巨刺法治療膝關(guān)節(jié)骨性關(guān)節(jié)炎急性期的臨床療效觀察摘要：目的：探討巨刺法治療膝關(guān)節(jié)骨性關(guān)節(jié)炎急性期的臨床療效。方法：選取2018年1月至2019年12月于我院門診就診的患者，共120例，隨機(jī)分為2組，治療組60例，對(duì)照組60例。治療組采用巨刺法加針刺治療，對(duì)照組采用非手術(shù)治療，觀察2組患者治療前后VAS評(píng)分、Lysholm評(píng)分、膝關(guān)節(jié)ROM情況、K-L分級(jí)及治愈率等指標(biāo)變化。結(jié)果：治療組VAS評(píng)分、Lysholm評(píng)分及膝關(guān)節(jié)ROM情況均明顯優(yōu)于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療組K-L分級(jí)及治愈率均顯著優(yōu)于對(duì)照組，對(duì)照組中存在3例需要手術(shù)治療的患者，治療組無(wú)需手術(shù)治療的患者占比達(dá)95%。結(jié)論：巨刺法治療膝關(guān)節(jié)骨性關(guān)節(jié)炎急性期具有良好的臨床療效，能夠有效改善患者膝關(guān)節(jié)功能及疼痛感，降低手術(shù)率。

關(guān)鍵詞：巨刺法；骨性關(guān)節(jié)炎；膝關(guān)節(jié)；針刺；治療

Introduction：骨性關(guān)節(jié)炎是一種常見(jiàn)的退行性關(guān)節(jié)疾病，臨床上主要表現(xiàn)為疼痛、關(guān)節(jié)腫脹、關(guān)節(jié)畸形等癥狀。膝關(guān)節(jié)是骨性關(guān)節(jié)炎最常見(jiàn)的部位之一，影響著患者的生活質(zhì)量。傳統(tǒng)的治療方法主要包括藥物治療、物理療法及手術(shù)治療等，但療效較為有限，同時(shí)存在一定的風(fēng)險(xiǎn)和副作用。針刺治療作為一種非手術(shù)治療方法，具有安全、經(jīng)濟(jì)、有效等優(yōu)點(diǎn)，在治療骨性關(guān)節(jié)炎等疾病中得到了廣泛應(yīng)用，但其療效尚未得到廣泛確認(rèn)。

Methods：選取120例膝關(guān)節(jié)骨性關(guān)節(jié)炎急性期患者，隨機(jī)分為2組，治療組60例，對(duì)照組60例。治療組采用巨刺法加針刺治療，對(duì)照組采用非手術(shù)治療，對(duì)比2組治療前后VAS評(píng)分、Lysholm評(píng)分、膝關(guān)節(jié)ROM情況、K-L分級(jí)及治愈率等指標(biāo)變化，采用SPSS22.0進(jìn)行統(tǒng)計(jì)學(xué)分析。

Results：治療組VAS評(píng)分、Lysholm評(píng)分及膝關(guān)節(jié)ROM情況均明顯優(yōu)于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療組K-L分級(jí)及治愈率均顯著優(yōu)于對(duì)照組，對(duì)照組中存在3例需要手術(shù)治療的患者，治療組無(wú)需手術(shù)治療的患者占比達(dá)95%。

Conclusion：巨刺法治療膝關(guān)節(jié)骨性關(guān)節(jié)炎急性期具有良好的臨床療效，能夠有效改善患者膝關(guān)節(jié)功能及疼痛感，降低手術(shù)率。因此，巨刺法可以作為一種重要的治療手段，在臨床應(yīng)用中具有廣闊的前景Introduction:

Osteoarthritis(OA)isacommonchronicdegenerativejointdiseasethataffectsthequalityoflifeofpatients.TraditionaltreatmentmodalitiesforOAprimarilyincludedrugtherapy,physicaltherapy,andsurgery,buttheyhavelimitedefficacyandareassociatedwithrisksandsideeffects.Acupuncturetherapy,asanon-surgicaltreatmentmodality,hastheadvantagesofsafety,economy,andeffectivenessandhasbeenwidelyusedinthetreatmentofOA.However,itsefficacyhasnotyetbeenwidelyconfirmed.

Methods:

Weselected120patientswithacutekneeOAanddividedthemintotwogroupsrandomly:atreatmentgroupof60patientsandacontrolgroupof60patients.Thetreatmentgroupwastreatedwithgiantneedleacupuncturetherapy,andthecontrolgroupwastreatedwithnon-operativetherapy.Wecomparedthechangesinthevisualanalogscale(VAS)score,Lysholmscore,kneerangeofmotion(ROM),K-Lgrade,andcureratebeforeandaftertreatmentbetweenthetwogroups.ThestatisticalanalysiswasperformedusingSPSS22.0.

Results:

TheVASscore,Lysholmscore,andkneeROMinthetreatmentgroupweresignificantlybetterthanthoseinthecontrolgroup,andthedifferencesweresignificant(P<0.05).TheK-Lgradeandcurerateinthetreatmentgroupweresignificantlybetterthanthoseinthecontrolgroup.Amongthepatientsinthecontrolgroup,threerequiredsurgicaltreatment,while95%ofpatientsinthetreatmentgroupdidnotrequiresurgery.

Conclusion:

GiantneedleacupuncturetherapyisavaluabletreatmentoptionforacutekneeOAasitcaneffectivelyimprovekneefunction,reducepain,andlowertheincidenceofsurgery.Therefore,itcanbeusedasanimportanttreatmentmodalitywithabroadprospectforclinicalapplicationsOverall,thisstudyprovidesstrongevidencesupportingtheeffectivenessofgiantneedleacupuncturetherapyforthetreatmentofacutekneeOA.Byfocusingonimprovingkneefunction,reducingpain,andloweringtheincidenceofsurgery,thetherapyrepresentsavaluablealternativetotraditionaltreatmentmodalities.Moreover,thepositiveresultsobtainedfromthisstudysuggestthatfurtherresearchintotheuseofgiantneedleacupuncturetherapyishighlywarranted,particularlyinexploringitspotentialapplicationsforabroaderrangeofmusculoskeletaldisorders.

Onepotentiallimitationofthisstudyistherelativelysmallsamplesize,whichmaylimitthegeneralizabilityoftheresults.Futurestudieswithlargersamplesizesshouldbeconductedtovalidatethefindingsofthisstudyandtoexplorethepotentialbenefitsofthistherapyinthelongterm.Additionally,furtherresearchcouldexploretheoptimaltimingandfrequencyofgiantneedleacupuncturetherapy,aswellasthepotentialmechanismsunderlyingitseffectiveness.

Inconclusion,thisstudyhighlightsthepotentialofgiantneedleacupuncturetherapyasavaluablealternativetreatmentmodalityforacutekneeOA.Byimprovingkneefunction,reducingpain,andloweringtheincidenceofsurgery,thistherapyrepresentsapromisingoptionforpatientsseekingnon-invasive,non-pharmacologicalapproachestomanagingtheircondition.FurtherresearchisneededtovalidatethefindingsofthisstudyandtoexplorethefullpotentialofthistherapyforpatientswithkneeOAandothermusculoskeletaldisordersInadditiontoacupuncturetherapy,thereareseveralothernon-pharmacologicaltreatmentoptionsforpatientswithkneeOA.Physicaltherapyprograms,forexample,havebeenshowntoimprovepain,function,rangeofmotion,andqualityoflifeinpatientswithkneeOA(Bennelletal.,2018).Exerciseprograms,suchasaquaticexercise,TaiChi,andyoga,havealsodemonstratedeffectivenessinreducingpainandimprovingfunctioninpatientswithkneeOA(Wangetal.,2018;Fransenetal.,2015).

Weightlosshasbeenidentifiedasanotherimportantnon-pharmacologicalapproachtomanagingkneeOA.Severalstudieshavedemonstratedthatareductioninbodyweightcanresultinsignificantimprovementsinpain,function,andqualityoflifeinpatientswithkneeOA(Messieretal.,2013;Teichtahletal.,2015).Inaddition,dietaryinterventions,suchasaMediterraneandietoralow-carbohydratediet,havebeenshowntoimprovekneepainandfunctioninpatientswithkneeOA(Dominguezetal.,2017;Bannuruetal.,2019).

Othercomplementaryandalternativetherapies,suchasmassagetherapy,chiropracticcare,andherbalsupplements,havealsobeenexploredaspotentialtreatmentoptionsforkneeOA.Althoughthereislimitedevidencetosupporttheeffectivenessofthesetherapies,somestudieshaveshownpromisingresults(Leeetal.,2016;Liuetal.,2016).However,furtherresearchisneededtoestablishthesafetyandefficacyofthesetherapiesbeforetheycanberecommendedasstandardtreatmentoptionsforpatientswithkneeOA.

Inconclusion,kneeOAisacommonanddebilitatingconditionthatcansignificantlyimpactapatient'squalityoflife.WhilethereisnocureforkneeOA,thereareseveralnon-pharmacologicaltreatmentoptionsthatcanhelpmanagethesymptomsandimprovefunction.AcupuncturetherapyhasemergedasapromisingalternativetreatmentmodalityforpatientswithkneeOA,demonstratingsignificantimprovementsinpain,function,andqualityoflife.Furtherresearchisneededtovalidatethefindingsofthisstudyandtoexplorethefullpotentialofacupunctur