膝康注射液关节腔内注射联合针灸治疗膝骨关节炎的临床疗效及对其血清BMP-2、COMP水平的影响  

Clinical Effect of Intra-Articular Injection of Xikang Injection(膝康注射液) Combined with Acupuncture and Moxibustion on Knee Osteoarthritis and Its Influence on Levels of BMP-2 and COMP in Serum

作　　者：刘继红[1] 任琴 唐丽[2] 周袁杰 LIU Jihong;REN Qin;TANG Li;ZHOU Yuanjie(PanzhihuaUniversity,Panzhihua 617000,Sichuan,China;Panzhihua Central Hospital,Panzhihua 617000,Sichuan,China;Nanchang Traditional Chinese Medicine Museum,Nanchang 330000,Jiangxi,China)

机构地区：[1]攀枝花学院,四川攀枝花617000 [2]攀枝花市中心医院,四川攀枝花617000 [3]南昌市中医馆,江西南昌330000

出　　处：《中华中医药学刊》2022年第10期167-170,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：中华医学会临床医学科研专项基金(19070085623)。

摘　　要：目的 探讨膝康注射液关节腔内注射联合针灸治疗膝骨关节炎(knee osteoarthritis, KOA)临床疗效及对其血清骨形态发生蛋白-2(BMP-2)、软骨寡聚基质蛋白(COMP)水平影响。方法 选取2018年4月—2020年3月在科室就诊的经中医辨证为气滞血瘀型KOA患者116例,随机分成两组。对照组关节腔内玻璃酸钠治疗,试验组予膝康注射液关节腔内注射联合针灸治疗,均治疗4周。观察两组治疗前后炎性因子、生活质量、相关评分等指标变化并比较,完成治疗后比较疗效情况。结果 (1)治疗前生活质量测定量表简表评分(QOL-BREF)、中医证候积分比较差异不显著(P>0.05),两组完成治疗后生活质量、健康状况、生理、心理、社会关系及环境较治疗前均显著上升(P<0.01),且试验组升高幅度均显著高于对照组(P<0.05)。(2)两组完成治疗后基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制物-1(TIMP-1)、COMP较治疗前均显著下降,超氧化物歧化酶(SOD)、透明质酸(HA)较治疗前均显著升高(P<0.05),且试验组均显著优于对照组(P<0.05)。(3)两组完成治疗后白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、BMP-2较治疗前均显著下降(P<0.05),且试验组均显著优于对照组(P<0.05)。(4)两组完成治疗后骨关节炎指数(WOMAC)(包括疼痛、僵硬、关节活动)、中医证候积分较治疗前均显著下降(P<0.05),且试验组以上指标均显著优于对照组(P<0.05)。(5)对照组临床控制率为31.03%(18/58)、总有效率为77.59%(45/58),试验组临床控制率为48.28%(28/58)、总有效率为89.66%(52/58),试验组显著高于对照组(P<0.05)。结论 膝康注射液关节腔内注射联合针灸能抑制炎性反应,改善软骨功能,从而提高KOA生活质量,改善临床症状。Objective To investigate the clinical effect of knee osteoarthritis(KOA)treated by intra-articular injection of Xikang Injection(膝康注射液)combined with acupuncture and moxibustion and the effect on the levels of bone morphogenetic protein-2(BMP-2)and cartilage oligomeric matrix protein(COMP)in serum.Methods A total of 116 patients with KOA of Qi stagnation and blood stasis type were treated in the department from April 2018 to March 2020 and divided into two groups.The control group was treated with sodium hyaluronate,and the experimental group was treated with Xikang Injection combined with acupuncture and moxibustion for 4 weeks.The changes of inflammatory factors,quality of life,related scores and other indicators were observed and compared before and after treatment,and the curative effect was compared after treatment.Results(1)There was no significant difference in QOL-BREF or TCM syndrome score before treatment(P>0.05).The quality of life,health status,physiological,psychological,social relationship and environment of the two groups after treatment were significantly higher than those before treatment(P<0.01),and the increase range of the experimental group was significantly higher than that of the control group(P<0.05).(2)After treatment,the levels of matrix metalloproteinase-3(MMP-3),tissue inhibitors of metalloproteinase 1(TIMP-1)and COMP were decreased significantly,superoxide dismutase(SOD)and hyaluronic acid(HA)increased significantly(P<0.05),and the experimental group was significantly better than the control group(P<0.05).(3)After treatment,the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and BMP-2 in the experimental group were significantly lower than those in the control group(P<0.05).(4)After treatment,the Osteoarthritis Index(WOMAC)(including pain,stiffness,joint activity)and TCM syndrome scores in the two groups were decreased significantly(P<0.05),and the above indexes in the experimental group were significantly better than those in the control group(P<0.05).(5)Th

关 键 词：膝康注射液 针灸 膝骨关节炎 软骨寡聚基质蛋白 骨形态发生蛋白 炎性因子 生活质量 疗效 

分 类 号：R245.31[医药卫生—针灸推拿学] R269.843[医药卫生—中医临床基础]