Efficacy of knee-balancing manipulation plus heat-sensitive moxibustion for knee osteoarthritis and its influence on CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3  

膝部调衡加热敏灸治疗膝骨关节炎疗效及对CTX-Ⅰ、TRACP-5b、ADAMTS-4和MMP-3的影响

作　　者：HE Yueyi MAO Zhen HONG Jue 何岳义;毛珍;洪珏(翻译)(Meishan Traditional Chinese Medicine Hospital,Sichuan Province,Sichuan 620000,China;People's Hospital of Caidian District,Wuhan City,Hubei Province,Wuhan 430100,China;不详)

机构地区：[1]Meishan Traditional Chinese Medicine Hospital,Sichuan Province,Sichuan 620000,China [2]People's Hospital of Caidian District,Wuhan City,Hubei Province,Wuhan 430100,China [3]不详

出　　处：《Journal of Acupuncture and Tuina Science》2022年第4期301-308,共8页针灸推拿医学（英文版）

基　　金：武汉市卫生和计划生育委员会临床医学科研项目,No.WZ20Q12;国家自然科学基金重大项目,No.81590955。

摘　　要：Objective To observe the efficacy of knee-balancing manipulation plus heat-sensitive moxibustion in treating knee osteoarthritis(KOA)and its impact on the expression of C-telopeptide of type I collagen(CTX-Ⅰ),tartrate-resistant acid phosphatase 5b(TRACP-5b),A disintegrin and metalloproteinase with thrombospondin motifs 4(ADAMTS-4),and matrix metalloproteinase 3(MMP-3).Methods A total of 134 unilateral KOA patients were randomized into a knee-balancing group,a heat-sensitive moxibustion group,and a joint intervention group.The knee-balancing group received knee-balancing Tuina(Chinese therapeutic massage)manipulation for treatment.The heat-sensitive moxibustion group received heat-sensitive moxibustion treatment.The joint intervention group received the heat-sensitive moxibustion in addition to the knee-balancing manipulation.The intervention period lasted for four weeks.After the treatment,and at the 2-week and 6-week follow-ups,the three groups were assessed using the visual analog scale(VAS)for knee joint pain and Western Ontario and McMaster Universities arthritis index(WOMAC),and clinical efficacy was also evaluated.The enzyme-linked immunosorbent assay was adopted to detect the expression levels of serum CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3.Results The knee-balancing group had 44 participants,but one dropped out;there was no dropout case among the 44 participants in the heat-sensitive moxibustion group;among the 46 participants in the joint intervention group,two cases dropped out.After the treatment,and at the 2-week and 6-week follow-ups,the total effective rate was found higher in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups(P<0.05).Compared with the baseline,the VAS and WOMAC scores and the serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 decreased significantly in all three groups after treatment and at the 2-week and 6-week follow-ups(P<0.05).At the same three time points,the VAS and WOMAC scores and serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-目的观察膝部调衡法加热敏灸治疗膝骨关节炎(KOA)的疗效及对I型胶原蛋白C末端异物肽(CTX-Ⅰ)、抗酒石酸盐酸性磷酸酶异构体5b(TRACP-5b)、聚蛋白多糖酶4(ADAMTS-4)及基质金属蛋白酶3(MMP-3)表达的影响。方法将134例单关节KOA患者随机分为膝部调衡组、热敏灸组和联合组。膝部调衡组接受膝部调衡推拿手法治疗;热敏灸组接受热敏灸治疗;联合组在膝部调衡推拿手法的基础上加用热敏灸治疗,共治疗4周。观察治疗后、随访2周、随访6周时3组患者膝关节疼痛的视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分和临床疗效。采用酶联免疫吸附试验检测血清CTX-Ⅰ、TRACP-5b、ADAMTS-4及MMP-3的表达水平。结果膝部调衡组共44人,脱落1人;热敏灸组共44人,无脱落;联合组共46人,脱落2人。联合组治疗后、随访2周和随访6周时的总有效率均高于膝部调衡组和热敏灸组(P<0.05)。治疗后、随访2周和随访6周时三组VAS评分、WOMAC评分和血清CTX-Ⅰ、TRACP-5b、ADAMTS-4及MMP-3水平均较本组治疗前显著降低(P<0.001)。联合组在上述三个时间点的VAS及WOMAC评分,血清CTX-Ⅰ、TRACP-5b、ADAMTS-4及MMP-3的表达水平均低于膝部调衡组和热敏灸组(P<0.05)。结论膝部调衡法及热敏灸疗法单独或联合使用均能改善KOA患者的症状,降低血清CTX-Ⅰ、TRACP-5b、ADAMTS-4及MMP-3水平,疗效持久稳定,二者合用效果更佳。

关 键 词：TUINA MASSAGE Manual Manipulation Moxibustion Therapy Heat Sensitive Moxibustion Osteoarthritis Knee ADAMTS4 Protein Matrix Metalloproteinase 3 

分 类 号：R244.1[医药卫生—针灸推拿学]