推拿通过减轻髌骨外侧倾斜程度改善髌股骨关节炎：一项基于随机对照试验的相关分析

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine Pub Date : 2025-08-24 DOI:10.1016/j.ctim.2025.103234

Jinguang Gu , Yongli Dong , Guangcheng Wei , Zechuan Zhuo , Aolin Sun , Dongliang Wei , Yong Zhao , Weikai Qin

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引用次数: 0

摘要

目的髌骨排列异常与髌股骨关节炎（PFOA）密切相关，髌骨外侧倾斜常加重疼痛。本研究通过分析推脑钠（TN）和关节内透明质酸注射（IAHA）干预的效果，探讨影像学参数变化与疼痛程度的关系。方法选取2022年10月8日至2024年12月31日在中国中医研究院望京医院就诊的126例PFOA患者为研究对象。参与者被随机分配到TN组或IAHA组。IAHA组每周注射一次，持续5周，而TN组每周注射3次，持续4周。在治疗前和治疗后1周评估视觉模拟量表（VAS）、西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）和髌骨成像指数（髌骨外侧位移（LPD）、同角（CA）、髌骨外侧角（LPFA）、髌骨指数（PFI））。为了研究成像参数与VAS评分之间的相关性，我们对非正态分布的数据进行Spearman秩相关分析，并使用散点图来阐明疼痛与成像参数之间的相关性趋势。建立多元线性回归模型，评估影像学参数对VAS评分变化的独立影响。结果TN和IAHA治疗均显著降低VAS和WOMAC评分（p <； 0.05）。两组VAS评分改善无显著差异（p >； 0.05）。而TN组在WOMAC评分上的改善明显更大（p <； 0.05）。与IAHA组相比，TN组在LPD和CA方面也有更好的改善（p <； 0.05）。Spearman相关性显示影像学指标与VAS评分无显著相关性（p >； 0.05）。多元回归分析显示，VAS评分的降低与LPD （β = 0.274, p = 0.038）和CA （β = 0.309, p = 0.033）的降低相关。结论推那在缓解PFOA患者疼痛方面与IAHA一样有效，可能通过降低LPD和ca来缓解疼痛。试验注册中国临床试验注册中心（ChiCTR）， ChiCTR2200059345，注册于2022年4月28日，https://www.chictr.org.cn/showproj.html?proj=166395

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Tuina improves patellofemoral osteoarthritis by alleviating the degree of lateral patellar tilt: a correlation analysis based on a randomized controlled trial

Purpose

Abnormal patellar alignment is closely linked to patellofemoral osteoarthritis (PFOA), with laterally tilted patellae often worsening pain. This study investigates the relationship between imaging parameter changes and pain levels by analyzing the effects of Tui Na (TN) and intra-articular hyaluronic acid injections (IAHA) intervention.

Methods

This study included 126 PFOA patients from Wangjing Hospital of the China Academy of Traditional Chinese Medicine, between October 8, 2022, and December 31, 2024. Participants were randomly assigned to the TN or IAHA group. The IAHA group received one injection per week for five weeks, while the TN group underwent three Tui Na sessions per week for four weeks. The Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and patellar imaging indices (Lateral Patellar Displacement (LPD), Congruence Angle (CA), Lateral Patellofemoral Angle (LPFA), Patellofemoral Index (PFI)) were assessed before and one week after treatment. To investigate the correlation between imaging parameters and VAS scores, Spearman rank correlation analysis was applied to non-normally distributed data, with scatter plots used to elucidate trends in the association between pain and imaging parameters. A multiple linear regression model was constructed to assess the independent effects of imaging parameters on changes in VAS scores.

Results

Both TN and IAHA treatments significantly reduced VAS and WOMAC scores (p < 0.05). No significant difference was observed in VAS score improvements between the two groups (p > 0.05). However, the TN group showed a significantly greater improvement in WOMAC scores (p < 0.05). The TN group also exhibited better improvements in LPD and CA compared to the IAHA group (p < 0.05). Spearman's correlation showed no significant link between imaging indices and VAS scores (p > 0.05). Multiple regression analysis revealed that reductions in VAS scores were associated with decreases in LPD (β = 0.274, p = 0.038) and CA (β = 0.309, p = 0.033).

Conclusion

Tui Na is as effective as IAHA in relieving pain in PFOA patients, potentially alleviating pain through reductions in LPD and CA.

Trial registration

Chinese Clinical Trial Registry(ChiCTR), ChiCTR2200059345, Registered on 28/04/2022, https://www.chictr.org.cn/showproj.html?proj=166395

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来源期刊

Complementary therapies in medicine 医学-全科医学与补充医学

CiteScore

8.60

自引率

2.80%

发文量

101

审稿时长

112 days

期刊介绍： Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients. Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare.