银质针导热疗法联合洛索洛芬钠贴剂治疗膝骨关节炎的疗效及机制研究  

Therapeutic effect and mechanism of silver needle heat conduction therapy combined with loxoprofen sodium patch in patients with knee osteoarthritis

作　　者：张振武 凌地洋 韩健 吴呈祥 王哲银 ZHANG Zhen-wu;LING Di-yang;HAN Jian;WU Cheng-xiang;WANG Zhe-yin(Pain Department,Shenzhen People’s Hospital,the 2^(nd)Clinical Medical College of Jinan University,the 1^(st)Affiliated Hospital of Southern University of Science and Technology,Shenzhen 518020,Guangdong Province,China)

机构地区：[1]深圳市人民医院(暨南大学第二临床医学院,南方科技大学第一附属医院)疼痛科,广东深圳518020

出　　处：《针刺研究》2021年第1期64-68,共5页Acupuncture Research

摘　　要：目的:探讨银质针导热疗法联合洛索洛芬钠贴剂治疗膝骨关节炎(KOA)的临床疗效。方法:选择92例KOA患者,按照随机数字表法分为治疗组和对照组,每组46例。治疗组予以银质针导热疗法(每次20 min,每周1次)联合洛索洛芬钠贴剂(每日1贴)治疗,对照组仅予以洛索洛芬钠贴剂治疗,均治疗4周。比较两组治疗前后西安大略和麦克马斯特大学骨关节炎指数量表(WOMAC)评分、骨代谢指标[包括骨钙素(BGP)、骨特异性碱性磷酸酶(BALP)、抗酒石酸盐酸性磷酸酶异构体(TRACP)-5b]含量、炎性因子[包括肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β)、白细胞介素-1β(IL-1β)]含量;并比较两组治疗总有效率。结果:与治疗前比较,治疗后两组WOMAC评分及血清TRACP-5b、TNF-α、IL-1β含量均显著降低(P<0.01),BGP、BALP、TGF-β含量明显升高(P<0.01)。治疗后治疗组WOMAC评分及血清TRACP-5b、TNF-α、IL-1β含量均低于对照组(P<0.01),BGP、BALP、TGF-β含量高于对照组(P<0.01)。治疗组总有效率为89.1%(41/46),对照组总有效率为71.7(33/46),治疗组总有效率高于对照组(P<0.05)。结论:银质针导热疗法联合洛索洛芬钠贴剂可有效缓解炎性反应,改善骨代谢,降低膝骨关节炎指数评分,治疗KOA效果显著。Objective To observe the clinical efficacy of silver needle heat conduction therapy combined with loxoprofen sodium patch in the treatment of knee osteoarthritis(KOA).Methods A total of ninety-two patients with KOA were randomly and equally divided into loxoprofen sodium group and silver needle heat conduction therapy+loxoprofen sodium(combination)group,with 46 cases in each group.Patients of the combination group were treated with silver needle heat conduction therapy combined with loxoprofen sodium patch,while those of the loxoprofen sodium group were treated with loxoprofen sodium patch.The treatment was conducted for 4 weeks.The Western Ontario McMaster Universities Osteoarthritis Index(WOMAC),bone metabolism index[including bone gla protein(BGP),bone-specific alkaline phosphatase(BALP),tartrate resistant acid phosphatase isomer(TRACP)-5b],and inflammation factors[including the tumor necrosis factor-α(TNF-α),transforming growth factor-β(TGF-β),interleukin-1β(IL-1β)]were observed before and after treatment.The therapeutic effect was assessed after the treatment.Results After the treatment,the total scores of WOMAC,the levels of serum TRACP-5 b,TNF-α and IL-1β were significantly decreased(P<0.01),while the levels of serum BGP,BALP,and TGF-β were significantly increased(P<0.01)in the two groups compared with their own pre-treatment.Silver needle plus loxoprofen sodium was more effective in reducing WOMAC score,TRACP-5 b,TNF-α,IL-1β level(P<0.01),and up-regulating BGP,BALP,and TGF-β level(P<0.01)than loxoprofen.Of the 46 cases in the loxoprofen sodium and combination groups,33 and 41 were effective,with the effective rate being 71.7% and 89.1%,respectively.The comprehensive therapeutic effect of the combination group was significantly superior to that of the loxoprofen group(P<0.05).Conclusion Silver needle heat conduction therapy combined with loxoprofen sodium can effectively treat KOA,its mechanism may be related to alleviating inflammation and improving bone metabolism.

关 键 词：膝骨关节炎 银质针导热疗法 洛索洛芬钠 骨代谢 炎性因子 

分 类 号：R246.2[医药卫生—针灸推拿学]