摘要
To observe the moxibustion sensation and the clinical therapeutic effect of heat-sensitive moxibustion of two different suspension moxibustion methods and imitation moxibustion apparatus on mild to moderate knee osteoarthritis (KOA), and compare the therapeutic effect of different moxibustion methods.A total of 90 patients with mild to moderate KOA were randomized into a hand-held group (30 cases, 1 case dropped off), an imitation moxibustion apparatus group (30 cases) and a moxibustion shelf group (30 cases, 1 case dropped off). Ashi point, Dubi (ST 35), Neixiyan (EX-LE 4), Yanglingquan (GB 34), Yinlingquan (SP 9), Liangqiu (ST 34) and Xuehai (SP 10) were selected as the frequent acupoint areas to explore and determine the heat-sensitive acupoints, after that, hand-held suspension moxibustion, suspension moxibustion with imitation moxibustion apparatus and suspension moxibustion with moxibustion shelf were adopted in the 3 groups respectively. The treatment was given once every 2 days, and totally 10-time treatment was required in the 3 groups. The moxibustion sensation (composition of moxibustion sensation, number of moxibustion sensation types in individuals and moxibustion sensation intensity) after each treatment, the visual analogue scale (VAS) score, the Lysholms knee function score and the depth of effusion and thickness of synovial hyperplasia of affected knee joint before and after treatment were observed, and the clinical therapeutic efficacy was compared in the 3 groups.The compositions of moxibustion sensation and numbers of moxibustion sensation types in individuals in the hand-held group and the moxibustion shelf group were richer, the moxibustion sensation intensity was higher than that in the imitation moxibustion apparatus group (P<0.01, P<0.05). After treatment, the VAS scores were decreased, the Lysholms knee function scores were increased compared before treatment in the 3 groups (P<0.01); the VAS score in the hand-held group was lower than the imitation moxibustion apparatus group (P<0.05), the Lysholms knee function scores in the hand-held group and the moxibustion shelf group were higher than the imitation moxibustion apparatus group (P<0.05). After treatment, the depth of effusion and thickness of synovial hyperplasia of affected knee joint were decreased compared before treatment in the 3 groups (P<0.01), and those in the hand-held group and the moxibustion shelf group were lower than the imitation moxibustion apparatus group (P<0.05). The cured and markedly effective rate in the hand-held group was 79.3% (23/29), which was better than 36.7% (11/30) in the imitation moxibuation apparatus group and 58.6% (17/29) in the moxibustion shelf group (P<0.01, P<0.05).Heat-sensitive moxibustion can effectively treat knee osteoarthritis, while the different suspension moxibustion methods have an influence on clinical therapeutic effect, hand-held suspension moxibustion has the best efficacy.目的:观察热敏灸两种不同悬灸方式及仿灸仪治疗轻中度膝关节骨关节炎(KOA)的灸感和临床疗效,探讨不同施灸方式的疗效差异。方法:将90例轻中度KOA患者随机分为手持组(30例,脱落1例)、仿灸仪组(30例)和灸架组(30例,脱落1例)。各组患者均以阿是穴、犊鼻、内膝眼、阳陵泉、阴陵泉、梁丘、血海为高发穴区探寻和确定热敏穴后,分别予以手持悬起灸、仿灸仪悬起灸、灸架悬起灸为主要施灸方式的热敏灸治疗,隔天治疗1次,共治疗10次。分别于每次治疗后评价各组患者的灸感情况(灸感类型构成、个体灸感种类数和灸感强度),比较各组患者治疗前后视觉模拟量表(VAS)评分、Lysholms膝关节功能评分、患侧膝关节积液量及滑膜增生厚度,并比较各组患者的临床疗效。结果:手持组、灸架组的灸感类型和个体灸感种类数均较仿灸仪组丰富、灸感强度均高于仿灸仪组(P<0.01,P<0.05)。治疗后,各组患者VAS评分均较治疗前降低、Lysholms膝关节功能评分均较治疗前升高(P<0.01);且手持组VAS评分低于仿灸仪组(P<0.05),手持组、灸架组Lysholms膝关节功能评分高于仿灸仪组(P<0.05)。治疗后,各组患者患侧膝关节积液量、滑膜增生厚度均较治疗前降低 (P<0.01),且手持组、灸架组低于仿灸仪组(P<0.05)。手持组的愈显率为79.3%(23/29),高于仿灸仪组的36.7%(11/30)和灸架组的58.6%(17/29,P<0.01,P<0.05)。结论:热敏灸治疗KOA疗效较好,但不同的悬灸方式对热敏灸的临床疗效有一定的影响,其中以手持悬起灸最佳。.