本文選題：膝關(guān)節(jié)骨性關(guān)節(jié)炎 + 針刺��； 參考：《中國針灸》2017年10期

【摘要】：目的:采用三維運動分析觀察電針治療對膝關(guān)節(jié)骨性關(guān)節(jié)炎(KOA)患者登梯活動時動力學即不同平面關(guān)節(jié)負荷的影響,為研究針灸康復療法的生物力學機制提供參考。方法:根據(jù)隨機數(shù)字表法將40例KOA患者隨機分成觀察組和對照組,每組20例,最終各18例完成研究。觀察組穴取內(nèi)膝眼、犢鼻、陽陵泉、陰陵泉、血海、梁丘、足三里,對照組于經(jīng)穴旁開約2 cm處淺刺。觀察組于內(nèi)膝眼和陰陵泉、梁丘和陽陵泉連接電針儀,對照組在其相應(yīng)穴旁處連接電針儀。觀察組采用頻率為2 Hz的連續(xù)方波,對照組無電流輸出。兩組各治療11次,共3周。于治療前后進行登梯步態(tài)檢測,分析上、下梯步速及登梯動力學參數(shù)(矢狀面髖、膝、踝關(guān)節(jié)屈伸峰力矩及冠狀面膝內(nèi)收外力矩)的變化。結(jié)果:治療后,觀察組上、下梯步速均較治療前明顯增加(P0.05,P0.01),上、下梯時踝關(guān)節(jié)跖屈肌峰力矩、上梯時第二膝內(nèi)收外力矩峰值(PEKAM2)均明顯增大(P0.05,P0.01)。對照組治療后,下梯時第一膝內(nèi)收外力矩峰值(PEKAM1)和PEKAM2均較治療前減小(P0.05,P0.01)。觀察組上梯時步速差值與踝跖屈肌群力矩差值呈正相關(guān)(r=0.598,P0.01)。排除步速的影響后,上梯時踝跖屈肌峰力矩的組內(nèi)差異無統(tǒng)計學意義(P0.05)。結(jié)論:電針能提高KOA患者的上下梯速度,對登梯過程中矢狀面和冠狀面的關(guān)節(jié)負荷均有一定的影響,改善了關(guān)節(jié)負荷的能力,但上梯的關(guān)節(jié)負荷改變可能與步速的增加有關(guān)。電針與最小針刺對關(guān)節(jié)負荷的效應(yīng)不同,但具體機制不夠明確,有待進一步深入探討。
[Abstract]:Objective: to observe the effect of electroacupuncture (EA) on escalator motion in patients with knee osteoarthritis (KOA) by three dimensional motion analysis, and to provide a reference for studying the biomechanical mechanism of acupuncture and moxibustion rehabilitation therapy. Methods: 40 patients with KOA were randomly divided into observation group (n = 20) and control group (n = 20). In the observation group, the internal knee eye, calf nose, Yangling spring, Yin Ling spring, blood sea, Liang Qiu, Zusanli were taken from the observation group, and the superficial prickles were opened about 2 cm beside the meridians in the control group. In the observation group, the electroacupuncture apparatus was connected with the eyes of the inner knee and Yin Ling Quan, Liang Qiu and Yang Ling Quan, and the control group connected with the electroacupuncture apparatus at the side of the corresponding acupoints. The observation group was treated with 2 Hz continuous square wave, while the control group had no current output. The two groups were treated for 11 times for 3 weeks. Step velocity and dynamic parameters (sagittal hip, knee, ankle joint flexion and extension peak moment and coronal knee adduction moment) were analyzed before and after treatment. Results: after treatment, the descending step speed of the observation group was significantly higher than that of the control group (P0.05 / P0.01). The peak moment of the ankle metatarsal flexor muscle and the peak value of the second knee adductive moment (PEKAM2) in the upper and lower ankle joints were significantly increased (P0.05 / P0.01). In the control group, the peak value of adductive moment (PEKAM1) and PEKAM2 in the first knee were decreased after treatment (P0.05 / P0.01). In the observation group, there was a positive correlation between the difference of walking speed and the moment difference of metatarsal flexor muscle group (r = 0.598p 0.01). After removing the effect of step speed, there was no significant difference in peak torque of flexor metatarsus muscle on ladder (P0.05). Conclusion: electroacupuncture can improve the ascending and descending speed of KOA patients, which has certain influence on the joint load of sagittal plane and coronal plane, and improves the ability of joint load, but the change of joint load may be related to the increase of step speed. The effects of electroacupuncture and minimal acupuncture on joint load are different, but the specific mechanism is not clear enough.
【作者單位】： 福建中醫(yī)藥大學康復醫(yī)學院;福建中醫(yī)藥大學附屬第三人民醫(yī)院康復科;福建省康復技術(shù)重點實驗室;福建省康復產(chǎn)業(yè)研究院;福建中醫(yī)藥大學附屬康復醫(yī)院;
【基金】：國家自然科學基金面上項目:81273819
【分類號】：R246.9
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本文編號：2083283