微創針刀治療膝骨性關節炎臨床總結

Clinical summary of minimally invasive acupotomy in the treatment of knee osteoarthritis

高宗桂(Tsung-kuei Kao)；高傳真(Chuan-chen Kao)；高水平(Shui-ping Kao)；夏君(Xiajun)

骨性關節炎 ； 膝關節 ； 針刀療法 ； 微創 ； osteoarthritis ； knee ； acupotomy therapy ； minimally invasive

北台灣中醫醫學雜誌

9卷2期（2017 / 09 / 01）

1 - 12

繁體中文

膝關節骨性關節炎是骨科臨床的常見病與多發病，具有高發病率、高致殘率的特點，嚴重影響患者的生活品質，對患者的家庭及社會造成沉重的經濟負擔。目前臨床上針對膝關節骨性關節炎的治療方法較多樣，主要分為藥物治療、物理治療、和手術治療。近年來，現代西醫做了大量的臨床研究，如解熱鎮痛劑和非類固醇抗炎藥、改變骨關節炎病程的藥物、關節軟骨營養藥、關節腔注射劑、全膝關節置換術、膝關節鏡手術、軟骨或軟骨細胞移植、基因療法等。中醫方面也有一定的改進，尤其是微創針刀醫學療法的發明，為膝關節骨性關節炎的治療提供了廣闊的前景。本文介紹微創針刀治療膝骨關節炎的方式分別是單用針刀治療、針刀配合藥物治療、針刀配合推拿手法治療、針刀配合物理治療。微創針刀療法可鬆解韌帶黏連，疏通經絡，明顯改善膝骨關節炎症狀。

Knee osteoarthritis is a clinically commonly and frequently-occurring disease of orthopedics, with high incidence and high disability rate, seriously affecting the quality of the life of patients, and causings heavy economic burden on patients' families and society. At present, the treatment of knee osteoarthritis is more diverse, mainly divided into drug therapy, physical therapy, and surgical treatment. In recent years, modern Western medicine has done a lot of clinical research, Such as antipyretic analgesics and nonsteroidal anti-inflammatory drugs, drugs that alter the course of osteoarthritis, articular cartilage nutrition, intra-articular injection, total knee arthroplasty, knee arthroplasty, cartilage or chondrocyte transplantation, and gene therapy. Traditional Chinese medicine also has some improvement, especially the invention of minimally invasive medical therapy of acupotomy for knee osteoarthritis treatment provides a broad prospect. This article describes the minimally invasive acupotomy treatment of knee osteoarthritis were treated with a single acupotomy, acupotomy with drug treatment, acupotomy with massage therapy, and acupotomy with physical therapy. Minimally invasive acupotomy therapy can release ligament adhesions, clear the meridians, significantly improve the symptoms of knee osteoarthritis.

1. Aaron, RK,Skolnick, AH,Reinert, SE(2006).Arthroscopic debridement for osteoarthritis of the Knee.J Bone Joint Surg Am,88(5),936-943.
2. Anderson, JW,Nicolosi, RJ,Borzelleca, JF(2005).Glucosamine effects in humans: a review of effects on glucose metabolism, side effects, safety considerations and efficacy.Food Chem Toxicol,43,187-201.
3. Aydin, O,Korkusuz, F,Korkusuz, P(2015).In vitro and in vivo evaluation of doxycycline - chondroitin sulfate/ PCL microspheres for intraarticular treatment of osteoarthritis.J Biomed Mater Res B Appl Biomater,103(6),1238-48.
4. Bauerova, K,Ponist, S,Kuncirova, V(2011).Chondroitin sulfate effect on induced arthritis in rats.Osteoarthritis Cartilage,19(11),1373-1379.
5. Day, B(2005).The indications for arthroscopic debridement for osteoarthritis of the knee.Orthop Clin North Am,36(4),413-417.
6. Filardo, G,Kon, E,Di Martino, A(2012).Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial.J Musculoskelet Disord,13,229.
7. Greenwald, RA(2011).The road forward: the scientific basis for tetracycline treatment of arthritic disorders.Pharmacol Res,64(6),610-613.
8. Jotanovic, Z,Mihelic, R,Sestan, B(2012).Role of interleukin-1 inhibitors in osteoarthritis : an evidence-based review.Drugs Aging,29(5),343-358.
9. Li, X,Wu, JF(2010).Recent developments in patent anti-cancer agents targeting the matrix metalloproteinases (MMPs).Recent Pat Anticancer Drug Discov,5(2),109-141.
10. Nixon, AJ,Haupt, JL,Frisbie, DD(2005).Gene-mediated restoration of cartilage matrix by combination insulin-like growth factor-I/interleukin-1 receptor antagonist therapy.Gene Ther,12(2),177-186.
11. Ritter, Merrill A,Lutgring, Joseph D(2007).Total knee arthroplasty effectiveness in patients 55 years old and younger: Osteoarthritis vs. rheumatoid arthritis.The knee,14(9),9-11.
12. Santilli, V,Paoloni, M,Mangone, M(2016).Hyaluronic acid in the management: of osteoarthritis injection therapies innovations.Clin Cases miner Bone Metab,13(2),131-134.
13. Steinmeyer, J,Kordelle, J,Stürz, H(2010).In vitro inhibition of aggrecanase activity by tetracyclines and proteoglycan loss from osteoarthritic human articular cartilage.J Orthop Res,28(6),828-33.
14. 王忠(2015)。小針刀聯合手法治療膝關節骨性關節炎療效觀察。實用中醫藥雜誌，31(3)，229-230。
15. 吳緒平(2008)。針刀醫學。北京:中國中醫藥出版社。
16. 吳緒平、張天民(2007)。針刀臨床治療學。北京:中國醫藥科技出版社。
17. 俞傑、王少傑、白文、張秀芬(2009)。針刀辨證分型治療膝關節骨關節炎76 例臨床觀察。北京中醫藥大學學報，32(10)，716-718。
18. 胡永均(2010)。針刀配合微波治療膝關節骨性關節炎臨床觀察。針灸臨床雜誌，26(10)，48-49。
19. 書哲(2012)。針刀配合藥物阻滯治療膝關節骨性關節炎。中醫臨床研究，4(15)，32-33。
20. 梁波、宋冠軍、彭簫(2005)。膝關節骨性關節炎鬆解術264 例療效觀察炎。中華適宜診療技術雜誌，23(1)，11。
21. 莫建英(2007)。微波配合關節鬆動術治療膝關節骨性關節炎40 例。柳州醫學，20(4)，272-273。
22. 陳梅、施曉陽、顧一煌(2011)。針刀治療膝關節骨性關節炎60 例。南京中醫藥大學學報，27(4)，384-386。
23. 楊中江(2009)。針刀配合藥物阻滯治療膝關節骨性關節炎。中國現代藥物應用，3(24)，190-191。
24. 劉峰、劉玉生(2003)。針刀加藥物治療膝關節骨性關節炎療效觀察。成都軍區醫院學報，5(6)，89。
25. 劉興勤(2010)。針刀整體鬆解術治療膝關節骨性關節炎50例。中國針灸2010 年針刀專刊，30，82-83。
26. 樸天龍(2007)。針刀治療膝關節骨性關節炎245 例療效觀察。當代醫學，131，53-54。

1. 蕭恆毅,洪美如,李作英,江慧珠(2023)。中醫門診骨關節炎病人的症狀描述。源遠護理，17(1)，61-69。