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¡¡¡¡¹Ø¼ü´Ê£º¡¡¹Ç¹Ø½ÚÑ×,Ï¥; ºÁÕëÁÆ·¨; »ðÕëÁÆ·¨; ƽºâÕëÁÆ·¨;

¡¡¡¡Abstract£º¡¡Objective: To compare the clinical efficacy of fire needle combined with balance needle versus the conventional needle in the treatment of knee osteoarthritis. Methods: A retrospective study was made of totally 67 patients with knee osteoarthritis received treated from June 2016 to August 2017 in the Orthopedics and Traumatology Department of the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. They were randomly classified into single acupuncture group(34 patients) and compound acupuncture group(33 patients). The single acupuncture group received the conventional filiform needle therapy, while the compound acupuncture group received fire needle combined with balanced needle therapy. VAS, WOMAC, and the comprehensive clinical efficacy evaluation were used as indicators to test the effectiveness of two therapeutic methods. t-test and χ2-test were used to compare the differences in curative effect between pre-treatment and post-treatment, as well as those the inter-group treatment efficiency. Results: Similarities were observed in age, sex, disease duration, VAS and WOMAC score between the groups before treatment(P>0.05). Conventional filiform needle therapy and combined needle therapy effectively reduced VAS and WOMAC scores of patients with knee osteoarthritis, indicating that both methods effectively alleviated the condition of knee osteoarthritis patients(P<0.05). Compared with single filiform needle therapy, combined needle therapy was more effective in relieving pain, stiffness of bone and joint, and disturbance of movement(P<0.05). Besides, although the overall efficacy of the two methods were similar(P>0.05), the curative effect of combined-needle therapy on knee osteoarthritis was significantly higher than that of single needle method(P<0.05). Conclusion: The clinical effectiveness of fire needle combined with balanced needle was better than that of conventional needling method in the treatment of knee osteoarthritis.

¡¡¡¡Keyword£º¡¡osteoarthritis,knee; milli-needle therapy; fire needle therapy; balanced needle therapy;

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¡¡¡¡[1] WOOD L R, PEAT G, THOMAS E, et al. Knee osteoarthritis in community-dwelling older adults:are there characteristic patterns of pain location?[J]. Osteoarthritis Cartilage,2007, 15(6):615-623.
¡¡¡¡[2] Ëᄃ,²ÌÉܽÜ,»Æΰ.Õë¾ÄÖÎÁÆÏ¥¹ÇÐԹؽÚÑ×µÄÖη¨×ÛÊö[J].ºþ±±ÖÐÒ½Ò©´óѧѧ±¨, 2017, 19(4):120-125.
¡¡¡¡[3] ÕÔ¾ê,ÍõÊ¢´º.Õë¾ÄÖÎÁÆÏ¥¹ÇÐԹؽÚÑ×ÁÙ´²Ñо¿½ü¿ö[J].ɽ¶«ÖÐÒ½Ò©´óѧѧ±¨, 2015, 39(6):578-580.
¡¡¡¡[4] ÌƲ¼Ãô,Ö£ÏþÑà,ÍòÇÉÇÙ,µÈ.Ï¥¹Ø½Ú¹ÇÐԹؽÚÑ×»¼ÕßÉú»îÖÊÁ¿¼°¸ÉÔ¤Ñо¿ÏÖ×´[J].ÏÖ´úÔ¤·Àҽѧ, 2016, 43(1):121-123.
¡¡¡¡[5] ºî½¨Åô,ÁõÅô,½ªÊ¤·å,µÈ.ÕëÒ©½áºÏÖÎÁÆÏ¥¹Ø½Ú¹ÇÐԹؽÚÑ×µÄÁÙ´²Ñо¿½øÕ¹[J].Õë¾ÄÁÙ´²ÔÓÖ¾, 2016, 32(11):98-102.
¡¡¡¡[6] °¬½ðΰ,ÀîµÂʤ,ÁõÓð,µÈ.ÖÐÒ½±çÖ¤ÖÎÁÆÏ¥¹ÇÐԹؽÚÑ×µÄÍø×´Meta·ÖÎö[J].Öйúѭ֤ҽѧÔÓÖ¾, 2016, 16(5):532-542.
¡¡¡¡[7] LEE H. Evidence is insufficient to support fire-needle moxibustion in patients with knee osteoarthritis[J]. Focus Altern Complement Ther, 2016, 21(3-4):150-151.
¡¡¡¡[8] ÖлªÒ½Ñ§»á¹Ç¿Æѧ·Ö»á.¹Ç¹Ø½ÚÑ×ÕïÖÎÖ¸ÄÏ(2007Äê°æ)[J].Öлª¹Ç¿ÆÔÓÖ¾, 2007, 27(10):793-796.
¡¡¡¡[9] ÀîÓÀæÃ,ʯ¹ãϼ,ÍÀ½¨·æ,µÈ.Õë¾ÄÖÎÁÆÏ¥¹Ç¹Ø½ÚÑ×ѡѨ¹æÂÉ·ÖÎö[J].ÁÉÄþÖÐÒ½ÔÓÖ¾, 2017, 44(10):2179-2182.
¡¡¡¡[10] ÁøÇà,µÔΰ,ÈÎÇïÀ¼,µÈ.Ï¥¹Ç¹Ø½ÚÑ×Õë¾ÄȡѨÅäÎé¹æÂÉdzÎö[J].ÁÉÄþÖÐÒ½ÔÓÖ¾, 2015, 42(5):927-929.
¡¡¡¡[11] ÔªÓÀ½ð,ÕÔÒ«¶«,ÕŹúÏþ,µÈ.»ùÓÚ¾­½îÀíÂÛ̽ÌÖºÁÕë´Ì·¨ÖÎÁÆÏ¥¹ÇÐԹؽÚÑ×[J].ÖлªÖÐÒ½Ò©ÔÓÖ¾, 2018, 33(3):979-982.
¡¡¡¡[12] ÕÅ־ǿ,°×ΰ½Ü,Ö£ÀûȺ.ÁõÊϺÁ»ðÕëÖÎÁÆÏ¥¹Ø½Ú¹ÇÐԹؽÚÑ×µÄÁÙ´²Ñо¿[J].Õë¾ÄÁÙ´²ÔÓÖ¾, 2017, 33(5):52-54.
¡¡¡¡[13] ËïÄþ,ÀîÓÀæÃ,ÁÖè´è´,µÈ.²»Í¬Õë¾ÄÁÆ·¨ÖÎÁÆÏ¥¹Ç¹Ø½ÚÑ׵ıȽÏÓë·ÖÎö[J].ÖлªÖÐÒ½Ò©ÔÓÖ¾, 2017, 32(7):3253-3255.
¡¡¡¡[14] ºØС»Ü,ÕÅÉÙÃ÷.²»Í¬Õë¾Ä·½Ê½¶ÔÐ麮ÐÍÏ¥¹Ç¹Ø½ÚÑ×»¼ÕßWOMACÆÀ·Ö¼°ÌÛÍ´Ö¢×´µÄÓ°Ïì±È½Ï[J].ÉÂÎ÷ÖÐÒ½, 2017,38(4):511-512.
¡¡¡¡[15] ºÎºé²¨,ÕŽÜ.Õë¾ÄÖÎÁÆÏ¥¹Ç¹Ø½ÚÑ×ÁÆЧÆÀ¼Û·½·¨¸Å¿ö[J].ÁÉÄþÖÐÒ½Ò©´óѧѧ±¨, 2017, 19(7):147-150.
¡¡¡¡[16] XIE D Y, JIANG Y X, CHEN R X, et al. Study on the thermesthesia features of heat-sensitive acupoints in patients with knee osteoarthritis[J]. J Acupunct Tuina Sci, 2016,14(2):110-114.
¡¡¡¡[17] ¸ßÖ¾.Ï¥¹Ø½Ú¹Ç¹Ø½ÚÑ×¾­ÖÐÎ÷Ò½²»Í¬ÁÆ·¨µÄ¶Ô±ÈÑо¿[J].ÊÀ½çÖÐÒ½Ò©, 2017, 12(8):1767-1770
¡¡¡¡[18] ÕűØÃÈ,ÎâÒ«³Ö,Éò½¡.³¤Õë͸´ÌÖÎÁÆÏ¥¹Ç¹Ø½ÚÑ×µÄÁÙ´²Ñо¿[J].ÖйúÕë¾Ä, 2004, 24(9):613-614.
¡¡¡¡[19] ÕÅÓÀ³¼,¬³Ð¶¥.çÑ´Ì·¨ÖÎÁÆÏ¥¹ÇÐԹؽÚÑ×54Àý[J].Õë¾ÄÁÙ´²ÔÓÖ¾, 2012, 28(6):20-21.
¡¡¡¡[20] ·üÐãϼ.¶Ì´ÌÎÂÕë¾ÄÅäºÏ´ÌÂç°Î¹ÞÖÎÁÆÏ¥¹Ç¹Ø½ÚÑ×ÁÆЧ¹Û²ì[J].ÉϺ£Õë¾ÄÔÓÖ¾, 2011, 30(8):564-565.
¡¡¡¡[21] Àîǧ.ÎÂÕë¾Ä¼ÓÖÐÒ©ÖÎÁÆÏ¥¹Ç¹Ø½ÚÑ×80ÀýÁÆЧ¹Û²ì[J].ÉîÛÚÖÐÎ÷Ò½½áºÏÔÓÖ¾, 2015, 25(1):73-74.
¡¡¡¡[22] ÀîÑÞÃ÷,Ô¬Áâ÷,³ÂÀöÃÃ.ÎÂÕë¾ÄÅäºÏ»ðÕëÖÎÁÆÏ¥¹ÇÐԹؽÚÑ×36Àý[J].Õë¾ÄÁÙ´²ÔÓÖ¾, 2015, 31(7):54-56.
¡¡¡¡[23] Ò¶Ó¾ËÉ,Áõ²¨,³ÂÖ¾¹â.¾²Ï¢Ì¬ÄÔ¹¦Äܼ¼Êõ¶ÔƽºâÕëÖÎÁÆÖÐÊà»úÖƵķÖÎöÓ¦ÓÃ[J].Öйú×éÖ¯¹¤³ÌÑо¿ÓëÁÙ´²¿µ¸´,2011, 15(48):8998-9002.
¡¡¡¡[24] ÍõÎÄÔ¶.ÍõÊÏƽºâÕëÁÆ·¨[M].±±¾©:ÖйúÖÐÒ½Ò©³ö°æÉç,2016:78-86.
¡¡¡¡[25] ö¤è´,ÍõÓñ,Öܾ§±ù,µÈ.ÄÚÈÈÕëÁªºÏÔÆ¿ËÁÆ·¨ÖÎÁÆÏ¥¹Ø½Ú¹ÇÐԹؽÚÑ×µÄÁÆЧ¼°Æä¶Ô»¼ÕßIL-1ºÍTNF-αˮƽµÄÓ°Ïì[J].ÊÀ½çÖÐÒ½Ò©, 2017, 12(12):3124-3127.
¡¡¡¡[26] ³ÂÒ浤,Çñ»ªÆ½,½ðФÇà,µÈ.²»Í¬Õë¾Ä·½·¨¶ÔÏ¥¹Ç¹Ø½ÚÑ×Ä£ÐÍϸ°ûÒò×Ó¼°»ùÖʽðÊôµ°°×øӰÏìµÄ±È½ÏÑо¿[J].Öйú±È½ÏҽѧÔÓÖ¾, 2016, 26(1):42-45, 64.

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