| 引用本文: |
谷欣宇, 张育康, 史兆杰, 程露露, 金祥雨, 李冬静, 陈朝晖.理筋正骨手法联合本体感觉神经肌肉促进技术治疗膝骨关节炎的随机对照试验[J].湖南中医药大学学报,2026,46(4):745-751[点击复制] |
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| 理筋正骨手法联合本体感觉神经肌肉促进技术治疗膝骨关节炎的随机对照试验 |
| 谷欣宇,张育康,史兆杰,程露露,金祥雨,李冬静,陈朝晖 |
| (安徽中医药大学第一临床医学院, 安徽 合肥 230038;安徽中医药大学针灸推拿学院, 安徽 合肥 230038;安徽省中医院针灸康复一科, 安徽 合肥 230031) |
| 摘要: |
| 目的 探讨理筋正骨手法联合本体感觉神经肌肉促进技术（PNF）治疗膝骨关节炎（KOA）的临床疗效。方法 采用单中心、随机、平行对照试验，将74例患者随机分为试验组和对照组（各37例）。试验组接受理筋正骨手法联合PNF治疗，对照组仅接受PNF治疗，干预8周。主要结局指标为视觉模拟评分（VAS）、膝关节损伤与骨关节炎结局评分（KOOS）及下肢肌肉共激活指数（CCI）；次要结局指标为“起立-行走”测试（TUGT）和步态参数。结果 试验组总有效率显著高于对照组（P<0.001）。干预8周后，时间主效应方面两组患者的VAS评分、CCI、TUGT时间均较治疗前显著降低，KOOS各维度评分及步频、步长均较治疗前显著升高（P<0.001），步速较治疗前升高，但差异无统计学意义（P=0.220）。组别效应方面试验组VAS评分、CCI、KOOS疼痛、症状、运动及娱乐、生活质量维度评分、步速、步频、步长及TUGT时间整体水平优于对照组（P<0.05）,KOOS日常生活活动维度两组整体水平差异无统计学意义（P=0.096）。在交互效应方面，与对照组相比，试验组VAS评分、CCI呈更显著降低趋势，KOOS疼痛、症状、运动及娱乐、生活质量维度评分与步频呈更显著升高趋势（P<0.05）。在TUGT时间、步速、KOOS日常生活活动维度及步长方面，两组的改善差异无统计学意义（P>0.05）。结论 理筋正骨手法联合PNF治疗可进一步缓解KOA患者疼痛、改善膝关节功能、提升生活质量、优化下肢肌肉协同状态及步频。 |
| 关键词: 膝骨关节炎|理筋正骨手法|本体感觉神经肌肉促进技术|肌肉共激活|随机对照试验 |
| DOI：10.3969/j.issn.1674-070X.2026.04.012 |
| 投稿时间：2025-12-02 |
| 基金项目:2024年度安徽省高等学校科学研究项目(2024AH051004) |
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| Randomized controlled trial of sinew-regulating and bone-aligning manipulation combined with proprioceptive neuromuscular facilitation in treating knee osteoarthritis |
| GU Xinyu, ZHANG Yukang, SHI Zhaojie, CHENG Lulu, JIN Xiangyu, LI Dongjing, CHEN Zhaohui |
| (The First Clinical Medical College, Anhui University of Chinese Medicine, Hefei, Anhui 230038, China;College of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, Anhui 230038, China;The First Department of Acupuncture and Rehabilitation, Anhui Provincial Hospital of Chinese Medicine, Hefei, Anhui 230031, China) |
| Abstract: |
| Objective To investigate the clinical efficacy of sinew-regulating and bone-aligning manipulation combined with proprioceptive neuromuscular facilitation(PNF) in treating knee osteoarthritis(KOA). Methods A single-center, randomized, and parallel-controlled trial was conducted. A total of 74 patients were randomly divided into experimental group and control group(37 cases in each group). The experimental group received sinew-regulating and bone-aligning manipulation combined with PNF, while the control group only received PNF, both for eight consecutive weeks. The primary outcome indicators included Visual Analogue Scale(VAS), Knee injury and Osteoarthritis Outcome Score(KOOS), and co-contraction index(CCI) of lower limb muscles. The secondary outcome indicators included Timed Up and Go Test(TUGT) as well as gait parameters. The total effective rate in the experimental group was significantly higher than that in the control group(P<0.001). Results After 8 weeks of intervention, in terms of time main effect, VAS scores, CCI, and TUGT time in both groups were significantly decreased compared with baseline, while all dimensions of KOOS scores, cadence, and step length were significantly increased(P<0.001), The increase in gait speed compared to baseline showed no statistically significant difference(P=0.220). In terms of group main effect, the overall levels of VAS score, CCI,KOOS pain, symptoms, sport and recreation, quality of life scores, gait speed, cadence, step length, and TUGT time in the experimental group were superior to those in the control group(P<0.05), and there was no statistically significant difference in the overall level of KOOS activities of daily living(ADL) dimension between the two groups(P=0.096). In terms of interaction effect, compared with the control group, the experimental group showed a more significant decreasing trend in VAS score and CCI, and a more significant increasing trend in KOOS pain, symptoms, sport and recreation, quality of life scores, and cadence(P<0.05). No statistically significant differences in improvement were observed between the two groups in TUGT time, gait speed, KOOS ADL dimension, and step length(P>0.05). Conclusion Sinew-regulating and bone-aligning manipulation combined with PNF can further alleviate pain,improve knee joint function, enhance quality of life, optimize lower limb muscle synergy as well as cadence in patients with KOA. |
| Key words: knee osteoarthritis|sinew-regulating and bone-aligning manipulation|proprioceptive neuromuscular facilitation|muscle co-contraction|randomized controlled trial |
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