电针联合独活寄生丸治疗老年膝骨关节炎的疗效及对炎性因子的影响  

Effect of electro acupuncture combined with Duhuo pubescens Pill on knee osteoarthritis and inflammatory factors in elderly patients

作　　者：陈长凯 叶宝飞[2] 张志伟[2] 胡万钧[2] CHEN Chang-kai;YE Bao-fei;ZHANG Zhi-wei;HU Wan-jun(Department of Orthopedics,the Fifth People's Hospital of Hainan, Haikou 571127,China;Department of Orthopedics,Hainan Provincial Hospital of Traditional Chinese Medicinem, Haikou 571127,China)

机构地区：[1]海南省第五人民医院中医骨科,海南省海口市571127 [2]海南省中医院骨科,海南省海口市5711272

出　　处：《实用老年医学》2019年第9期884-887,891,共5页Practical Geriatrics

基　　金：海南省医药卫生科研基金项目(17A305062)

摘　　要：目的探讨电针联合独活寄生丸治疗老年膝骨关节炎(KOA)的疗效及对血清白细胞介素-6(IL-6)、IL-8及肿瘤坏死因子-α(TNF-α)水平的影响。 方法选取2015年1月至2018年6月海南省第五人民医院收治的老年KOA病人170例,按随机数表法将病人随机分为观察组和对照组,每组各85例。对照组采用电针+扶他林治疗,观察组采用电针+扶他林+独活寄生丸治疗。观察2组疗效及治疗前后血清IL-6、IL-8及TNF-α水平的变化,并采用肢体活动疼痛视觉模拟评分(VAS)、Lequesne评分和WOMAC骨关节炎指数评价病人膝关节疼痛和功能情况。结果治疗后,观察组和对照组VAS评分、Lequesne评分及WOMAC评分均明显低于治疗前(P<0.05),且观察组明显低于对照组(P<0.05或 P <0.01);观察组和对照组血清IL-6、IL-8及TNF-α水平均明显低于治疗前(P <0.05),且观察组明显低于对照组( P<0.05或 P <0.01)。观察组治疗总有效率明显优于对照组(92.9%比75.3%, P <0.05)。2组不良反应发生率比较,差异无统计学意义( P>0.05)。 结论电针联合独活寄生丸治疗老年KOA病人的临床疗效较好,且能有效降低炎性因子水平。Objective To investigate the therapeutic effect of electro acupuncture combined with Duhuo Pubescens Pill on knee osteoarthritis (KOA) and its influence on serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α(TNF-α) in the elderly patients. Methods A total of 170 elderly patients with KOA admitted to the Fifth People s Hospital of Hainan Province from January 2015 to June 2018 were selected, and the patients were randomly divided into observation group and control group according to the random number table, with 85 cases in each group. The control group received electro acupuncture and voltaren, and the observation group received electro acupuncture, voltaren and Duhuo Pubescens Pill. The therapeutic effect and the changes of serum levels of IL-6, IL-8 and TNF-α before and after treatment were observed and compared. The pain and function of knee joint were evaluated by visual analogue scale (VAS), Lequesne score and WOMAC osteoarthritis index. Results After the treatment, the VAS scores, Lequesne scores and WOMAC scores in both groups were significantly lower than those before treatment ( P < 0.05), especially in the observation group ( P < 0.05 or P < 0.01). After the treatment, the serum levels of IL-6, IL-8 and TNF-α in the observation group and the control group were significantly lower than those before treatment ( P < 0.05), especially in the observation group ( P < 0.05 or P < 0.01). The total effective rate of the observation group was significantly better than that of the control group (92.9% vs 75.3%, P < 0.05). There was no statistically significant difference in adverse reactions between the two groups(χ 2=0.311, P > 0.05). Conclusions Electro acupuncture combined with Duhuo Pubescens Pill is effective in the treatment of elderly KOA patients, and can effectively reduce the levels of inflammatory factors.

关 键 词：膝骨关节炎 独活寄生丸 电针 炎性因子 老年人 

分 类 号：R684.3[医药卫生—骨科学]