弹拨牵引松解三部平衡法联合塞来昔布对膝骨关节炎患者膝关节功能及基质金属蛋白酶3、转化生长因子β_(1)、内皮素-1的影响  

Effects of plucking traction release three-part balance method combined with celecoxib on knee joint function,matrix metalloproteinases 3,transforming growth factor beta 1,endothelin-1 in patients with knee osteoarthritis

作　　者：傅聪 郭运岭 佟成成 李蕊[3] 王雷 FU Cong;GUO Yunling;TONG Chengcheng;LI Rui;WANG Lei(Second Department of Orthopedics,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066003;Department of Endocrinology,Peking University Third Hospital Qinhuangdao Hospital,Qinhuangdao,Hebei 066001;Department of Traditional Chinese Medicine Rehabilitation,First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066099)

机构地区：[1]河北省秦皇岛市中医医院骨伤二科,河北秦皇岛066003 [2]北京大学第三医院秦皇岛医院内分泌科,河北秦皇岛066001 [3]河北省秦皇岛市第一医院中医康复科,河北秦皇岛066099

出　　处：《河北中医》2023年第9期1530-1534,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2020年度中医药类科研计划项目(编号:2020373)。

摘　　要：目的观察弹拨牵引松解三部平衡法联合塞来昔布治疗膝骨关节炎(KOA)的临床疗效。方法将72例KOA患者按照随机数字表法分为2组。对照组36例予塞来昔布治疗,治疗组36例在对照组治疗基础上加弹拨牵引松解三部平衡法治疗,2组疗程均为4周。比较2组临床疗效及不良反应,比较2组治疗前后疼痛视觉模拟评分(VAS)、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分(以下简称为WOMAC评分)、膝关节活动度、Lysholm膝关节评分及基质金属蛋白酶3(MMP-3)、转化生长因子β_(1)(TGF-β_(1))、内皮素-1(ET-1)水平。结果治疗后,2组疼痛VAS、WOMAC评分均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,2组膝关节活动度、Lysholm膝关节评分均较本组治疗前增加(P<0.05),且治疗组均高于对照组(P<0.05)。治疗后,2组MMP-3、ET-1水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,2组TGF-β_(1)水平均较本组治疗前升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗组总有效率91.7%(33/36),对照组总有效率75.0%(27/36),治疗组总有效率高于对照组(P<0.05)。2组均未见不良反应。结论弹拨牵引松解三部平衡法联合塞来昔布可提高KOA患者的治疗效果,缓解疼痛,抑制炎症反应,改善血管内皮损伤和膝关节功能,安全性高,值得临床推广。Objective To observe the clinical efficacy of plucking traction release three-part balance method combined with celecoxib on knee osteoarthritis(KOA).Methods A total of 72 KOA patients were randomly assigned into the treatment group(n=36)and the control group(n=36).All patients were managed by celecoxib,and those in the treatment group were additionally treated with plucking traction release three-part balance method.Treated for 4 weeks,aiming to compare visual analogue scale(VAS)for pain,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),knee joint activity,Lysholm knee score,matrix metalloproteinases 3(MMP-3),transforming growth factor beta 1(TGF-β1),endothelin-1(ET-1).The curative effect and adverse reaction were assessed.Results After treatment,the scores of VAS and WOMAC in groups were decreased(P<0.05),which decreased in the treatment group compared with the control group(P<0.05).The knee joint activity and Lysholm knee score in groups were increased(P<0.05),which were increased in the treatment group than in the control group(P<0.05).MMP-3 and ET-1 in groups were decreased(P<0.05),the decrease in the treatment group was more prevalent(P<0.05).TGF-β1 in groups was increased(P<0.05),the treatment group was more common(P<0.05).The overall effective rate in the treatment group was better than that in the control group(91.7%[33/36]vs 75.0%[27/36],[P<0.05],respectively).No adverse reaction in the two groups was found.Conclusion For KOA patients,plucking traction release three-part balance method combined with celecoxib can improve the therapeutic effect,relieve pain,inhibit inflammatory response,improve vascular endothelial injury and knee joint function,with high safety.It is worthy of clinical promotion.

关 键 词：骨关节炎 膝 穴位弹拨疗法 牵引术 针刀疗法 塞来昔布 基质金属蛋白酶3 转化生长因子β_(1) 

分 类 号：R684.305[医药卫生—骨科学] R244.1[医药卫生—外科学]