三联中医外治疗法分期治疗膝痹的临床研究∗

摘要

Objective:To observe the efficacy of Three-combination TCM external treatment on the knee rheu⁃matism disease. Methods:270 cases of the knee rheumatism disease were divided into acute stage,remission, rehabilitation period according to the condition of disease,90 cases in each stage,each stage was randomized in⁃to a staging treatment group,western medication group,Pain-relieving Paste group,30 cases in each one. In the staging treatment group,The patients of acute stage were given the Jinshushuang ointment with massage and Su⁃perficial needle therapy,The patients of remission were given the Jiajingtuizhouqianxi massage with hot com⁃press treatment. The patients of rehabilitation period were given knee joint local tensile with rehabilitation train⁃ing. The patients of western medication group were treated with diclofenac sodium sustained of all 3 stage. The patients of Pain-relieving Paste group were given Qizheng Pain-relieving Paste of all 3 stage. After 4 weeks′treatment,Evaluated with western Ontario and McManaster Universtities Osteoarthritis Index(WOMAC) and VAS each symptom and sign were compared before and after treatment for patients of every groups. The efficacy were evaluated. Results:After the treatment,the scores of staging treatment group were superior to other groups, indicating statistical significant differences(P<0.05),The total effective rate of 93.3% in the staging treatment group was better than 80.0% in the western medication group and 75.0% in the Pain-relieving Paste group with a significant difference of all groups(P<0.05). Conclusion:the clinical therapy of Three-combination TCM ex⁃ternal treatment on the knee rheumatism disease was reliable. It could be an ideal combination therapy for knee rheumatism disease.%目的：观察三联中医外治法分期治疗膝痹的疗效。方法选取270例膝痹患者，按病情分为急性期、缓解期、康复期，每期90例，每期分为治疗组、西药组、贴敷组各30例。治疗组急性期采用筋舒霜膏摩结合浮针治疗、缓解期采用夹胫推肘牵膝推拿法结合热敷治疗，康复期采用膝关节局部拉伸结合康复训练治疗；西药组采用双氯芬酸钠缓释胶囊口服治疗；贴敷组采用奇正消痛贴治疗，各组连治疗4周。治疗前后膝关节骨性关节炎自评量表（WOMAC）及疼痛视觉评分表（VAS）进行疗效评估。结果治疗组膝关节功能评分、VAS评分显著低于对照组（P<0.05），分期治疗组临床疗效总效有效率为93.33%；西药组有效率仅为80.00%，贴敷组为75.00%，分期治疗组疗效明显优于对照组（P<0.05）。结论三联中医外治疗法能明显提高治疗膝痹治疗的临床疗效。