[논문]퇴행성 슬관절염에서의 온침과 침의 효능 비교 연구

민웅기; 여수정; 김이화; 송호섭; 구성태; 이재동; 임사비나

doi:10.14406/acu.2013.30.1.064

퇴행성 슬관절염에서의 온침과 침의 효능 비교 연구
Comparison of Warm-Needling and Acupuncture for Knee Osteoarthritis: A Randomized Controlled Trial 원문보기

Korean journal of acupuncture, v.30 no.1, 2013년, pp.64 - 72

민웅기 (경희대학교 동서의학연구소) , 여수정 (경희대학교 동서의학연구소) , 김이화 (세명대학교 한의과대학 경혈학교실) , 송호섭 (가천대학교 한의과대학 침구학교실) , 구성태 (부산대학교 한의학전문대학원 경락구조의학부) , 이재동 (경희대학교 한의과대학 침구학교실) , 임사비나 (경희대학교 동서의학연구소)

초록
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목적 : 본 연구는 퇴행성 슬관절염 환자의 통증을 줄이고 증상을 개선하는데 있어 현재 침구임상에서 활용되고 있는 온침이 침보다 더욱 유효한지를 알아보기 위하여 임상연구로 시행되었다. 방법 : 총 76명의 퇴행성 슬관절염 지원자가 연구에 참가하였으며, 이들 모두는 선정기준과 제외기준에 의하여 선발되었고 최종적으로 임상연구를 마친 지원자는 66명이었다. 지원자들은 무작위로 온침군과 침군 중에 할당이 되었다. 실험군(온침)에 속한 38명은 온침시술을, 대조군(침)에 속한 38명은 침시술을 받았으며, 8주 동안 총 16회의 시술을 환측의 무릎에 시행하였다. 주된 평가척도는 Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)이었고, 부수적 평가척도는 physical health score based on the 36-Item Short-Form Health Survey(SF-36), Patient Global Assessment이었다. 결과 : 실험군이 대조군에 비해서 WOMAC의 pain, function, total score와 Patient Global Assessment에서 월등한 감소를 나타내었으나 SF-36에서는 유의한 변화가 없었다. 결론 : 이번 연구의 결과를 통해 온침이 침에 비하여 퇴행성 슬관절염 환자의 통증 감소와 기능개선에 유의성있게 효과가 있음을 확인하였다.

Abstract ▼ AI-Helper

Objectives : The aim of this study was to investigate whether warm-needling is more effective than acupuncture in relieving the pain and improving the symptoms of knee osteoarthritis(OA). Methods : 76 volunteers with knee OA participated in the study. The subjects were randomly assigned to one of two groups. One group received warm-needling(n=38), while the other group received acupuncture(n=38). Sixteen sessions of warm-needling or acupuncture were conducted on the pain region of each problematic knee over a period of 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) scores, physical health score based on the 36-Item Short-Form Health Survey(SF-36) and the Global Assessment(PGA) was measured. Results : Compared to the acupuncture group, the warm-needling group showed a significant decrease in pain, function, and total WOMAC scores according to the Mann-Whitney U-test. The PGA scores of the warm-needling group also showed a significant improvement compared to the acupuncture group. Conclusions : Warm-needling showed a greater pain relief effect on knee OA compared to the acupuncture group. These findings suggest that warm-needling may be a promising alternative therapy for treating knee OA.

주제어

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가설 설정

1. The subjects were not acupuncture naïve since acupuncture treatment is common in South Korea.

제안 방법

The warm needling group’s treatment was performed at the selected acupoints(see Table 2). Patients received warm needling treatments twice a week over an eight-week period. The depth of acupuncture was about 2∼10 mm, and treatment duration was about 20 minutes.
The goals of this investigation were to determine whether warm needling is a clinically effective method for relieving pain in patients with knee OA and to compare the therapeutic effects of warm needling with those of acupuncture.

대상 데이터

2). In total, 76 volunteers with knee OA participated in the study. The subjects were randomly divided into a warm needling and an acupuncture group; the demographic and baseline characteristics for both groups are shown in Table 1.

데이터처리

The differences in the demographic and baseline characteristics of the subjects were assessed using a Chi square test and the changes of the mean scores between pre-trial baselines and post-trial outcomes between the warm needling and the acupuncture groups were assessed using ANCOVA. Patient Global Assessment was assessed using Mann-Whitney U-test(SPSS 12.0).
The differences in the demographic and baseline characteristics of the subjects were assessed using a Chi square test and the changes of the mean scores between pre-trial baselines and post-trial outcomes between the warm needling and the acupuncture groups were assessed using ANCOVA. Patient Global Assessment was assessed using Mann-Whitney U-test(SPSS 12.

성능/효과

The WOMAC total score for the warm needling group was 45.43±19.50 in the pre-trial and 20.61±12.19 after the 8 weeks of treatment.
We evaluated the therapeutic efficacy and safety of warm needling and compared them to those of traditional acupuncture treatment. The results of our study indicate that patients with knee OA showed significant improvement after 8 weeks of either acupuncture or warm needling therapy. However, the warm needling group showed a more significant pain relief effect on knee OA than the acupuncture group according to the pain, function, and total scores of WOMAC at the 4-week and 8-week points and the Patient Global Assessment.

후속연구

Due to methodological problems in comparing the studies that were done so far, the general consensus is that the results are promising but that more research is needed(see also: http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3 Aproject=medlineplus&query=acupuncture).

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