Fujian University of Traditional Chinese Medicine
目的 观察电针治疗对膝骨性关节炎患者登梯时下肢关节负荷的影响，探索电针的生物力学效应。方法 膝骨性关节炎患者40例，随机分配至电针观察组及浅刺对照组各20例，最终各18例完成研究。观察组选取7个膝周穴位，连接电针仪，采取2Hz方波；对照组取膝周非经非穴点浅刺后连接电针仪但不通电。两组每次治疗均30min，持续3周,共治疗11次，并分别于治疗前、后采用三维步态分析进行登梯生物力学测试，计算上、下梯时垂直地面反作用力峰值、冲量及其对称性。结果 3周治疗后，观察组的垂直地反力上梯右足峰值、下梯左足峰值较治疗前增加（P＜0.05）；上梯左右足冲量、下梯右足冲量较治疗前降低（P＜0.05）；峰值及冲量对称指数治疗前后比较差异无统计学意义（P＞0.05）。浅刺组仅上梯冲量对称指数较治疗前增加（P＜0.05）。两组各项指标治疗前后的差值组间比较均无统计学意义（P＞0.05）。结论 电针能有效改善膝骨性关节炎患登梯过程中的关节负荷能力，降低动态累积负荷，可能对减缓病程有帮助。
Objective To observe the effects of electro-acupuncture on the joint loading during stair climbing in knee osteoarthritis (KOA) and explore the related biomechanical mechanism. Method Forty patients with KOA were randomly assigned to 20 patients in the observation group (electro-acupuncture group, EA group) and 20 patients in the control group (superficial acupuncture group, SA group), finally 18 patients in each group completed the study. The observation group chose seven knee acupuncture points and connected with electro-acupuncture instrument to take 2Hz square wave; while in the control group, the electro-acupuncture instrument was connected but not electrified after superficial acupuncture at non-acupoint points. Both groups consisted of 11 sessions of treatment in 3 weeks and 30 minutes per session. The three-dimensional gait analysis system was used to assess the ground reaction force during climbing stairs before and after treatment, biomechanical parameters included peak vertical force (PFz), vertical impulse (IFz) and symmetry index (SI%). Results After 3 weeks of treatment in EA group, PFz of the right foot during ascending stairs and PFz of the left foot during descending stairs increased (P < 0.05); IFz of both feet during ascending stairs and IFz of the right foot during descending stairs significantly decreased (P < 0.05); no significant difference showed in SI% (P > 0.05). In SA group, only SI% of impulse increased (P < 0.05). There was no significant difference between two groups before and after treatment (P > 0.05). Conclusion Electro-acupuncture can effectively improve the joint load capacity and reduce the dynamic cumulative load during stair climbing in KOA, which may be helpful to slow down the course of disease.