tendon acupuncture combined with rehabilitation training on early and middle knee osteoarthritis. Methods A total of 80 patients with early and mid-stage knee osteoarthritis treated by our hospital from August 2017 to January 2019 were randomly divided into a treatment group and a control group， with 40 cases in each group. The treatment group was received tendon acupuncture combined with rehabilitation training， and the control group was received oral irixibu tablets combined with rehabilitation training. The changes of osteoarthritis index （WOMAC） score of Western Ontario and McMaster University， visual analog scale （VAS） score， serum leukocyte （WBC） and C-reactive protein （CRP） before and after treatment in the two groups were observed. The clinical efficacy between two groups was compared. Results After treatment， the WOMAC and VAS scores， WBC and CRP levels of two groups were lower than those before treatment （P<0.05）. And the above indexes in the treatment group were lower than those in the control group（P<0.05）. The total effective rate of the treatment group was 95.00%， and the total effective rate of the control group was 77.50%. The difference between the two groups was statistically significant（P<0.05）. Conclusion Compared with arixibu and rehabilitation training， tendon acupuncture combined with rehabilitation training can better improve the clinical symptoms of early and mid-stage knee osteoarthritis patients， reduce inflammation， and has better clinical efficacy， which is worthy of clinical application.

[Key words] Tendon acupuncture; Rehabilitation training; Irixibu; Early and middle knee osteoarthritis

膝骨關节炎（Knee osteoarthritis，KOA）是一种以膝关节疼痛、活动不利等为主要临床表现的常见关节疾病[1]。流行病学资料表明，60岁以上的人群KOA的患病率可达50%，75岁以上的人群中则达80%[2]，伴随着人口老龄化的加剧，KOA的发病率仍呈逐年上升的趋势[3]，且KOA患者由于疼痛和关节功能障碍，也更容易并发心血管、肥胖、代谢性等疾病[4]，给社会带来巨大的经济负担[5-6]。康复训练是治疗KOA常用的方法，可以维持关节活动范围，增强肌力，提高关节稳定性，改善关节功能[7]。然而在康复训练过程中，患者常因疼痛而导致康复训练的积极性不高，故积极缓解康复训练中的疼痛反应，对于提高患者训练的积极性非常重要[8]。筋针来源于《内经》经筋理论，具有良好的止痛作用[9]。本研究在早中期KOA患者中将筋针联合康复训练，取得较好的疗效，现报道如下。

1 资料与方法

1.1 一般资料