中医正骨2025，Vol.37Issue(6)：19-27,9.
平乐正骨平衡理论指导下的刃针综合疗法治疗早中期膝骨关节炎气滞血瘀证的临床研究
A clinical study of blade needle combined therapy under the guidance of Pingle Zhenggu(平乐正骨)balance the-ory for treatment of early-and mid-stage knee osteoarthritis with syndrome of qi stagnation and blood stasis
摘要
Abstract
Objective:To evaluate the clinical curative effect and safety of blade needle combined therapy under the guidance of Pingle Zhenggu(平乐正骨,PLZG)balance theory for treatment of early-and mid-stage knee osteoarthritis(KOA)with syndrome of qi stagnation and blood stasis.Methods:One hundred early-and mid-stage KOA patients with syndrome of qi stagnation and blood stasis recruited from February 2022 to March 2023 were randomly divided into 2 groups,50 cases in each group.All patients in the 2 groups were treated with oral application of Xuefu Zhuyu Tang(血府逐瘀汤),external application of Shujin Huoxue Qutong Gao(舒筋活血祛痛膏)and knee func-tional exercises.In addition,50 patients(blade needle therapy group)were further treated with blade needle therapy under the guidance of PLZG balance theory according to the cardinal symptomatic sites(suprapatellar bursa,infrapatellar fat pad,Point Neixiyan(ST34),Point Dubi(ST35),etc.),2-3 times a week for consecutive 2 weeks.The other 50 patients(acupuncture therapy group)were treated with fili-form needle acupuncture at Point Xuehai(SP10),Point Neixiyan(ST34),Point Dubi(ST35),Point Yanglingquan(GB34),Point Yin-lingquan(SP9),etc.,once a day for consecutive 2 weeks.The knee pain visual analogue scale(VAS)scores,the Western Ontario and Mc-Master Universities osteoarthritis index(WOMAC)scores and the range of motion(ROM)of knee were evaluated and compared between the two groups before the treatment and at post-treatment and 1-,3-,6-month-post-treatment.The adverse effects and complications were ob-served and compared between the 2 groups during the treatment and follow-up period.Results:①General condition.During the treatment period,2 patients in the blade needle therapy group withdrew from the trial due to traumatic fracture and transfer to another department,re-spectively;and 4 patients in the blade needle therapy group and 3 patients in the acupuncture therapy group withdrew from the trial due to failure to receive treatment according to the plan.Finally,44 patients in the blade needle therapy group and 47 patients in the acupuncture therapy group were included.②The knee pain VAS scores.The knee pain VAS scores presented a decreasing trend over time in the 2 groups before and after the treatment(Wald x2=371.079,P=0.000;Wald x2=316.248,P=0.000).There was statistical difference between the 2 groups at 1 month after the end of the treatment(Z=-2.715,P=0.007),but the difference was small and lack of clinical significance,and there was no statistical difference between the 2 groups at the remaining timepoints.③WOMAC total scores.In general,the WOMAC total scores presented a time-dependent trend of decreasing firstly and slightly increasing subsequently before and after the treat-ment(Wald x2=179.547,P=0.000),and there was no statistical difference between the 2 groups(Wald x2=0.031,P=0.860).④WOMAC pain scores and stiffness scores.In general,the WOMAC pain scores and stiffness scores presented a time-dependent trend of decreasing firstly and slightly increasing subsequently before and after the treatment(Wald x2=231.809,P=0.000;Wald x2=104.917,P=0.000),and there was no statistical difference between the 2 groups(Wald x2=0.288,P=0.591;Wald x2=0.004,P=0.947).⑤WOMAC physical function scores.The WOMAC physical function scores presented a time-dependent trend of decreasing firstly and slightly increasing subsequently in the 2 groups before and after the treatment(Wald x2=125.244,P=0.000;Wald x2=122.438,P=0.000),and there was no statistical difference between the 2 groups at all timepoints.⑥The knee ROM.In general,the knee flexion ROM,inward rotation ROM and outward rotation ROM presented a time-dependent trend of increasing firstly and slightly decreasing subsequently before and after the treatment(Wald x2=36.852,P=0.003;Wald x2=12.997,P=0.011;Wald x2=149.501,P=0.000).There was no statistical difference among the timepoints in knee extension ROM(Wald x2=9.358,P=0.052).There was no statistical difference be-tween the 2 groups in knee flexion ROM,extension ROM and inward rotation ROM(Wald x2=0.707,P=0.400;Wald x2=0.273,P=0.601;Wald x2=0.655,P=0.418).The knee outward rotation ROM was greater in blade needle therapy group compared to acupuncture therapy group(Wald x2=4.552,P=0.033),but the difference was small,and lack of clinical significance.⑦The adverse reactions and complications.No adverse reactions and complications were found in the 2 groups during the treatment and follow-up period.Conclusion:For treatment of early-and mid-stage KOA with syndrome of qi stagnation and blood stasis,the blade needle combined therapy under the guidance of PLZG balance theory can alleviate knee pain and stiffness,increase knee ROM and improve knee function,and it is comparable to the acupuncture therapy in the clinical curative effect and safety.关键词
骨关节炎,膝/血瘀气滞/刃针/针刺/平衡理论/随机对照试验专题Key words
osteoarthritis,knee/syndrome of blood stasis and qi stagnation/blade needle/acupuncture/balance theory/randomized con-trolled trials as topic引用本文复制引用
王智勇,丁永利,郑福增,杜进林,郭珈宜,李峰,张云飞,杨孟孟,文永兵,付卓,耿丰勤,沈素红..平乐正骨平衡理论指导下的刃针综合疗法治疗早中期膝骨关节炎气滞血瘀证的临床研究[J].中医正骨,2025,37(6):19-27,9.基金项目
河南省中医药科学研究专项课题(20-21ZY1005) （20-21ZY1005）
全国中医学术流派传承工作室建设项目(国中医药人教函[2019]62号) （国中医药人教函[2019]62号）
