摘要
目的 观察痛点推拿手法干预膝骨关节炎患者的临床疗效并探讨其作用机制.方法 50例患者随机分为痛点推拿手法组(试验组)与健康宣教组(对照组)各25例.观察两组干预前后的疼痛与功能障碍量表评分,并利用德国足底压力分布测量平板对膝骨关节炎患者进行客观评估.结果 两组治疗前VAS评分、WOMAC评分、COP轨迹长度和两侧对称性比较差异无统计学意义(均P＞0.05).对照组治疗后VAS评分与治疗前比较变化不大(P＞0.05).治疗后痛点推拿组的VAS评分与治疗前比较下降,且试验组低于对照组(P＜0.05).痛点推拿组治疗后受试者膝关节疼痛、僵硬、功能受限及总体评分较治疗前均改善(均P＜0.05);对照组治疗后疼痛评分变化不大(P＞0.05),僵硬、功能受限及总体评分较治疗前均改善(均P＜0.05);两组治疗前后差值比较,试验组WOMAC评分差值均高于对照组(P＜0.01).治疗后,试验组较治疗前COP轨迹长度增加、两侧对称偏移减小,步态稳定性提高(均P＜0.05),而对照组改善均不明显(均P＞0.05),且治疗后试验组COP轨迹长度、两侧对称性均优于对照组(均P＜0.05).两组治疗前后第三跖骨(M3区)、第四跖骨(M4区)、足后跟内侧(HM区)压力比较,差异具有统计学意义(P＜0.05).结论 痛点推拿手法能够有效缓解膝骨关节炎患者疼痛、僵硬和活动受限,改善患者的步态和对称性,本研究可为痛点推拿手法干预膝骨关节炎的临床疗效提供支持.
Abstract
Objective:To explore the clinical efficacy of pain point massage intervention for patients with knee osteoarthritis and to investigate its mechanism of action.Methods:50 subjects with knee osteoarthritis were in-cluded and randomly divided into a pain point massage manipulation group(treatment group)and a health educa-tion group(control group).The pain and dysfunction scale scores before and after the intervention were observed,and the German plantar pressure distribution measurement plate was used to objectively evaluate the knee osteoar-thritis patients.Results:There were no significant differences in VAS score,WOMAC score,COP trajectory length and bilateral symmetry between the two groups before treatment(all P＞0.05).There was little change in VAS score in the control group after treatment compared with that before treatment(P＞0.05).After treatment,the VAS score of the treatment group decreased compared with that before treatment,and the treatment group was low-er than that of the control group(P＜0.05).After treatment,the pain,stiffness,functional limitation and overall scores of the subjects in the treatment group were all improved compared with those before treatment(all P＜0.015);the pain scores of the control group did not change much after treatment(P＞0.05),while the stiffness,functional limitation and overall scores were improved compared with those before treatment(all P＜0.05).After treatment,the length of COP trajectory,the symmetrical deviation of both sides decreased,and the gait stability im-proved in the treatment group(all P＜0.05),while the control group did not improve significantly(all P＞0.05).Af-ter treatment,the length of COP trajectory and bilateral symmetry in the treatment group were better than those in the control group(all P＜0.05).There were statistically significant differences in the pressures of the third metatar-sal(M3 area),the fourth metatarsal(M4 area)and the medial heel(HM area)between the two groups before and after treatment(P＜0.05).Conclusion:Pain point massage can effectively alleviate pain,stiffness,and limited mo-bility in patients with knee osteoarthritis,improve their gait and symmetry.This study can provide support for the clinical efficacy of pain point massage intervention in knee osteoarthritis.
基金项目
国家自然科学基金面上项目(82274670)
上海市嘉定区卫生健康委中医药科研课题(2020-KY-ZYY-02)
NETL
NSTL
维普
万方数据