温针治疗不同中医证型膝骨性关节炎临床研究  

Clinical Observation of Warm Needling Therapy for Treating Knee Osteoarthritis of Different Chinese Medical Syndrome Types

作　　者：洪昆达[1,2] 李俐[2] 李西海 吴广文 吴明霞[2] 

机构地区：[1]福建中医药大学骨伤学院,福州350122 [2]福建中医药大学附属第二人民医院针灸科,福州350003 [3]福建省中西医结合老年性疾病重点实验室,福州350122

出　　处：《中国中西医结合杂志》2012年第11期1466-1469,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.30873277);福建省卫生厅青年基金资助项目(No.2009-2-55)

摘　　要：目的观察温针治疗不同中医证型膝骨性关节炎的疗效差异。方法对门诊197例膝骨性关节炎患者[风寒湿阻型50例(61膝);阳虚寒凝型48例(58膝);瘀血阻滞型49例(63膝);肾虚髓亏型50例(66膝)]均采用温针治疗,10次为1个疗程,共3个疗程,评价不同证型患者治疗前后症状积分及临床疗效变化;并测定治疗前后关节滑液中白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量。结果各中医证型治疗后症状积分及临床疗效均有改善(P<0.05),阳虚寒凝型优于其他3型(P<0.05),风寒湿阻型及肾虚髓亏型优于瘀血阻滞型(P<0.05)。各型治疗后关节滑液中IL-1、IL-6、TNF-α含量均下降(P<0.05),阳虚寒凝型优于其他3型(P<0.05)。结论温针治疗风寒湿阻型、阳虚寒凝型、肾虚髓亏型膝骨性关节炎有较好的临床疗效,而以阳虚寒凝型疗效最好。Objective To observe the difference in the therapeutic efficacy of warm needling therapy on knee osteoarthritis （KOA） patients of different Chinese medical syndrome types. Methods Totally 197 KOA outpatients [including wind-cold-damp retention syndrome （50 cases, 61 knees）, yang deficiency cold coagulation syndrome （48 cases, 58 knees）, stagnation of blood stasis syndrome （49 cases, 63 knees）, and insufficiency of Shen-essence syndrome （50 cases, 66 knees）] were treated with warm needling therapy, 10 days as one therapeutic course, 3 courses in total. The symptom score and changes of clinical efficacy were assessed. The contents of interleukin-1 （IL-1）, interleukin- 6 （IL- 6）, and tumor necrosis factor-α （TNF-α） in the synovial fluid were determined before and after treatment. Results The symptom scores and the clinical efficacy were improved in all syndrome groups after treatment （P0.05）, with the best effects shown in the yang deficiency cold coagulation syndrome （P0.05） and the worst effects shown in the stagnation of blood stasis syndrome （P0.05）. The contents of IL-1, IL- 6, and TNF-α in the synovial fluid decreased after treatment in all syndrome groups （P0.05）, with the best effects shown in the yang deficiency cold coagulation syndrome （P0.05）. Conclusion Warm needling therapy had favorable therapeutic effects on KOA patients of wind-cold-damp retention syndrome, yang deficiency cold coagulation syndrome, and insufficiency of Shen-essence syndrome, with the best effects shown on KOA patients of yang deficiency cold coagulation syndrome.

关 键 词：骨性关节炎 温针 中医证型 

分 类 号：R246.9[医药卫生—针灸推拿学]