电针联合推拿治疗膝骨关节炎疗效及对IL-1β、IL-6、TNF-α、MMP-3、TIMP-1表达水平的影响  

Effect of Electroacupuncture Combined with Tuina on Joint Function and Inflammation Indexes of Synovial Fluid in Patients with Knee Osteoarthritis

作　　者：叶必宏 叶绿[3] 廖文军 潘录录 林碎康 张全 宋丰军 王庆来 YE Bihong;YE Lyu;LIAO Wenjun;PAN Lulu;LIN Suikang;ZHANG Quan;SONG Fengjun;WANG Qinglai(Department of Acupuncture,Wenzhou Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Wenzhou 325000,Zhejiang,China;Taishun Hospital of Traditional Chinese Medicine,Taishun 325000,Zhejiang,China;The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]浙江中医药大学附属温州中医院,浙江温州325000 [2]泰顺县中医院,浙江泰顺325000 [3]温州医科大学附属第二医院,浙江温州325000

出　　处：《辽宁中医杂志》2023年第1期163-166,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：中国民族医药学会科研项目(2020ZY150-470005);“十三五”浙江省中医药(中西医结合)重点学科建设计划项目(2017-XK-A49);浙江省公益技术应用研究资助项目(LGF20H170001);温州市科技局课题项目(Y20211089);温州市卫生健康委中医药课题项目(Z2021001);温州市重大科技创新攻关项目(2018ZY017)。

摘　　要：目的观察电针联合推拿手法对膝骨关节炎(KOA)患者的关节功能及关节液炎性指标的影响。方法纳入浙江中医药大学附属温州中医院就诊100例膝骨关节炎患者,随机分为观察组50例与对照组50例。对照组给予口服氨基酸葡萄糖胶囊治疗,观察组在对照组基础上给予电针联合推拿治疗,两组均治疗4周。观察两组治疗后总有效率、视觉模拟评分(VAS评分)、西安大略-麦克马斯特大学骨关节量表(WOMAC评分)及白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶组织抑制剂-1(TIMP-1)水平。结果两组患者经4周治疗后,观察组总有效率为90.00%(45/50),显著优于对照组的总有效率72.00%(36/50)(P<0.05);两组VAS评分均较治疗前有所改善(P<0.05),观察组显著优于对照组(P<0.05);WOMAC评分变化均较治疗前下降(P<0.05),且观察组下降程度显著优于对照组;两组在IL-1β、IL-6、TNF-α、MMP-3、TIMP-1较治疗前均有显著改善(P<0.05),其中观察组在IL-1β、IL-6、TNF-α、MMP-3水平显著低于对照组(P<0.05),TIMP-1水平显著高于对照组。结论电针联合推拿手法治疗膝骨关节炎疗效确切,有效改善患者关节功能,调节关节液中的炎性因子。Objective To observe the effect of electroacupuncture combined with Tuina on the joint function and inflammatory indexes of synovial fluid in patients with knee osteoarthritis(KOA).Methods A total of 100 patients with KOA and were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with amino acid glucose capsules orally,and the observation group was treated with electroacupuncture and Tuina on the basis of the control group.Both groups were treated for 4 weeks.The total effective rate,visual analogue score(VAS score),Western Ontario-McMaster University Bone and Joint Scale(WOMAC score),interleukin-1β(IL-1β)and interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),matrix metalloproteinase-3(MMP-3)and tissue inhibitor of matrix metalloproteinase-1(TIMP-1)after treatment in the two groups were observed.ResultsAfter 4 weeks of treatment in the two groups,the total effective rate of the observation group was 90.00%,which was significantly better than that(72.00%)of the control group(P<0.05).The VAS scores of the two groups were improved compared to those before treatment(P<0.05),and the score of the observation group was significantly better than that of the control group(P<0.05).WOMAC scores were lower than those before treatment(P<0.05),and the degree of decline in the observation group was significantly better than that of the control group.The levels of IL-1β,IL-6.TNF-α,MMP-3 and TIMP-1 of two groups were significantly improved compared with those before treatment(P<0.05),and the levels of IL-1β,IL-6,TNF-α,and MMP-3 in the observation group were significantly lower than those of the control group(P<0.05).The level of TIMP-1 was significantly higher than that in the control group.ConclusionThe combination of electroacupuncture and Tuina is effective on treating knee osteoarthritis,which can effectively improve the joint function of patients and regulate the inflammatory factors in joint fluid.

关 键 词：电针 推拿 膝骨关节炎 关节功能 关节液 炎性指标 

分 类 号：R684.3[医药卫生—骨科学]