补肾活血方配合针灸治疗骨关节炎临床疗效观察及对关节液中炎症因子表达的影响  

Observation of Curative Effect on Osteoarthritis by Bushen-Huoxue Decoction Combined with Acupuncture and Effect on the Expression of Inflammatory Cytokines in Joint Fluid

作　　者：刘进[1] 杨仁轩[2] 黄永明[2] 徐逸生[2] 徐伟龙[2] 朱兴阳[2] 

机构地区：[1]广州市白云区人民医院,广州510500 [2]广州中医药大学第二临床医学院

出　　处：《中国中医骨伤科杂志》2014年第4期9-11,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：广东省科技厅科研基金资助项目(编号:2011B031700021)

摘　　要：目的:观察补肾活血方内服配合针灸治疗膝关节骨性关节炎的临床疗效,以及此法对关节液中炎症因子IL-1β、TNF-α含量变化的影响,探讨中医综合疗法改善骨关节炎症状的机理。方法:将60例患者随机分为两组,治疗组予以补肾活血方内服及针灸进行治疗,对照组予以扶他林缓释片内服,对治疗前后关节液中炎症因子IL-1β、TNF-α含量的变化,以及膝关节功能、疼痛等临床症状进行评估。结果:两组病例中关节液炎症因子治疗前后自身含量变化相比,差异有统计学意义(P<0.05),其中以IL-1β下降更明显。以此同时,治疗组含药血清对滑液干细胞的分化较空白血清组有明显增殖作用,差异有统计学意义(P<0.05)。两组病例治疗前后功能改善及疼痛方面比较差异均有统计学意义(P<0.05)。结论:应用补肾活血方内服配合针灸治疗膝关节骨性关节炎,能明显降低关节滑液中炎症因子尤其是IL-1β的含量,并明显改善膝关节整体功能,其机理可能与中医药综合疗法可促进间充质干细胞分化,并抑制局部细胞因子释放等因素密切相关。Objective：To observe the clinical efficacy of Bushen-Huoxue Decoction Combined with acupuncture for the treat-ment of knee osteoarthritis, and the effect on content change of inflammatory cytokines in joint synovial fluid such as IL-1 β,TNF-α. Study on the mechanism of integrated traditional Chinese medicine therapy in improving the symptoms of osteo-arthritis. Methods：60 patients were randomly divided into two groups, treatment group were given Bushen-Huoxue Decoc-tion orally and acupuncture treatment, the control group were given Voltaren sustained release tablets orally, to assess the changes of inflammatory factor in the synovial fluid such as IL-1β,TNF-α before and after treatment, as well as the knee joint function,pain and other clinical symptoms. Results：There was statistically significant difference （P〈0.05） between the two groups ,comparing the content changes of inflammatory cytokines in synovial fluid before and after treatment , in which IL-1β decreased more significantly. Meanwhile, the medicated serum of treatment group had obvious proliferation on the differentiation of Synovial stem cells compared to blank serum group , there was statistically significant （P〈 0.05）. There were statistically significant （P〈0.05） on improvements in function and pain between two groups before and after treatment. Conclusion：The application of Bushen-Huoxue Decoction Combined with acupuncture in the treatment of osteo-arthritis of the knee joint synovial fluid can significantly reduce the content of inflammatory factors especially IL-1β, and significantly improve the whole function of the knee joint, the mechanism might be closely related to comprehensive therapy of traditional Chinese medicine ,also it can promote the differentiation of mesenchymal stern cells, and inhibit the release of local cytokine factors.

关 键 词：骨关节炎 补肾活血 针灸 炎症因子 滑液间充质干细胞 

分 类 号：R684[医药卫生—骨科学]