腹针结合温针灸治疗膝关节骨性关节炎临床研究  

Clinical Studies of Abdominal Acupuncture Combined with Warm Needling on Knee Osteoarthritis

作　　者：李其友[1] 郭瑾[1] 田华张 张春燕[1] 彭志贤 黄兴鹏[1] 

机构地区：[1]广东省深圳市宝安区石岩人民医院针灸康复科,深圳518108

出　　处：《针刺研究》2017年第4期350-353,共4页Acupuncture Research

基　　金：广东省深圳市宝安区科技计划项目(No.2015290)

摘　　要：目的:探讨腹针结合温针灸治疗膝关节骨性关节炎(KOA)的临床疗效。方法:将KOA患者按照随机数字表法分为治疗组和对照组,各43例。治疗组采用腹针结合温针灸治疗,腹针取穴中脘、关元及患侧滑肉门、外陵、下风湿点,温针灸取患侧内膝眼、外膝眼、鹤顶、梁丘、血海,对照组仅给予温针灸治疗,每周治疗5次,共治疗4周。比较两组治疗前后西大略湖和麦克马斯特大学骨关节炎指数(WOMAC)量表及健康调查简表(SF-36量表)各维度评分。应用酶联免疫法测定血清中血管内皮细胞生长因子(VEGF)和促血管生成素-1(Ang-1)水平。结果 :与治疗前比较,治疗后两组WOMAC量表的疼痛、僵硬、关节功能评分及血清VEGF、Ang-1水平均显著降低(P<0.01),SF-36量表各维度评分显著增加(P<0.01)。治疗后,治疗组WOMAC量表的疼痛、僵硬、关节功能评分及血清VEGF、Ang-1水平显著低于对照组(P<0.01),SF-36量表各维度评分显著高于对照组(P<0.01)。治疗组总有效率93.0%(40/43)显著高于对照组74.4%(32/43)(P<0.05)。结论:腹针结合温针灸可有效减轻KOA患者关节疼痛僵硬,改善膝关节功能和生活质量,疗效确切,其作用机制可能与降低血清VEGF、Ang-1水平有关。Objective To explore the clinical effects of abdominal acupuncture combined with warm needling on knee osteoarthritis（KOA）.Methods Eighty-six patients with KOA were divided into a treatment group and a control group according to the digital random table,43 cases in each one.In the treatment group,patients were treated with abdominal acupuncture at Zhongwan（CV 12）,Guanyuan（CV 4）and Huaroumen（ST 24）,Wailing（ST 26）and Xiafengshidian（Extra）on the affected side,as well as warm needling at Neixiyan（EX-LE 4）,Dubi（ST 35）,Heding（EX-LE 2）,Liangqiu（ST 34）and Xuehai（SP 10）of the affected side.In the control group,warm needling was given.All the patients were treated 5times a week for 4weeks.Each dimension score of Western Ontario and McMaster University（WOMAC）osteoarthritis index scale and health survey 36-item short form（SF-36）of the two groups was compared before and after treatment.Enzyme-linked immunosorbent assay was applied to test serum vascular endothelial growth factor（VEGF）and angiopoietin-1（Ang-1）.Results Compared with those before treatment,the scores of pain,stiffness,joint function of WOMAC scale and serum VEGF,Ang-1of the two groups were lower after treatment（all P〈0.01）,and each dimension score of SF-36 scale increased significantly（all P〈0.01）.Each dimension score of WOMAC scale and serum VEGF,Ang-1in the treatment group were lower than those in the control group after treatment（all P〈0.01）,and each score of SF-36 was higher（all P〈0.01）.The total effective rate of 93.0%（40/43）in the treatment group was higher than 74.4%（32/43）in the control group（P〈0.05）.Conclusion Abdominal acupuncture combined with warm needling can effectively alleviate pain and stiffness,improve the function of knee joint and quality of life,with definite effect for KOA.The mechanism may be related to the decreasing of serum VEGF and Ang-1.

关 键 词：膝关节骨性关节炎 腹针 温针灸 

分 类 号：R245.8[医药卫生—针灸推拿学]