易筋經功法訓練對膝骨關節炎患者膝關節功能的影響

葉銀燕　牛曉敏　邱志偉　仲衛紅　黃承武　陳劍　陳長興　李宇濤

【摘 要】目的：觀察易筋經功法訓練對膝骨關節炎患者膝關節功能的影響。方法：將52例符合膝骨關節炎診斷、膝關節X線診斷屬于Kellgren-Lawrance分級Ⅱ級或Ⅲ級的患者隨機分為治療組和對照組，每組26例。治療組在具有豐富功法教學經驗的教練指導下練習易筋經功法，對照組在專業康復治療師指導下進行Prokin本體感覺和平衡訓練。2組均每周3次，共治療8周。觀察2組膝關節疼痛視覺模擬評分法（VAS）評分、膝關節活動度、本體感覺敏感度和平衡能力、西安大略和麥克馬斯特大學骨關節炎指數（WOMAC）評分。結果：治療后，2組患者VAS評分、本體感覺敏感度和平衡能力、WOMAC評分較治療前均有改善（P < 0.05），且治療組優于對照組（P < 0.05）;2組膝關節活動度較治療前未見明顯改善（P > 0.05）。2組治療過程中均未出現不良反應。結論：易筋經功法訓練可減輕膝關節疼痛、緩解關節僵硬、提高患者本體感覺敏感度和平衡能力，改善膝關節功能，防治膝骨關節炎。

【關鍵詞】 骨關節炎，膝;易筋經;膝關節功能;臨床療效

Effect of Yijinjing on Knee Joint Function in Patients with Knee Osteoarthritis

YE Yin-yan，NIU Xiao-min，QIU Zhi-wei，ZHONG Wei-hong，HUANG Cheng-wu，CHEN Jian，CHEN Chang-xing，LI Yu-tao

【ABSTRACT】Objective：To observe the effect of Yijinjing on knee joint function in patients with knee osteoarthritis.Methods：Fifty-two patients with osteoarthritis of Kellgren-Lawrance gradeⅡor gradeⅢwere randomly divided into a treatment group and a control group，26 cases in each group.The treatment group practiced Yijinjing under the guidance of instructors with rich teaching experience，while the control group performed Prokin proprioception and balance training under the guidance of professional rehabilitation therapists.The two groups were treated 3 times a week for 8 weeks.VAS，range of knee motion，proprioception sensitivity and balance ability， WOMAC score，were observed in the two groups.Results：After treatment，VAS，proprioceptive sensitivity and balance ability，WOMAC of the two groups were improved compared with those before treatment（P < 0.05），and the treatment group was better than the control group（P < 0.05）;the knee joint activity of the two groups was not significantly improved compared with that before treatment（P > 0.05）.There were no adverse reactions in both groups.Conclusion：Yijinjing can reduce knee pain，relieve joint stiffness，improve proprioception sensitivity and balance ability，improve knee joint function and prevent knee osteoarthritis.

【Keywords】 osteoarthritis，knee;Yijin-jing;knee joint function;clinical efficacy

膝骨關節炎（knee osteoarthritis，KOA）是一種以關節軟骨磨損、滑膜炎癥、骨質增生等病理改變為特征的慢性進行性關節疾病，主要表現為關節炎性疼痛、腫脹、僵硬等[1]。隨著人口老齡化的進程加快，KOA的高發病率和強致殘性嚴重影響其生活質量，給患者家庭和社會造成了極大的經濟負擔[1-2]。目前，國內外KOA的最新指南充分關注了疾病管理中的非藥物治療方法，尤其是運動康復和運動支持[3-5]，運動鍛煉被多部臨床指南強證據推薦作為KOA的有效治療手段[6-7]，步行、太極拳、游泳等有氧運動[8]和柔韌性運動、力量訓練[9]等已被證實能夠有效減輕患者的疼痛和腫脹、緩解病情進展、增強關節穩定性[10]。……