刺络拔罐加温针灸治疗膝关节内侧痛症临床观察(1)

1、刺络拔罐加温针灸治疗膝关节内侧痛症临床观察(1)    【摘要】  目的  观察针灸综合疗法治疗膝关节内侧痛症的临床疗效，寻找治疗膝关节内侧痛症的最佳方法。方法  将膝关节内侧痛症患者按就诊顺序随机分为治疗组55例与对照组55例，治疗组采用刺络拔罐加温针灸治疗，对照组采用电针刺加TDP治疗，两组均治疗20次后进行疗效对比。结果  治疗组显效42例，有效8例，无效5例，总有效率90.91%；对照组显效24例，有效14例，无效17例，总有效率69.09%。经统计学处理，两组显效和总有效率差异均有非常显著性（P0.01）

2、。结论  刺络拔罐加温针灸对膝关节内侧病症有较好疗效。     【关键词】  膝关节内侧痛症；针灸疗法；刺络拔罐、温针灸；电针刺+TDP     膝关节病是针灸科门诊的常见病、多发病，其中膝关节内侧痛症发病率较高，常见原因为膝关节内侧副韧带损伤、内侧半月板损伤，骨性关节炎、局限性滑膜炎、胫骨结节骨骺炎、膑骨软化症等。中医属痹证。笔者以刺络拔罐加温针灸治疗55例(治疗组)，电针刺加TDP治疗55例(对照组)，治疗组疗效明显优于对照组，现报告如下。    1  临床资料

3、    1.1  一般资料  110例均为针灸科门诊病人，男37例，女73例；单膝发病56例，双膝发病54例，共164膝；年龄最大79岁，最小17岁，平均年龄44岁；病程1个月内23例，1个月2年43例，2年以上44例。按就诊顺序随机分为治疗组55例，对照组55例。治疗组男19例，女36例；单膝33例，双膝22例；病程1个月内13例，1个月2年21例，2年以上21例。对照组男18例，女37例；单膝23例，双膝32例；病程1个月内10例，1个月2年22例，2年以上23例。两组患者在性别、年龄、病程、病情及单双膝关节发病方面，差异无显著性（P0.0

4、5）。    1.2  诊断要点    1.2.1  病史  有外伤、劳损、病损史。    1.2.2  症状  膝关节痛以内侧为主，关节发软无力，跳跃、上下楼梯、负重、屈膝及由蹲位骤然站起时疼痛加重，部分患者活动膝关节时髌骨有一过性抖动，伴膝关节弹响。    1.2.3  体征  膝关节内侧压痛明显，常可扪及痛性条索，病程短者局部可见肿胀，病程长者膝关节内侧骨节突出，肌肉萎缩。膝关节功能受限制。 

5、;   1.2.4  X线片  在年轻或病程短患者可无明显异常，年长及病程长患者可见膝关节骨性退变征象。查血尿酸、血沉、类风湿因子，抗“O”等均正常而排除相关疾病。    2  治疗方法    2.1  取穴  阿是穴、阴陵泉、膝关、曲泉、阴谷。    2.2  方法  治疗组：在膝关节内侧按压寻找最痛点，即阿是穴，梅花针叩刺，拔罐5min。叩刺拔罐隔日操作1次。取罐后在阿是穴三根针齐刺法刺入，针刺阴陵泉、膝关、曲泉

6、、阴谷穴，得气后均施行针刺补法，留针时用艾条剪成长约2cm左右，插在针柄上，点燃施灸，烧尽后将针取出，每日1次，10天1个疗程，休息1周后行第2个疗程。对照组：阿是穴三根针齐刺法刺入，针刺阴陵泉、膝关、曲泉、阴谷穴，得气后施行补法，留时用G6805-2A电针仪每膝2组输出，并加TDP照射，时间30min，每日1次，10天1个疗程，休息1周后行第2个疗程。 1      operating system. The desktop configuration consisted of a P III processor, standard 24-b

7、it video-graphics card on it and a monitor with 85 Hz. horizontal frequencies and resolution of 800x600 pixels. The first image of the program is in a circular order of 30 round shapes, each having a different color (see Figure 1A). These colored circles are numbered on the screen and are separated

8、by equal distance in a circular fashion. These 30 different color hues were created using HLS color naming space with a programming algorithm derived from RGB system of Microsoft so as to have constant saturation and brightness but differing hue components. The hue component presents the changed par

9、ameters of each color. This avoids the possibility of color blinds to discriminate colors by saturation and/or brightness.    Application of the NCACVT All subjects were well informed by the tester about the test procedure. There is an introductory mini-test at the beginning of the pr

10、incipal testing program. This introductory phase there were 7 different color caps were showed, which are recognizable for both in normal and the color blinds. The subjects compared the sample test color with the circle colors by moving the mouse anticlockwise for matching until subject reaches the

11、corresponding color cap and clicks on the mouse (Figure 1A). After this mini-test illustration the principal test was started. The colored circles are numbered on the screen and are separated by equal distance in a circular fashion. The principal colors representing red, green and blue (RGB) are num

12、bered as 1, 11, and 21 respectively and they are shown with bold arrows. Numbers 6, 16 and 26 are the colors created by mixing two of the principal colors of the RGB system and they are shown with light arrows. In other words, these are the cyan-magenta-yellow (CMYK) systems principal colors. There

13、are 4 more intermediate hues in between these marked ones (Figure 1B). This presentation allows an even distribution of colors having close wavelengths in different quadrants. Consecutive presentations of the comparing test colors are also random and successive colors have distant wavelengths. Thirt

14、y colors are presented one after another and the subject moves the comparing test color anticlockwise until subject reaches the corresponding color cap and clicks on the mouse (Figure 1C). If the subject has color vision deficiency, subject may choose more than one colored circles which disappeared from view and saved (Figure 1D). Eve