壮医药线点灸治疗肝肾亏虚型膝骨关节炎的疗效观察及对血清TGF-β1、OPG、5-HT水平及Th1/Th2细胞因子平衡的影响  

Observation on the therapeutic effect of medicated thread moxibustion of Zhuang medicine in the treatment of knee osteoarthritis with deficiency of the liver and kidney pattern and its effect on serum TGF-β1,OPG,5-HT levels and Th1/Th2 cytokine balance

作　　者：彭彩钰 欧阳礼 张燕珍 梁超 PENG Caiyu;OUYANG Li;ZHANG Yanzhen;LIANG Chao(Haikou Hospital of Traditional Chinese Medicine,Haikou 570216,China)

机构地区：[1]海口市中医医院,海口570216

出　　处：《上海针灸杂志》2023年第5期520-525,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：海南省卫生计生行业科研项目(18A200123);海南省卫生健康委员会科学研究项目(19A200100)。

摘　　要：目的 观察壮医药线点灸治疗肝肾亏虚型膝骨关节炎的临床疗效及对血清转化生长因子-β1(transforming growth factor-β, TGF-β1)、护骨素(osteoprotegerin, OPG)、5-羟色胺(5-hydroxytryptamine,5-HT)水平及Th1/Th2细胞因子平衡的影响。方法 将116例肝肾亏虚型膝骨关节炎患者随机分为观察组和对照组,每组58例。对照组采用西医常规治疗,观察组在对照组治疗基础上联合壮医药线点灸治疗。比较两组治疗前后血清TGF-β1、环氧合酶-2(cyclooxygenase-2, COX-2)、OPG、白介素-6(interleukin-6, IL-6)、白介素-10(interleukin-10, IL-10)、5-HT和前列腺素E2(Prostaglandin E2, PGE2)水平,观察两组治疗前后健康调查简表(36-item short-form health survey, SF-36)、视觉模拟量表(visual analog scale, VAS)评分和西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and Mc Master Universities osteoarthritis index, WOMAC)评分变化,并比较两组临床疗效。结果 治疗后,两组血清TGF-β1、COX-2、IL-6、PGE2和5-HT水平较治疗前降低(P<0.05),血清OPG、IL-10水平较治疗前升高(P<0.05);观察组血清TGF-β1、COX-2、IL-6、PGE2和5-HT水平高于对照组(P<0.05),血清OPG、IL-10水平低于对照组(P<0.05)。治疗后,两组VAS评分、WOMAC评分较治疗前降低(P<0.05),SF-36评分较治疗前升高(P<0.05);观察组VAS评分、WOMAC评分低于对照组(P<0.05),SF-36评分高于对照组(P<0.05)。观察组总有效率为94.8%,高于对照组的79.3%(P<0.05)。结论 在西医常规治疗基础上,采用壮医药线点灸治疗肝肾亏虚型膝骨关节炎效果显著,可减轻炎症反应,促进Th1/Th2平衡恢复,调节骨质代谢。Objective To observe the clinical effect of medicated thread moxibustion of Zhuang medicine in the treatment of knee osteoarthritis patients with deficiency of the liver and kidney pattern and its effect on the serum levels of ransforming growth factor-β1(TGF-β1),osteoprotegerin(OPG),5-hydroxytryptamine(5-HT)and the balance of Th1/Th2 cytokines.Method A total of 116 knee osteoarthritis patients with deficiency of the liver and kidney pattern were randomly divided into an observation group and a control group,with 58 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with medicated thread moxibustion of Zhuang medicine in addition to the treatment of the control group.The TGF-β1,cyclooxygenase 2(COX-2)and OPG,interleukin-6(IL-6),interleukin-10(IL-10),5-HT and Prostaglandin E_(2)(PGE_(2))were compared between the two groups before and after treatment.The 36-item short-form health survey(SF-36),visual analog scale(VAS)and Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score before and after treatment were observed in the two groups.The clinical efficacy of the two groups was compared.Result After treatment,the serum levels of TGF-β1,COX-2,IL-6,PGE_(2) and 5-HT in the two groups were lower than those before treatment(P<0.05),and the serum levels of OPG and IL-10 were higher than those before treatment(P<0.05).The serum levels of TGF-β1,COX-2,IL-6,PGE_(2) and 5-HT in the observation group were higher than those in the control group(P<0.05),and the serum levels of OPG and IL-10 were lower than those in the control group(P<0.05).After treatment,the VAS and WOMAC score were lower than those before treatment(P<0.05),and the SF-36 score was higher than that before treatment in the two groups(P<0.05).The VAS and WOMAC score of the observation group were lower than those of the control group(P<0.05),and the SF-36 score was higher than that of the control group(P<0.05).The total effective rate was 94.8%in the observation group,w

关 键 词：灸法 线壮灸 骨关节炎 膝 肝肾亏虚 TH1/TH2平衡 

分 类 号：R246.2[医药卫生—针灸推拿学]