温针灸联合塞来昔布治疗膝骨关节炎疗效及对患者血清相关物质水平的影响  

Efficacy of needle warming moxibustion combined with celecoxib on knee osteoarthritis and its effects on levels of serum MMP-3, TIMP-1, TMP-1 and IGF-1

作　　者：林树梁[1] 叶明 LIN Shu-liang;YE Ming(Department of Acupuncture Physiotherapy,Jinhua Municipal Central Hospital,Jinhua,Zhejiang 321000,China;不详)

机构地区：[1]金华市中心医院针灸理疗科,浙江金华321000 [2]金华市中医院针灸科,浙江金华321017

出　　处：《中华全科医学》2020年第3期476-479,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金(LY17H040005)。

摘　　要：目的抗炎药物是治疗膝骨性关节炎(KOA)的主要用药,但其毒副作用明显,中医温针灸被应用于治疗KOA的历史悠长,分析温针灸联合塞来昔布治疗KOA的疗效。方法将80例KOA患者按照随机分配原则分为对照组(40例,塞来昔布0.2 g/次,1次/d,2周)与观察组(40例,在对照组用药基础上行2周温灸针治疗),分别于治疗1周及2周后,评估2组骨关节炎指数、膝关节疼痛程度、血清相关物质水平、治疗效果及安全性。结果治疗1周及2周后,2组WOMAC量表各项得分、膝关节疼痛程度均较同组治疗前显著下降(均P<0.05),且观察组治疗后WOMAC量表各项得分及膝关节疼痛程度均显著低于对照组(均P<0.05);治疗1周及2周后,观察组TGF-β、IGF-1较治疗前显著上升(均P<0.05),MMP-3、TIMP-1水平均较治疗前显著下降(均P<0.05),对照组治疗后,血清MMP-3、TIMP-1水平较治疗前显著下降(均P<0.05),且观察组治疗后血清TGF-β及IGF-1水平显著高于同时间段对照组,MMP-3、TIMP-1水平均显著低于同时间段对照组(均P<0.05);观察组治疗有效率显著高于对照组(P<0.05);2组治疗不良反应发生率比较差异无统计学意义(P>0.05)。结论温针灸联合塞来昔布能有效改善KOA患者临床症状,修复膝关节受损软组织,且治疗安全性较高。Objective Anti-inflammatory drugs are the main drugs for the treatment of knee osteoarthritis(KOA), but the drugs have obvious toxic and side effects. Traditional Chinese medicine needle warming moxibustion is used in the treatment of KOA for a long time.The following research aimed to study the efficacy of needle warming moxibustion combined with celecoxib on KOA. Methods Eighty patients with KOA were divided into control group(n=40, 0.2 g/time, once/d, two weeks) and observation group(n=40, 2-week needle warming moxibustion on the basis of control group) according to the random assignment principle. After 1 week and 2 weeks of treatment, the osteoarthritis index, degree of knee joint pain,levels of serum related substances, treatment effects and safety were evaluated. Results After 1 week and 2 weeks of treatment, the scores of items of WOMAC scale and degree of knee joint pain in the two groups were significantly lower than those in the same group before treatment(all P<0.05), and the scores of items of WOMAC scale and degree of knee joint pain after treatment in observation group were significantly lower than those in control group(all P<0.05). After 1 week and 2 weeks of treatment, the levels of TGF-β and IGF-1 in observation group were significantly higher than those before treatment(all P<0.05) while the levels of MMP-3 and TIMP-1 were significantly lower than those before treatment(all P<0.05), and the levels of serum MMP-3 and TIMP-1 in control group after treatment were significantly lower than those before treatment(all P<0.05), and the levels of serum TGF-β and IGF-1 in observation group after treatment were significantly higher than those in control group at the same time while the levels of MMP-3 and TIMP-1 were significantly lower than those in control group at the same time(all P<0.05). The effective rate of treatment in observation group was significantly higher than that in control group(P<0.05). There were no significant differences in adverse treatment reactions between the two groups(P>0.05

关 键 词：温针灸 塞来昔布 膝骨性关节炎 疗效 基质金属蛋白酶-3 基质金属蛋白酶抑制剂-1 

分 类 号：R684.3[医药卫生—骨科学] R245[医药卫生—外科学]