热敏灸配合常规药物治疗膝骨性关节炎阳虚寒凝证的临床疗效观察  

Effects of heat-sensitized moxibustion combined with conventional medicine on knee osteoarthritis of yang-deficiency cold-congealing pattern: a clinical trial

作　　者：王智琴[1] 谢洪武[1] 刘福水[1] 焦琳[1] 陈日新[1] Wang Zhiqin, Xie Hongwu, Liu Fushui, Jiao lin, Chen Rixin(Department of Acupuncture and rehabilitation, The First Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Jiangxi 330006, Chin)

机构地区：[1]江西中医药大学附属医院针灸康复科,江西330006

出　　处：《北京中医药大学学报》2018年第2期171-176,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)资助项目(No.2015CB554503);江西省卫生计生委项目(No.2014B034)~~

摘　　要：目的观察热敏灸配合常规药物治疗膝骨性关节炎(KOA)的临床疗效及对血清细胞因子的影响。方法选择60例双侧KOA患者在接受常规药物治疗的基础上按热敏灸操作步骤区分热敏灸组(治疗组)和常规艾灸组(对照组),每组30例,以双侧犊鼻、阳陵泉、鹤顶6穴为施灸部位,每穴灸疗时间大约15 min,每日1次,连续6 d为1个小疗程,小疗程间隔1 d,总疗程为4个小疗程。采用Lysholm膝关节功能评分表评价总疗程前后的临床疗效,比较2组患者在总治疗前后关节疼痛、膝关节肿胀、膝关节日常活动能力评分及血清细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1),以不良反应指标的分级评定方法来评价其配合药物的安全性。结果 2组患者在总疗程后关节疼痛、膝关节肿胀、膝关节日常活动能力评分及血清细胞因子TNF-α、IL-1均较治疗前改善(P<0.05),但治疗组以上各指标较对照组改善更明显(P<0.01)。治疗组总有效率为86.7%,对照组为66.7%,治疗组总有效率明显优于对照组(P<0.01),且治疗组的不良反应少(P<0.05)。结论热敏灸配合药物治疗膝骨性关节炎疗效优于常规艾灸疗法,临床疗效确切,无创无毒副作用,且能更好地改善患者的症状和体征。Objective To explore the effects of heat-sensitized moxibustion combined with conventional medicine on knee osteoarthritis（ KOA） including clinical efficacy and cytokine levels. Methods 60 patients with bilateral knee osteoarthritis was divided into two groups（ n = 30）. The treatment group was given heat-sensitized moxibustion combined with conventional drugs,while the control group was administered with routine acupuncture treatment besides conventional drugs. Bilateral ST35,GB34,and EX-LE2 were selected as treating acupoints for 15 minutes once a day for 6 days as one treatment session. Four treatment sessions were one total treatment course,with 1-day interval between two sessions. The Lysholm knee function score was applied to evaluate clinical efficacy before and after treatment. The scores of joint pain,joint swelling,and walking ability and cytokine TNF-α/IL-1 were also compared before and after treatment. Criteria of adverse effect factors was adopted to evaluate the safety. Results The scores of joint pain,joint swelling,walking ability and serum cytokines TNF-α/IL-1 of patients in both groups were improved after treatment（ P〈0. 05）. Compared with the control group,those above index in the treatment group were improved more markedly（ P〈0. 01）. The effective rate of the treatment group and control group was 86. 7%,and 66. 7% respectively,thus the efficacy of treatment group was significantly superior to that of the control group（ P〈0. 01）. Moreover,compared with control group,there were less adverse effects in treatment group（ P〈0. 05）. Conclusion To treat knee osteoarthritis,heat-sensitized moxibustion appears to be superior to routine moxibustion therapy in terms of efficacy and safety. The non-invasive heat-sensitized moxibustion may alleviate symptoms,and improve physical signs effectively,which warrants further exploration and development.

关 键 词：热敏灸 膝骨性关节炎 细胞因子 疗效 不良反应 

分 类 号：R245.81[医药卫生—针灸推拿学]