针刀松解腘肌结合隐神经阻滞治疗膝骨性关节炎屈伸功能受限的临床效果(1)
[摘要] 目的 探討针刀松解腘肌结合隐神经阻滞治疗膝骨性关节炎(KOA)屈伸功能受限的临床效果。 方法 选取南京中医药大学附属沭阳县中医院针灸推拿疼痛科2017年9月～2019年9月收治的KOA屈伸功能受限患者68例，根据随机数字表法将其分为两组，各34例。对照组给予隐神经阻滞治疗，观察组给予针刀松解腘肌联合隐神经阻滞治疗。比较两组临床疗效，采用数字量表疼痛评分(NRS)记录患者治疗前后疼痛改善情况，采用Noraxon telemyo 2400表面肌电仪检测股四头肌和股二头肌平均功率频率(MPF)、表面肌电均方根值(RMS)。 结果 观察组总有效率显著高于对照组，差异有统计学意义(P < 0.05)。两组治疗后NRS均显著低于治疗前，且观察组低于对照组(P < 0.05)。两组治疗后股二头肌、股直肌、股外侧肌和股内侧肌MPF值均显著高于治疗前，且观察组高于对照组(P < 0.05)。两组治疗后股二头肌、股直肌、股外侧肌和股内侧肌RMS值均显著高于治疗前，且观察组高于对照组(P < 0.05)。 结论 针刀松解腘肌结合隐神经阻滞治疗KOA效果满意，可减轻患者疼痛程度，增强股二头肌、股四头肌的收缩力和对疲劳的耐受力，从而有效改善患者膝关节的运动功能。
[关键词] 膝骨性关节炎;临床疗效;屈伸功能受限;针刀松解;腘肌;隐神经阻滞
[中图分类号] R274 [文献标识码] A [文章编号] 1673-7210(2020)06(c)-0177-04
[Abstract] Objective To investigate clinical effect of needle knife lysis for popliteus combined with saphenous nerve block in the treatment of knee osteoarthritis (KOA) with limited flexion and extension function. Methods Sixty-eight KOA patients with limited flexion and extension in Department of Acupuncture， Massage and Pain， Shuyang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2017 to September 2019 were selected and divided into two groups according to the random number table method， with 34 cases in each group. Control group was treated with saphenous nerve block， observation group was treated with needle knife lysis for popliteus and saphenous nerve block. Clinical effect of two groups was compared. The improvement of pain was recorded by NRS before and after treatment. The mean power frequency (MPF) and root mean square (RMS) of quadriceps femoris and biceps femoris were measured by Noraxon telemyo 2400 surface electromyography. Results Total effective rate of observation group was significantly higher than that of control group (P < 0.05). NRS of two groups after treatment was significantly lower than that before treatment， which of observation group was lower than that of control group (P < 0.05). MPF of biceps femoris， rectus femoris， lateral femoris and medial femoris in two groups were significantly higher than those before treatment， and MPF of observation group was higher than that of control group (P < 0.05). RMS of biceps femoris， rectus femoris， lateral femoris and medial femoris in two groups were significantly higher than those before treatment， and RMS of observation group was higher than that of control group (P < 0.05). Conclusion The effect of needle knife lysis for popliteus combined with saphenous nerve block in the treatment of KOA is satisfactory. It can reduce the degree of pain， enhance the contractile force and endurance to fatigue of biceps femoris and quadriceps femoris， so as to effectively improve the movement function of knee joint., 百拇医药(张欣 李开平)
[关键词] 膝骨性关节炎;临床疗效;屈伸功能受限;针刀松解;腘肌;隐神经阻滞
[中图分类号] R274 [文献标识码] A [文章编号] 1673-7210(2020)06(c)-0177-04
[Abstract] Objective To investigate clinical effect of needle knife lysis for popliteus combined with saphenous nerve block in the treatment of knee osteoarthritis (KOA) with limited flexion and extension function. Methods Sixty-eight KOA patients with limited flexion and extension in Department of Acupuncture， Massage and Pain， Shuyang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2017 to September 2019 were selected and divided into two groups according to the random number table method， with 34 cases in each group. Control group was treated with saphenous nerve block， observation group was treated with needle knife lysis for popliteus and saphenous nerve block. Clinical effect of two groups was compared. The improvement of pain was recorded by NRS before and after treatment. The mean power frequency (MPF) and root mean square (RMS) of quadriceps femoris and biceps femoris were measured by Noraxon telemyo 2400 surface electromyography. Results Total effective rate of observation group was significantly higher than that of control group (P < 0.05). NRS of two groups after treatment was significantly lower than that before treatment， which of observation group was lower than that of control group (P < 0.05). MPF of biceps femoris， rectus femoris， lateral femoris and medial femoris in two groups were significantly higher than those before treatment， and MPF of observation group was higher than that of control group (P < 0.05). RMS of biceps femoris， rectus femoris， lateral femoris and medial femoris in two groups were significantly higher than those before treatment， and RMS of observation group was higher than that of control group (P < 0.05). Conclusion The effect of needle knife lysis for popliteus combined with saphenous nerve block in the treatment of KOA is satisfactory. It can reduce the degree of pain， enhance the contractile force and endurance to fatigue of biceps femoris and quadriceps femoris， so as to effectively improve the movement function of knee joint., 百拇医药(张欣 李开平)