三种中医理筋正骨手法治疗膝骨关节炎随机对照研究OA北大核心CSTPCD

Objective To observe the differences in efficacy among three kinds of traditional Chinese medicine tendon boning techniques,knee-around manipulation,lumbar and hip joint treatment,and lumbar-hip-knee joint treatment,in treating patients with knee osteoarthritis(KOA).Methods A total of 385 KOA patients admitted to the First Affiliated Hospital,Hebei University of Traditional Chinese Medicine from July 2022 to May 2023 were screened,and 296 patients met the inclusion criteria.They were randomly assigned to four groups using random digit table:the knee-around manipulation group(84 cases),the lumbar and hip joint treatment group(84 cases),the lumbar-hip-knee joint treatment group(84 cases),and the blank control group(44 cases).The three treatment groups received health education,while the knee-around manipulation group received knee joint local manipulation and adjustment techniques(twice a week for 2 weeks).Patients in the lumbar and hip joint treatment group received hip joint pushing and rocking manipulation combined with spinal fixed rotation and repositioning techniques(twice a week for 2 weeks).And patients in the lumbar-hip-knee joint treatment group received knee-around manipulation and lumbar and hip joint treatment techniques(twice a week for 2 weeks).Patients in the blank control group received health education alone.The Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities(WOMAC)Osteoarthritis Index of the four groups were observed before treatment and at week 2 after treatment.VAS,WOMAC,and quality of life scorey(SF-12)of the three treatment groups were compared before treatment,post-treatment 2 weeks,and post-treatment 3 months(follow-up).Results Compared with the same group before treatment,the VAS and WOMAC scores of the blank control group decreased,but with no statistical differences(P＞0.05).VAS and WOMAC significantly decreased,and SF-12 scores significantly increased in the three treatment groups at post-treatment week 2 and follow-up(all P＜0.05).VAS and WOMAC significantly decreased,and SF-12 scores significantly increased in the lumbar and hip joint treatment group and lumbar-hip-knee joint treatment group at post-treatment week 2 and follow-up(all P＜0.05).However,there were no statistically significant differences between the lumbar and hip joint treatment group or the lumbar-hip-knee joint treatment group at post-treatment week 2 and follow-up(P＞0.05).Conclusions The knee-around,lumbar and hip joint treatment,and lumbar-hip-knee joint treatment techniques had certain effects in attenuating pain,improving knee joint function,and enhancing quality of life in KOA patients.The lumbar-hip-knee joint treatment technique was more effective than the knee-around technique,but showed similar efficacy to the lumbar and hip joint treatment group.