浮针疗法联合中药治疗股骨头缺血性坏死的疗效观察及对髋关节功能和血清TGF-β、BMP、VEGF水平的影响  

Observation on the efficacy of superficial needling therapy combined with chinese herbal medicine for avascular necrosis of the femoral head and its effect on hip function and TGF-β, BMP, serum VEGF levels

作　　者：马家宾 曹玉举 王俊发 张欣凯 MA Jiabin;CAO Yuju;WANG Junyou;ZHANG Xinkai(Zhengzhou Traditional Chinese Hospital of Orthopaedics,Zhengzhou 450000,China)

机构地区：[1]郑州中医骨伤病医院,郑州450000

出　　处：《上海针灸杂志》2023年第1期66-71,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河南省中医药科学研究专项课题(2018ZY3011)。

摘　　要：目的 观察浮针疗法联合中药治疗股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)的临床疗效及对髋关节功能和血清转化生长因子-β(transforming growth factor-β, TGF-β)、骨形态发生蛋白(bone morphogenetic protein, BMP)、血管内皮生长因子(vascular endothelial growth factor, VEGF)水平的影响。方法 将127例ANFH患者随机分为对照组(63例)和浮针组(64例)。两组患者均给予抗凝、扩血管、降脂等基础治疗,对照组给予仙灵骨葆胶囊治疗,浮针组在对照组治疗基础上给予浮针。观察两组治疗前后髋关节疼痛分级和活动度、血清相关因子(TGF-β、BMP和VEGF)及影像学指标(骨坏死区灰度、骨坏死区体积和股骨头灰度)的变化,并比较两组临床疗效。结果 浮针组总有效率为93.8%(60/64)高于对照组79.4%(50/63),差异有统计学意义(P<0.05)。浮针组治疗后疼痛分级水平优于对照组,差异有统计学意义(P<0.05)。两组治疗后屈曲、外展和外旋角度较治疗前升高,且浮针组高于对照组,差异有统计学意义(P<0.05)。两组治疗后血清TGF-β、BMP和VEGF水平较治疗前升高,且浮针组高于对照组,差异有统计学意义(P<0.05)。两组治疗后骨坏死区灰度和股骨头灰度水平较治疗前升高,且浮针组高于对照组;骨坏死区体积水平较治疗前降低,且浮针组低于对照组,差异有统计学意义(P<0.05)。结论 在基础治疗的基础上,浮针疗法联合中药治疗ANFH疗效优于中药治疗,可改善影像学指标,调节血清相关因子水平,改善髋关节功能。Objective To observe the efficacy of superficial needling therapy combined with Chinese herbal medicine in treating avascular necrosis of the femoral head and its effect on hip function and serum levels of transforming growth factor-β(TGF-β), bone morphogenetic protein(BMP) and vascular endothelial growth factor(VEGF) levels. Method One hundred and twenty-seven patients with ANFH were randomly divided into a western medicine group(63 cases) and a superficial needling group(64 cases). Patients in both groups were given basic treatment including anticoagulation, vasodilation, and lipid lowering. The control group was given Xian Ling Gu Bao capsule treatment, and the superficial needling group was given superficial needling in addition to the treatment used in the control group. The change of hip pain grade and mobility, serum related factors(TGF-β, BMP and VEGF) and imaging indexes(gray scale of osteonecrosis area, volume of osteonecrosis area, gray scale of femoral head) before and after treatment were observed in both groups, and the clinical efficacy of the two groups were compared. Result The total effective rate of 93.8%(60/64) in the superficial needling group was higher than that of 79.4%(50/63) in the control group, and the difference was statistically significant(P<0.05). After treatment, the level of pain grade in the superficial needling group was better than that in the control group, and the difference was statistically significant(P<0.05). The flexion, abduction, and external rotation angles of the two groups were elevated after treatment compared with those before treatment, and they were higher in the superficial needling group than in the control group, with a statistically significant difference(P<0.05). The serum levels of TGF-β, BMP and VEGF were increased in both groups after treatment compared with before treatment, and were higher in the superficial needling group than in the control group, with a statistically significant difference(P<0.05). The gray levels of the osteonecrosis area and

关 键 词：针刺疗法 针药并用 浮刺 股骨头坏死 髋关节 转化生长因子-β 骨形态发生蛋白 

分 类 号：R246.2[医药卫生—针灸推拿学]