针刀联合透明质酸钠关节内注射治疗膝骨性关节炎的临床研究

目的 观察针刀法联合透明质酸钠（sodium hyaluronate，SH）关节内注射治疗膝骨性关节炎（knee osteoarthritis，KOA）的临床疗效。方法 选取KOA患者60例，抽签随机分为试验组和对照组，比例为1：1。对照组行针刀疗法，试验组行针刀手术的过程中复合注射SH。评价两组间临床疗效、Lequene评分及步态相关指标差异。结果 试验组优良率80.0%显著高于对照组53.3%（P<0.05）；治疗后，两组Lequene评分较治疗前均降低（P<0.01），试验组Lequene评分低于对照组（P<0.05）；治疗后，两组左右足负荷、时间及负重积分比例均高于治疗前（P<0.05）；治疗后试验组左右足负荷、时间及负重积分比例均高于对照组（P<0.05）。结论 针刀法联合SH关节内注射治疗KOA具有较好临床疗效，能显著改善患者晨僵、关节肿胀等一系列症状，并可改善步态，提高患者负重及时间耐力，临床价值较高。

Clinical Effect of Acupotomy Combined with Intra-Articular Injection of Sodium Hyaluronate on Knee Osteoarthritis

Objective To observe the clinical effect of acupotomy combined with sodium hyaluronate (SH) on knee osteoarthritis (KOA). Methods 60 patients with KOA were selected and randomly divided into experimental group and control group, with a ratio of 1:1. The control group was treated with acupotomy, the experimental group was given the injection of SH during the process of acupotomy. The differences of clinical efficacy, Lequene score and gait related indexes between the two groups were compared. Results The excellent and good rate of the experimental group 80.00% was significantly higher than that of the control group 53.33% (P<0.05). After treatment, the Lequene scores of the two groups were lower than those before treatment (P<0.01), and the score of Lequene in the experimental group was lower than that in the control group (P<0.05). After treatment, the load, time and integral load ratio of left and right foot in the two groups were higher than those before treatment (P<0.05). After treatment, the load, time and integral load ratio of left and right foot in the experiment group were higher than those in the control group, the difference was statistically significant (P<0.05). Conclusion Acupuncture combined with intra-articular injection of SH treatment has significant clinical efficacy in treatment of KOA, which could significantly improve patients with morning stiffness, joint swelling and other symptoms, gait, weight-bearing and endurance time in patients with high clinical value.