电针足少阳经穴联合本体感觉训练对膝关节骨性关节炎患者步行能力、血液流变学和骨代谢的影响

摘要 目的：探讨电针足少阳经穴联合本体感觉训练对膝关节骨性关节炎（KOA）患者步行能力、血液流变学和骨代谢的影响。方法：按照随机数字表法，将2019年8月~2022年1月期间于我院就诊的KOA患者204例分为对照组（102例，本体感觉训练）和研究组（102例，电针足少阳经穴联合本体感觉训练）。对比两组膝关节功能、疼痛症状、步行能力、血液流变学和骨代谢情况。结果：治疗4周后，两组视觉疼痛模拟评分（VAS）、西安大略和麦克马斯特大学骨关节炎调查量表（WOMAC）评分下降，Lysholm 膝关节功能评分升高，且研究组的改变程度大于对照组（P<0.05）。治疗4周后，两组双支撑相下降，步速、步长升高，且研究组的改变程度大于对照组（P<0.05）。治疗4周后，两组纤维蛋白原、红细胞聚集指数、全血黏度（高切）、全血黏度（低切）下降，研究组的改变程度大于对照组（P<0.05）。治疗4周后，两组碱性磷酸酶（ALP）、骨钙素（BGP）、骨特异性碱性磷酸酶（BALP）水平升高，研究组的改变程度大于对照组（P<0.05）。结论：电针足少阳经穴联合本体感觉训练可改善KOA患者的疼痛症状，促进膝关节功能恢复，改善步行能力，作用机制可能与调节血液流变学和骨代谢有关。

Effects of Electroacupuncture at Foot Shaoyang Meridian Combined with Proprioceptive Training on Walking Ability, Hemorheology and Bone Metabolism in Patients with Knee Osteoarthritis

ABSTRACT Objective: To investigate the effects of electroacupuncture at foot Shaoyang meridian combined with proprioceptive training on walking ability, hemorheology and bone metabolism in patients with knee osteoarthritis (KOA). Methods: According to the random number table method, 204 patients with KOA who were treated in our hospital from August 2019 to January 2022 were divided into control group (102 cases, proprioception training) and study group (102 cases, electroacupuncture at foot Shaoyang meridian combined with proprioception training). The knee function, pain symptoms, walking ability, hemorheology and bone metabolism were compared between the two groups. Results: 4 weeks after treatment, the scores of visual pain analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis survey scale (WOMAC) in two groups decreased, Lysholm knee function score increased, and the degree of change in the study group was greater than that in the control group (P<0.05). 4 weeks after treatment, the biphasic support phase in two groups decreased, and the walking speed and step length increased, and the degree of change in the study group was greater than that in the control group (P<0.05). 4 weeks after treatment, fibrinogen, erythrocyte aggregation index, whole blood viscosity (high shear) and whole blood viscosity (low shear) decreased in the two groups, and the degree of change in the study group was greater than that in the control group (P<0.05). 4 weeks after treatment, alkaline phosphatase (ALP), osteocalcin (BGP) and bone specific alkaline phosphatase (BALP) increased in the two groups, and the degree of change in the study group was greater than that in the control group (P<0.05). Conclusion: Electroacupuncture at foot Shaoyang meridian combined with proprioceptive training can improve the pain symptoms of patients with KOA, promote the recovery of knee function, and improve walking ability. The mechanism may be related to the regulation of hemorheology and bone metabolism.