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“以痛为腧”推拿对膝骨关节炎患者步态及足底压力的影响研究
A clinical study of massage intervention in knee osteoarthritis gait and plantar pressure with "painful locality taken as acupoint"
- 北京中医药 2025年44卷第1期 页码：36-40
- 作者机构：
1.上海中医药大学附属岳阳中西医结合医院推拿科，上海 200437
2.上海市第一人民医院推拿科，上海 200080
3.上海市中医药研究院中医推拿研究所，上海 200437
- 作者简介：
付阳阳，男，31岁，博士，主治医师。研究方向：推拿手法治疗四肢关节疾病的基础与临床研究。
孙武权，E-mail：drsunwuquan@163.com
- 基金信息：国家中医药管理局高水平中医药重点学科项目(zyyzdxk-2023061);国家自然科学基金面上项目(81973973);上海市卫生健康委员会中医药科研项目(2022QN087)
DOI：10.16025/j.1674-1307.2025.01.008
中图分类号：纸质出版日期：2025-01-25，
收稿日期：2024-04-24，
- 稿件说明：
移动端阅览
付阳阳, 梁红广, 朱清广, 等. “以痛为腧”推拿对膝骨关节炎患者步态及足底压力的影响研究[J]. 北京中医药, 2025,44(1):36-40.
FU YANGYANG, LIANG HONGGUANG, ZHU QINGGUANG, et al. A clinical study of massage intervention in knee osteoarthritis gait and plantar pressure with "painful locality taken as acupoint". [J]. Beijing journal of traditional chinese medicine, 2025, 44(1): 36-40.
付阳阳, 梁红广, 朱清广, 等. “以痛为腧”推拿对膝骨关节炎患者步态及足底压力的影响研究[J]. 北京中医药, 2025,44(1):36-40. DOI： 10.16025/j.1674-1307.2025.01.008.
FU YANGYANG, LIANG HONGGUANG, ZHU QINGGUANG, et al. A clinical study of massage intervention in knee osteoarthritis gait and plantar pressure with "painful locality taken as acupoint". [J]. Beijing journal of traditional chinese medicine, 2025, 44(1): 36-40. DOI： 10.16025/j.1674-1307.2025.01.008.
摘要
目的
2
观察“以痛为腧”推拿手法对膝骨关节炎（knee osteoarthritis，KOA）患者步态及足底压力平衡分布的影响。
方法
2
选取2023年3月—2023年10月上海中医药大学附属岳阳中西医结合医院推拿科就诊的KOA患者50例，将其随机分为观察组和对照组，各25例。观察组给予推拿干预，对照组给予宣教干预。对比2组干预前后西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、步态相关参数（步速、步幅、步长、双侧支撑相、单支撑相）及足底压力。
结果
2
2组均未出现严重安全问题及不良事件，50例患者均完成研究。干预后，观察组WOMAC总分、疼痛评分、活动程度评分均较干预前降低，且低于对照组干预后（
P
<
0.05）。观察组干预前后僵硬评分比较差异无统计学意义（
P
>
0.05）。干预后，观察组步速、步幅、双侧支撑相、单支撑相均较干预前改善，且优于对照组（
P
<
0.05）。观察组干预前后步长比较差异无统计学意义（
P
>
0.05）。干预后，观察组前足内部区压力较干预前升高，且高于对照组（
P
<
0.05）。观察组干预前后其他区压力比较差异无统计学意义（
P
>
0.05）。
结论
2
基于“以痛为腧”推拿能显著提高患者的步行能力及前足内部压力，有助于恢复步态的稳定性。
Abstract
Objective
2
To observe the gait and plantar pressure balance distribution patterns of the massage technique based on "painful locality taken as acupoint" in the treatment of knee osteoarthritis （KOA）.
Method
2
Fifty KOA patients from the Department of Massage in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine， Shanghai University of Traditional Chinese Medicine， from March 2023 to October 2023 were randomly divided into an observation group and a control group， with 25 cases in each group. The observation group received massage intervention， while the control group received education intervention. The Western Ontario and McMaster Universities Arthritis Index （WOMAC） scores， gait-related parameters （walking speed， stride length， stride width， bilateral support phase， unilateral support phase）， and plantar pressure were compared before and after intervention in both groups.
Result
2
No severe safety issues or adverse events occurred in either group， and all 50 patients completed the study. After intervention， the WOMAC total score， pain score， and activity level score in the observation group were significantly lower than those before intervention， and lower than those in the control group after intervention （
P
<
0.05）. There was no significant difference in the stiffness score in the observation group before and after intervention （
P
>
0.05）. After intervention， the observation group showed improvement in walking speed， stride width， bilateral support phase， and unilateral support phase compared with the condition before intervention， and these improvements were better than those in the control group （
P
<
0.05）. No significant difference was observed in stride length in the observation group before and after intervention （
P
>
0.05）. After intervention， the pressure in the internal area of the forefoot in the observation group increased significantly compared with pre-treatment value， and was higher than that in the control group （
P
<
0.05）. There were no significant differences in pressure distribution in other areas between pre- and post-intervention in the observation group （
P
>
0.05）.
Conclusion
2
The massage technique based on "painful locality taken as acupoint" can significantly improve walking ability and increase forefoot internal pressure， which helps restore gait stability in patients with KOA.
关键词
膝骨关节炎以痛为腧推拿步态足底压力
Keywords
Knee osteoarthritispainful locality taken as acupointmassagegaitplantar pressure
references
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