针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效观察及对炎症因子和血液流变学影响  

Acupuncture Combined with Duhuo Jisheng Decoction in Treatment of Patients with Knee Osteoarthritis and Its Clinical Effect on Inflammatory Cytokines and Blood Rheology

作　　者：庞青民[1] 赵欲晓[2] 王承惠[1] 李玲[1] 谌少颖 孙洁[1] 赵莉[1] 

机构地区：[1]郑州大学附属郑州中心医院针灸理疗科,河南郑州450007 [2]河南邵氏针灸流派传承工作室郑州市中心医院工作站,河南郑州450007

出　　处：《辽宁中医杂志》2017年第4期782-785,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河南省医学科技攻关计划项目(14B360020;2013ZY02001)

摘　　要：目的:探讨针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效及对炎症因子和血液流变学的影响。方法:选自2013年3月—2015年3月期间本院收治的膝骨性关节炎82例,依据随机数字表法随机分为观察组41例与对照组41例。对照组口服西乐葆胶囊,观察组采用针灸联合独活寄生汤加减治疗。两组疗程均为8周。比较两组患者治疗疗效,治疗前后静息痛指数、关节肿胀指数、关节压痛指数、血清炎症因子和血液流变学水平变化及不良反应。结果:观察组疾病治疗总有效率(95.24%)高于对照组(73.81%)(P<0.05);观察组中医证候治疗总有效率(97.62%)高于对照组(69.05%)(P<0.05);两组静息痛指数、关节肿胀指数及关节压痛指数治疗后明显下降(P<0.05);观察组静息痛指数、关节肿胀指数及关节压痛指数治疗后低于对照组(P<0.05);观察组血清TNF-α、IL-6、IL-1治疗后水平降低(P<0.05);观察组血清TNF-α、IL-6、IL-1治疗后低于对照组(P<0.05);观察组全血黏度高切、全血黏度低切、ESR、纤维蛋白原治疗后水平降低(P<0.05);观察组全血黏度高切、全血黏度低切、ESR、纤维蛋白原治疗后低于对照组(P<0.05);两组均未见严重药物不良反应。结论:针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效显著,可明显减轻炎症反应,改善血液流变学,且安全可靠,具有重要研究价值。Objective：To investigate the patients of acupuncture combined with Duhuo Jisheng Decoction in the treatment of knee osteoarthritis efficacy and effects on inflammatory cytokines and blood rheology. Methods ： Eighty - two cases of knee osteoar- thritis from March 2013 to March 2015 were treated in our hospital, and according to random number table method were randomly divided into observation group 41 cases and control group 41 cases. The control group used oral celebrex capsules. The observation group was treated with acupuncture combined with Duhuo Jisheng Decoction. Two groups＇ treatment was 8 weeks. Comparison of two groups＇curative effect, the changes of resting pain index ,joint swelling index ,joint tenderness index, serum inflammatory factor and blood rheology and adverse reactions were observed before and after treatment. Results ： The total effective rate of the observa- tion group （95.24%） was higher than that of the control group （73.81%） （P 〈0. 05）. The TCM syndrome total effective rate （97.62%） in the observation group was higher than that in the control group （69.05%） （P 〈0. 05）. Two groups＇ resting pain index ,joint swelling index and joint tenderness index decreased significantly after treatment （P 〈0. 05 ）. The rest pain index,joint swelling index and joint tenderness index of the observation group were lower than those of the control group （ P 〈 0.05 ）. The lev- els of serum TNF - α, IL - 6 and IL - 1 in the observation group were decreased （P 〈 0. 05 ）. The serum TNF - α, IL - 6 and IL - 1 in the observation group were lower than those in the control group （P 〈 0.05 ）. Observation group＇s whole blood viscosity at high and low shear whole blood viscosity, ESR and fibrinogen levels decreased after treatment （ P 〈 O. 05 ）. The observation group＇ s whole blood viscosity at high shear rate,low shear whole blood viscosity, fibrinogen and ESR were lower than those of the control group after treatment （ P 〈 0. 05 ）. No s

关 键 词：针灸 独活寄生汤加减 膝骨性关节炎 疗效 炎症因子 血液流变学 

分 类 号：R684.3[医药卫生—骨科学]