针刺联合祛风汤加减方治疗骨关节炎的临床观察  

Clinical Observation of Acupuncture Combined with Modified Qufeng Decoction in the Treatment of Osteoarthritis

作　　者：郑宗志 李建华 吴晓萍 房敏[2] ZHENG Zong-Zhi;LI Jian-Hua;WU Xiao-Ping;FANG Min(910th Hospital of PLA Joint Logistic Support Force,Quanzhou 362000 Fujian,China;Yueyang Hospital of Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院,福建泉州362000 [2]上海中医药大学附属岳阳中西结合医院,上海200437

出　　处：《广州中医药大学学报》2022年第10期2315-2320,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局资助项目[编号:ZY(2018-2020)-FWTX-2005]。

摘　　要：【目的】观察针刺联合祛风汤加减方治疗骨关节炎的临床疗效。【方法】将106例骨关节炎患者随机分为观察组和对照组,每组各53例,2组患者均给予玻璃酸钠注射联合双氯芬酸钠口服的常规治疗,在此基础上,对照组给予针刺治疗,观察组给予针刺联合祛风汤加减方治疗,连续治疗4周。治疗4周后,评价2组临床疗效,观察2组患者治疗前后视觉模拟量表(VAS)评分的变化情况,以及膝关节功能(Lysholm)评分的情况。比较2组患者治疗前后血清和关节液中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平的变化情况,以及骨代谢生物标志物X型胶原α1链(COL10A1)和ⅡA型前胶原氨基端肽(PⅡANP)水平的变化情况。【结果】(1)治疗后,2组患者的VAS评分明显改善(P<0.05),且观察组在改善VAS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的Lysholm评分明显改善(P<0.05),且观察组在改善Lysholm评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)观察组总有效率为96.23%(51/53),对照组为84.91%(45/53)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的血清相关因子IL-1β、IL-6、TNF-α水平均明显改善(P<0.05),且观察组在改善血清相关因子IL-1β、IL-6、TNF-α水平方面明显优于对照组,差异均有统计学意义(P<0.05)。(5)治疗后,2组患者的血清中COL10A1、PⅡANP水平明显改善(P<0.05),且观察组在改善血清中COL10A1、PⅡANP水平方面明显优于对照组,差异有统计学意义(P<0.05或P<0.01)。【结论】针刺联合祛风汤加减方治疗骨关节炎能明显改善患者的疼痛症状,改善患者膝关节功能的恢复状况,临床效果显著。Objective To observe the clinical efficacy of acupuncture combined with modified Qufeng Decoction in the treatment of osteoarthritis(OA).Methods The 106 patients with OA were randomly divided into the observation group and the control group,with 53 patients in each group.Both groups were given the conventional treatment of sodium hyaluronate injection combined with oral administration of diclofenac sodium,and additionally,the control group was treated with acupuncture,and the observation group was treated with acupuncture combined with modified Qufeng Decoction.The treatments in both groups lasted for 4 weeks.After 4 weeks of treatment,the clinical efficacy of the two groups was evaluated.The changes in the visual analogue score(VAS)and the knee joint function(Lysholm)score of the two groups were observed before and after treatment.The changes in serum and joint fluid levels of interleukin 1β(IL-1β),interleukin 6(IL-6)and tumor necrosis factorα(TNF-α),as well as changes in the levels of the biomarkers of bone metabolism,collagen type X alpha 1 chain(COL10A1)and pre-collagen typeⅡA amino-terminal peptide(PⅡANP),were compared in the two groups before and after treatment.Results(1)After treatment,the VAS scores of the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the VAS scores,the difference being statistically significant(P<0.05).(2)After treatment,the Lysholm scores of patients in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the Lysholm scores,the difference being statistically significant(P<0.05).(3)The total effective rate of the observation group was 96.23%(51/53),compared with 84.91%(45/53)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(4)After treatment,the levels of serum-related factor IL-1β,IL-6 and TNF-αwere s

关 键 词：针刺 祛风汤加减方 骨关节炎 炎症因子 X型胶原α1链 ⅡA型前胶原氨基端肽 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]