补阳还五汤加二陈汤化裁方联合针刺对肘关节骨关节炎继发轻中度尺神经卡压患者IL-1、IL-6、MMP-13及电生理的影响  

Effects of Modified Buyang Huanwu Decoction and Erchen Decoction Joined with Acupuncture on the Levels of IL-1,IL-6,MMP-13 and Electrophysiology in Patients with Mild to Moderate Cubital Tunnel Syndrome Secondary to Elbow Osteoarthritis

作　　者：代丽 陈华[1] 杨雅慧 孙立盼 DAI Li;CHEN Hua;YANG Yahui;SUN Lipan(Cangzhou Hospital of Integrated TCM-WM,Cangzhou 061000,China)

机构地区：[1]沧州中西医结合医院,河北沧州061000

出　　处：《西部中医药》2023年第8期102-106,共5页Western Journal of Traditional Chinese Medicine

基　　金：2021年度河北省中医药管理局中医药类科技计划项目(2021336)。

摘　　要：目的:分析补阳还五汤加二陈汤化裁方联合针刺对肘关节骨关节炎继发轻中度尺神经卡压综合征(cubital tunnel syndrome,CuTS)患者白细胞介素1(interleukin-1,IL-1)、白细胞介素6(interleukin-6,IL-6)、基质金属蛋白酶13(matrix metalloproteinase-13,MMP-13)及电生理的影响。方法:选取104例肘关节骨性关节炎患者作为研究对象,按照不同治疗方法分为观察组和对照组,每组52例。两组均给予抗炎、营养神经等药物治疗,对照组同时给予补阳还五汤加二陈汤化裁方,观察组在对照组治疗基础上增加针刺疗法,两组共治疗4周。对比两组临床疗效、治疗前后视觉疼痛评定量表(visual analogue scale,VAS)和上肢功能评定量表(disabilities of arm,shoulder and hand,DASH)评分、IL-1、IL-6、MMP-13水平、尺神经肘段运动传导速度(motor conduction velocity,MCV)、尺神经肘段感觉传导速度(sensory conduction velocity,SCV)、尺神经干肘段动作电位(nerve action potentia,NAP)改变及不良事件发生情况。结果:观察组优良率[76.92%(42/52)]高于对照组[73.08%(38/52)](P<0.05)。治疗后,两组VAS、DASH评分及IL-1、IL-6、MMP-13水平均低于治疗前,且观察组上述指标均低于对照组(P<0.05)。治疗后,两组MCV、SCV和NAP水平均高于治疗前,且观察组MCV、SCV和NAP水平均高于对照组(P<0.05)。两组不良事件发生率比较差异无统计学意义(P>0.05)。结论:补阳还五汤加二陈汤化裁方联合针刺治疗肘关节骨关节炎继发轻中度CuTS患者疗效确切,可降低患者IL-1、IL-6、MMP-13水平,缓解疼痛,促进上肢功能恢复,并改善神经电生理,安全性高。Objective:To analyze the influence of modified Buyang Huanwu decoction and Erchen decoction joined with acupuncture on the levels of IL-1,IL-6 and MMP-13,and electrophysiology in patients with mild to moderate cubital tunnel syndrome(CuTS)secondary to elbow osteoarthritis.Methods:All 104 patients were selected as the objects of study,and allocated to the observation group and the control group according to different therapeutic methods,with 52 cases in each group.Both groups accepted the medicine for resisting inflammation and nourishing nerve,the control group was given modified Buyang Huanwu decoction and Erchen decoction,the observation group accepted acupuncture based on the decoction,both groups were treated for four weeks.To compare clinical effects,VAS and DASH scores before and after the treatment,the levels of IL-1,IL-6 and MMP-13,the changes of MCV,SCV and NAP and the incidence of adverse reactions between both groups.Results:The excellence rate of the observation group was[76.92%(42/52)],higher than[73.08%(38/52)]of the control group(P<0.05).After the treatment,the scores of VAS and DASH and the levels of IL-1,IL-6 and MMP-13 of both groups were lower than these before the treatment,and the indexes of the observation group were lower than these of the control group(P<0.05).After the treatment,the levels of MCV,SCV and NAP were higher than these before treatment in both groups,and the levels of MCV,SCV and NAP of the observation group were higher than these of the control group(P<0.05).During therapeutic period,no severe adverse reaction occurred in both groups,and the difference had no statistical meaning in the incidences of adverse reaction(P>0.05).Conclusion:Modified Buyang Huanwu decoction and Erchen decoction joined with acupuncture could obtain definite clinical effects in the treatment of mild to moderate CuTS secondary to elbow osteoarthritis,which could lower the levels of IL-1,IL-6 and MMP-13,relieve pain,promote the functional recovery of upper limb,improve neural electrophysiology with high

关 键 词：骨关节炎 肘关节 针刺 尺神经卡压综合征 白细胞介素1 白细胞介素6 基质金属蛋白酶13 

分 类 号：R684.3[医药卫生—骨科学]