标题：推拿手法与针灸治疗膝关节骨性关节炎的临床疗效对比研究

      作者：张大富，吕应惠，曲建蕊，吴银义，刘耀明
    （兰州军区总医院安宁分院创伤外科，甘肃 兰州 730070）

      卷次： 2014年25卷5期

      【摘要】 目的 对比推拿手法和针灸疗法治疗膝关节骨性关节炎的临床疗效，为优化本病的非药物治疗方
案提供参考。方法 选取膝关节骨性关节炎患者120例，随机分为针灸组和推拿组各60例。针灸组采用针灸疗
法进行治疗，推拿组采用推拿手法进行治疗。采用WOMAC评分量表在治疗前、治疗2周后以及治疗4周后对两
组患者的病情进行评估，并对两组患者治疗前后的临床疗效进行比较。结果 治疗 2周后，针灸组疼痛得分
为 (71.52±36.81)分，僵硬得分为 (32.94±31.06)分，关节功能得分为 (286.33±208.92)分；推拿组疼痛得分为
(83.39±42.73)分，僵硬得分为(21.17±36.54)分，关节功能得分为(292.46±213.48)分。两组患者的疼痛和关节功能
得分显著低于治疗前(均P<0.05)，针灸组僵硬得分和治疗前比较差异无统计学意义(P>0.05)，而推拿组僵硬得分
显著低于治疗前(P<0.05)。两组患者治疗2周后的疼痛和关节功能得分比较差异无统计学意义(P>0.05)，而推拿
组僵硬得分显著低于针灸组(P<0.05)。治疗4周后，针灸组疼痛得分为(43.86±35.31)分，僵硬得分为(13.69±12.32)
分，关节功能得分为(179.41±165.18)分；推拿组疼痛得分为(51.79±42.68)分，僵硬得分为(11.52±10.74)分，关节功
能得分为(195.39±158.92)分。两组患者疼痛、僵硬以及关节功能的得分显著低于治疗2周后(均P<0.05)。两组患
者治疗4周后的疼痛、僵硬以及关节功能得分的比较差异无统计学意义(P>0.05)。结论 相对于针灸疗法，推拿
手法治疗关节僵硬起效更快，两种疗法均可有效缓解膝关节骨性关节炎的病情，长期疗效相当，是治疗本病较为
理想的非药物治疗方法。

      【关键词】 膝关节骨性关节炎；针灸；推拿手法

      【中图分类号】 R684.3 【文献标识码】 A 【文章编号】 1003—6350(2014)05—0661—03


Comparative study of the clinical efficacy of manipulation and acupuncture in the treatment of knee
osteoarthritis.
ZHANG Da-fu, LV Ying-hui, QU Jian-rui, WU Yin-yi, LIU Yao-ming. Department of Trauma Surgery,
Anning Branch, General Hospital of Lanzhou Military Region, Lanzhou 730070, Gansu, CHINA

【Abstract】 Objective To compare the clinical efficacy of manipulation and acupuncture therapy in the treat-
ment of knee osteoarthritis, and to provide reference for the optimization of the non-drug treatment scheme of the dis-
ease. Methods One hundred and twenty patients with knee osteoarthritis were selected and randomly divided into
acupuncture group and manipulation group, with 60 cases in each group. The acupuncture group was treated by acu-
puncture therapy, and the manipulation group was treated by manipulation. WOMAC scale was used to evaluate the
clinical efficacy of the two groups before treatment, 2 weeks and 4 weeks after treatment. Results After 2 weeks’
treatment, in the acupuncture group, the pain score was (71.52±36.81), the stiff score was (32.94±31.06), and the joint
function score was (286.33±208.92). In the manipulation group, the pain score was (83.39±42.73), the stiff score was
(21.17±36.54), and the joint function score was (292.46±213.48). The pain score and joint function score of the two
groups were significantly lower than those before treatment (P<0.05). The difference of the stiff score in the acupunc-
ture group before and after treatment was not statistically significant (P>0.05). The stiff score of the manipulation
group was significantly lower than that before treatment (P<0.05). Two weeks after treatment, the pain score and joint
function score showed no statistically significant difference between the two groups (P>0.05), but the stiff score of the
manipulation group was significantly lower than the acupuncture group (P<0.05). Four weeks after treatment, the pain
score, stiff score, the joint function score were (43.86±35.31), (13.69±12.32), (179.41±165.18) in the acupuncture
group, and (51.79±42.68), (11.52±10.74), (195.39±158.92) in the manipulation group, respectively, which were signifi-
cantly less than the scores 2 weeks after treatment (P<0.05). But the differences between the two groups 4 weeks after
treatment were not statistically significant (P>0.05). Conclusion Compared with the therapy of acupuncture, manipu-
lation treatment for joint stiffness results in faster onset. Two kinds of therapies are all effective for patients with knee
osteoarthritis, which are ideal non-drug therapies for the disease.

      【Key words】 Knee osteoarthritis; Acupuncture; Manipulation