培元通痹膏摩结合推拿治疗气滞血瘀型膝关节骨性关节炎的临床疗效观察

Clinical Observation of Peiyuan Tongbi Ointment Combined with Massage in the Treatment of Knee Osteoarthritis with Qi Stagnation and Blood Stasis Type

摘要: 目的：观察培元通痹膏摩结合推拿对气滞血瘀型膝关节骨性关节炎患者的治疗效果。方法：选取2022年4月至2023年4月就诊于新疆医科大学第四附属医院推拿科门诊及骨伤科住院部的膝关节骨性关节炎患者120例，按照随机数字表法分为培元通痹膏摩组与常规推拿对照组，每组60例。常规推拿对照组给予常规推拿治疗及膏摩治疗，培元通痹膏摩组给予培元通痹膏摩联合推拿手法治疗。观察两组患者临床疗效、膝关节Lysholm评分、VAS评分、WOMAC骨关节炎指数、中医证候积分及不良反应发生率等各项指标。结果：培元通痹膏摩结合推拿治疗气滞血瘀型KOA的临床疗效显著优于常规推拿治疗(P < 0.01)，且在安全性方面与常规推拿治疗无明显差异(P > 0.05)。在运动功能改善方面，常规推拿和培元通痹膏摩结合推拿治疗均能有效改善患者膝关节Lysholm评分、WOMAC骨关节炎指数及中医证候积分(P < 0.05)，且培元通痹膏摩结合推拿治疗相较于常规推拿手法对运动功能的改善更加明显(P < 0.01)。在疼痛程度改善方面，常规推拿手法和培元通痹膏摩结合推拿治疗均能有效减轻患者下肢疼痛症状、降低各项疼痛评分(P < 0.05)，但培元通痹膏摩结合推拿治疗相较于常规推拿手法对膝关节疼痛的改善更加明显(P < 0.01)。结论：培元通痹膏摩结合推拿治疗相较于常规推拿手法对气滞血瘀型KOA有更好的临床疗效，相较于药物及手术治疗安全性更高，能够更加有效地改善KOA患者患侧膝关节疼痛、活动受限等临床症状，最大限度地恢复患者日常活动能力。

Abstract: Objective: To observe the therapeutic effect of Peiyuan Tongbi ointment combined with massage on patients with KOA of Qi stagnation and blood stasis type. Methods: From April 2022 to April 2023, 120 patients with KOA admitted to the outpatient department of Massage and inpatient department of orthopaedics, the Fourth Affiliated Hospital of Xinjiang Medical University were selected and divided into Peiyuan Tongbi paste group and conventional massage control group according to random number table method, with 60 cases in each group. Conventional massage control group was given massage treatment and plaster treatment; Peiyuan Tongbi paste massage group was given Peiyuan Tongbi paste massage combined massage treatment. Clinical efficacy, Lysholm score of knee joint, VAS score, WOMAC osteoarthritis index, TCM syndrome score and incidence of adverse reactions were observed in 2 groups. Results: The clinical efficacy of Peiyuan Tongbi ointment combined with massage in the treatment of KOA with Qi stagnation and blood stasis type was significantly better than that of conventional massage (P < 0.01), and there was no significant difference in safety with conventional massage treatment (P > 0.05). In terms of the improvement of motor function, both conventional massage and Peiyuan Tongbi paste combined massage treatment could effectively improve the Lysholm score of knee joint, WOMAC osteoarthritis index and TCM syndrome score (P < 0.05), and Peiyuan Tongbi paste combined massage treatment had more obvious improvement on motor function compared with conventional massage (P < 0.01). In terms of pain degree improvement, both conventional massage and Peiyuan Tongbi ointment combined with massage treatment could effectively reduce the symptoms of lower limb pain and reduce pain scores (P < 0.05), but compared with conventional massage treatment, Peiyuan Tongbi ointment combined with massage treatment improved knee pain more significantly (P < 0.01). Conclusion: Compared with conventional massage, Peiyuan Tongbi ointment combined with massage has better clinical effect on KOA with Qi stagnation and blood stasis type. Compared with drug and surgical treatment, it is safer to improve clinical symptoms such as knee pain and limited movement in KOA patients more effectively, and maximize the recovery of patients’ daily activity ability.