来源：风湿病与关节炎,2018,7（9）:18-21.

手法联合中药外敷治疗膝骨关节炎75例临床观察

（临床研究）

刘彦璐，管恩福，杨明会

　　【摘　要】目的：观察手法联合中药外敷治疗膝骨关节炎的临床疗效。方法：将149例膝骨关节炎患者按照简单数字随机表法随机分为治疗组75例和对照组74例，对照组采用中药外敷治疗，治疗组在对照组基础上联合正骨手法治疗。2组均以1周为1个疗程，共治疗4个疗程。根据膝关节功能Lysholm评价标准评定2组临床疗效，观察2组西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。结果：治疗组痊愈11例，显效35例，有效21例，无效8例，总有效率为89.33%；对照组痊愈9例，显效32例，有效20例，无效13例，总有效率为82.43%。2组比较，差异有统计学意义（P < 0.05）。治疗1周、1个月及随访3个月，2组WOMAC各项评分较治疗前均有改善（P < 0.05），且治疗组优于对照组（P < 0.05）。结论：手法联合中药外敷作为一种绿色治疗方案，具有良好的疗效和优势，值得在基层医院推广运用。

　　【关键词】　骨关节炎，膝；手法；中药外敷；临床疗效

Clinical Observation on 75 Cases of Knee Osteoarthritis Treated with Manipulation Combined with External Application of Chinese Medicine

LIU Yan-lu,GUAN En-fu,YANG Ming-hui

　　【ABSTRACT】Objective:To observe the clinical effect of manipulative therapy combined with external application of Chinese medicine on knee osteoarthritis.Methods:One hundred and forty-nine patients with knee osteoarthritis were randomly divided into a treatment group（75 cases）and a control group（74 cases）according to the random number table.The control group was treated with external application of Chinese medicine.The treatment group was treated with bone-setting manipulation on the basis of the treatment for the control group.The two groups were treated with 1 week as a course ,and 4 courses were treated.The clinical efficacy of the two groups was evaluated according to Lysholm criteria for knee function,and the scores of WOMAC were observed.Results:In the treatment group,11 cases were cured,35 cases were markedly effective,21 cases were effective,8 cases were ineffective,and the total effective rate was 89.33%;while in the control group,9 cases were cured,32 cases were markedly effective,20 cases were effective,13 cases were ineffective,and the total effective rate was 82.43%.The difference between the two groups was statistically significant（P < 0.05）.After 1 week,

1 month and 3 months’ follow-up,the WOMAC scores of the two groups were improved（P < 0.05）,and the treatment group was better than the control group（P < 0.05）.Conclusion:Manipulation combined with external application of Chinese medicine as a green treatment program has good efficacy and advantages,worthy of being popularized and applied in grass-root hospitals.