肌筋膜触发点理论指导下针刀精准治疗膝骨 关节炎的临床研究

Clinical Research on Precise Acupotomy Therapy for Knee Osteoarthritis Guided by Myofascial Trigger Point Theory

摘要: 目的：观察肌筋膜触发点理论指导下针刀治疗对早中期膝骨关节炎患者激痛点位置、数量变化及临床症状的影响。方法：采用随机分组法将我科门诊70例膝骨关节患者分为治疗组、对照组各35例，连续治疗2周、随访1月；记录其Lequesne评分、骨关节炎指数(WOMAC)及膝周核心肌群激痛点位置、数量变化。结果：两组患者在治疗后1周、治疗后2周和随访1月的Lequesne评分、WOMAC评分均有明显降低(P < 0.05)，且治疗组显著低于同期对照组(P < 0.05)；同时两组患者在治疗后1周、治疗后2周在膝周核心肌群上活化激痛点数量均有明显减少(P < 0.05)，且治疗组低于对照组(P < 0.05)；同时股四头肌(前侧伸肌群)中活化激痛点频次及频率最多、后侧、内侧次之、外侧最少。结论：基于肌筋膜理论指导下针刀治疗膝骨关节炎的临床疗效显著，可通过抑制活化的激痛点，恢复肌群协调性，进而改善KOA患者的疼痛及功能障碍，提高其生活质量。

Abstract: Objective: To observe the effect of acupotomy therapy under the guidance of myofascial trigger point theory on the location, quantity of trigger points and clinical symptoms in patients with early‑to‑midstage knee osteoarthritis (KOA). Methods: Using a random grouping method, 70 patients with knee osteoarthritis in our outpatient department were divided into a treatment group and a control group, with 35 cases in each group. They were continuously treated for 2 weeks and followed up for 1 month; the Lequesne score, osteoarthritis index (WOMAC), and the location and number changes of trigger points in the peri-knee core muscle group were recorded. Results: Both groups of patients showed significant decreases in Lequesne scores and WOMAC scores at 1 week and 2 weeks after treatment and at 1 month follow-up (P < 0.05), with the treatment group significantly lower than the control group at the same time points (P < 0.05); meanwhile, both groups had a significant reduction in the number of activated trigger points in the knee core muscle group at 1 week and 2 weeks after treatment (P < 0.05), with the treatment group lower than the control group (P < 0.05); in addition, within the quadriceps (anterior extensor group), the frequency and incidence of activated trigger points were highest, followed by the posterior and medial regions, and lowest in the lateral region. Conclusion: Acupotomy therapy for KOA under the guidance of myofascial theory achieves significant clinical efficacy. It can inhibit active trigger points, restore muscle coordination, thereby improving pain and dysfunction in KOA patients and enhancing their quality of life.