热敏灸对急性膝关节痛患者血清中骨桥蛋白、基质金属蛋白酶-3的影响  

Effect of Acupoint Heat-sensitive Moxibustion Intervention on Serum Osteopontin and Matrix Metalloproteinase-3 in Patients with Acute Knee Pain

作　　者：蔡国伟[1] 李静[1] 徐晓娟[2] 薛远志[1] 李刚[1] 吴熳[1] 李鹏飞[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院针灸科,武汉430022 [2]华中科技大学同济医学院附属协和医院西区分院中医康复科,武汉430056

出　　处：《针刺研究》2013年第6期488-492,共5页Acupuncture Research

基　　金：湖北省自然科学基金项目(No.2012FFB 02312)

摘　　要：目的:观察热敏灸治疗急性膝关节痛患者的疗效,并检测血清骨桥蛋白(OPN)、基质金属蛋白酶-3(MMP-3)含量变化,初步探讨其作用机制。方法:将144例急性膝关节痛患者随机分为热敏灸组、电针组及药物组。热敏灸组取热敏穴膝痛点、委中行悬灸治疗,每天1次,每次每穴40min,共治疗15d;电针组取内膝眼、犊鼻、血海、梁丘穴,行电针治疗,每天1次,每次30min,共治疗15d;药物组采用口服三七通舒胶囊,每天3次,每次1粒,共服用15d。采用酶联免疫吸附法检测3组治疗前后血清OPN、MMP-3含量,并评价各组的治疗效果。结果:热敏灸组、电针组在治疗后血清OPN较治疗前明显降低(P<0.01),热敏灸组、电针组血清OPN显著低于药物组(P<0.05);热敏灸组治疗后血清MMP-3较治疗前明显降低(P<0.01),热敏灸组血清MMP-3显著低于电针组和药物组(P<0.05)。热敏灸组总体优良率为84.0%(42/50),电针组为72.0%(36/50),药物组为61.4%(27/44),热敏灸组、电针组优于药物组(P<0.05)。结论:热敏灸治疗急性膝关节痛疗效肯定,其机制可能与降低血清中OPN、MMP-3水平,从而抑制软骨降解相关。Objective To observe the clinical effect of acupoint heat-sensitive moxibustion for acute knee arthralgia and to analyze its effect on serum osteopontin （OPN） and matrix metalloproteinase-3 （MMP-3） contents in patients with knee osteoar- thritis so as to study its mechanism underlying improving arthralgia. Methods One hundred and forty-four patients with acute knee osteoarthritis were randomly allocated to acupoint heat-sensitive moxibustion （moxibustion）, electroacupuncture （EA） and medication groups. Patients of the moxibustion group were treated by suspended moxibustion over bilateral Weizhong （BL 40） for 40 min each point, once daily for 15 days. Patients of the EA group were treated by EA stimulation of Neixiyan （EX-LE 4）, Dubi （ST 35）, Xuehai （SP 10） and Liangqiu （ST 34） for 30 min, once daily for 15 days; and those of the medication group treated by oral administration of Sanqi Tongshu capsules（Panax Notoginseng, etc. used for promoting blood circulation and removing blood stasis）, 3 times daily for 15 days. Serum OPN and MMP-3 levels were detected with ELISA. Results Following the treatment, of the 50, 50 and 44 cases in the moxibustion, EA and medication groups, 24, 20 and 14 were excellent, 18, 16 and 13 were good in the therapeutic effect, 7, 4 and 3 were effective, and 1, 10 and 14 invalid, with the excellent and good rates being 84%, 72.0% and 61.4%, respectively. Serum OPN content of the moxibistion and EA groups, and serum MMP-3 content of the moxi- bustion group were reduced considerably in comparison with pre-treatment in the same one group （P〈0.01）, while serum OPN level of the medication group and MMP-3 of the EA group were decreased slightly. The effect of moxibustion was evidently supe- rior to that of medication in lowering serum OPN level （P〈0.05） and superior to that of both EA and medication in lowering serumMMP-3 content （P〈0.05）. Conclusion Acupoint heat-sensitive moxibustion has a good therapeutic effect in relieving acute knee

关 键 词：穴位热敏灸 急性膝关节痛 血清骨桥蛋白 血清基质金属蛋白酶-3 

分 类 号：R245.8[医药卫生—针灸推拿学]