短刺法治疗膝骨关节炎瘀血阻滞证疗效及对机体炎性反应控制的探究  

Clinical efficacy of short-needle for knee osteoarthritis of blood stasis syndrome and its influence on inflammatory response

作　　者：熊良晶 卢金城 丁慧 XIONG Liangjing;LU Jincheng;DING Hui(Guangzhou University of Chinese Medicine,Clinical Medical College of Acupuncture and Moxibustion Rehabilitation,Guangzhou,Guangdong 510006;Department of Acupuncture and Moxibustion,Dongguan Hospital Affiliated to Guangzhou University of Chinese Medicine,Dongguan,Guangdong 523000;Clinical Department of Acupuncture and Moxibustion,Guangzhou University of Chinese Medicine,Clinical Medical College of Acupuncture and Moxibustion Rehabilitation,Guangzhou,Guangdong 510006)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510006 [2]广州中医药大学附属东莞医院针灸科,广东东莞523000 [3]广州中医药大学针灸康复临床医学院针灸临床教研室,广东广州510006

出　　处：《河北中医》2022年第11期1879-1883,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的 观察短刺法治疗膝骨关节炎(KOA)瘀血阻滞证的临床疗效及对机体炎性反应控制的影响。方法 将102例KOA瘀血阻滞证患者按照随机数字表法分为2组,对照组51例予常规西药联合常规针刺治疗,治疗组51例予常规西药联合短刺法治疗。2组均治疗4周。比较2组治疗前后西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分、血清炎症因子指标[白细胞介素6(IL-6)、IL-1β、肿瘤坏死因子α(TNF-α)]、骨代谢指标[骨保护素(OPG)、骨钙素(BGP)、成纤维细胞生长因子2(FGF-2)]变化,并统计2组临床疗效和治疗安全性。结果 治疗组总有效率88.2%(45/51),对照组总有效率72.5%(37/51),治疗组临床疗效优于对照组(P<0.05)。2组治疗后膝关节僵硬、膝关节疼痛、膝关节功能评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后血清IL-6、IL-1β、TNF-α水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后血清OPG、BGP、FGF-2水平均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。结论 短刺法治疗KOA瘀血阻滞证疗效显著,能够减轻膝关节疼痛,降低血清炎症因子水平,调节骨代谢指标,提高膝关节活动功能,临床疗效优于常规针刺法。Objective To observe the clinical efficacy of short-needle for knee osteoarthritis(KOA) of blood stasis syndrome and its influence on inflammatory response. Methods Totally 102 KOA patients(blood stasis syndrome) were randomized 1:1 to receive conventional Western medicine + conventional acupuncture(the control group) or conventional Western medicine + short-needle(the treatment group) for 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), inflammatory factors(interleukine-6 [IL-6], IL-1β, tumor necrosis factor-α [TNF-α]), bone metabolism indexes(osteoprotegerin [OPG], bone gla protein [BGP], fibroblast growth factor 2 [FGF-2]) were included as comparators. The curative effect and treatment safety were assessed. Results The overall effective rate in the treatment group was better than that in the control group(88.2% [45/51] vs 72.5% [37/51], [P<0.05], respectively). After treatment, the WOMAC scores(knee joint stiffness, knee pain, knee joint function) in groups were decreased(P<0.05), which were decreased in the treatment group as compared with the control group(P<0.05);IL-6, IL-1β, TNF-α in groups were decreased(P<0.05), which were more pronounced in the treatment group compared with the control group(P<0.05);OPG, BGP, FGF-2 in groups were increased(P<0.05), which in the treatment group was more prevalent than the control group(P<0.05). Conclusion For KOA patients(blood stasis syndrome), short-needle is superior to the conventional acupuncture, which has a significant curative effect, can relieve knee joint pain, reduce serum inflammatory factor levels, regulate bone metabolism indexes, improve knee joint function.

关 键 词：骨关节炎 膝 血瘀 针刺疗法 

分 类 号：R684.3[医药卫生—骨科学] R245.31[医药卫生—外科学]