补肾活血通络针刺法联合中药熏洗疗法治疗肝肾亏虚型膝骨关节炎临床观察  

Clinical Effect of Kidney-tonifying,Blood-activating,and Collateral-dredging Acupuncture Combined with Traditional Chinese Medicine Fumigation and Washing in Treatment of Knee Osteoarthritis with Deficiency of Liver and Kidney

作　　者：李仁重 吴三兵[1] 孙奎[1] 张昊 林永艳 臧乃丰 钟志伟 俞世亮 LI Renzhong;WU Sanbing;SUN Kui;ZHANG Hao;LIN Yongyan;ZANG Naifeng;ZHONG Zhiwei;YU Shiliang(Second Department of Orthopedics,The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第二附属医院骨二科,安徽合肥230061 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《安徽中医药大学学报》2023年第6期45-49,共5页Journal of Anhui University of Chinese Medicine

基　　金：国家重大疾病治疗重点专科针灸科项目(皖财社[2022]622号);安徽省省级临床重点专科中医骨伤科项目(卫科教秘[2017]529号)。

摘　　要：目的 观察补肾活血通络针刺法联合中药熏洗疗法治疗老年性膝骨关节炎(knee osteoarthritis, KOA)的临床疗效。方法 将76例KOA患者按照随机数字表法分为对照组和观察组,每组38例;对照组采用西医常规治疗,观察组在对照组治疗基础上采用补肾活血通络针刺法联合中药熏洗疗法治疗;观察两组患者治疗前后视觉模拟量表(visual analogue scale, VAS)评分,西安大略和麦克马斯特大学骨关节炎指数(the Western Ontario and McMaster University osteoarthritis index, WOMAC),Lequesne MG评分,关节液白细胞介素(interleukin, IL)-1β、IL-6、肿瘤坏死因子(tumor necrosis factor, TNF)-α水平,血清环氧化酶-2(cyclooxygenase-2,COX-2)、基质金属蛋白酶-3(matrix metalloproteinase-3,MMP-3)水平的变化情况及临床疗效。结果 两组患者治疗后VAS评分、WOMAC、Lequesne MG评分均较治疗前显著降低(P<0.05),且观察组降低程度较对照组更显著(P<0.05)。两组患者治疗后关节液IL-1β、TNF-α、IL-6水平,血清COX-2、MMP-3水平均较治疗前显著降低(P<0.05),且观察组降低程度较对照组更显著(P<0.05)。观察组疗效优于对照组(P<0.05)。结论 补肾活血通络针刺法联合中药熏洗疗法可显著改善KOA患者临床症状,减轻疼痛,改善膝关节功能。Objective To investigate the clinical effect of kidney-tonifying,blood-activating,and collateral-dredging acupuncture combined with traditional Chinese medicine(TCM)fumigation and washing in the treatment of knee osteoarthritis(KOA)with deficiency of liver and kidney.Methods A total of 76 patients with KOA were divided into control group and observation group using the random number table method,with 38 patients in each group.The patients in the control group received conventional Western medicine treatment,and those in the observation group received kidney-tonifying,blood-activating,and collateral-dredging acupuncture combined with TCM fumigation and washing.The two groups were observed in terms of clinical outcome and the changes in visual analogue scale(VAS)score,Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score,Lequesne MG score,the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)in synovial fluid,and the serum levels of cyclooxygenase-2(COX-2)and matrix metalloproteinase-3(MMP-3)after treatment.Results After treatment,both groups had significant reductions in VAS score,WOMAC score,and Lequesne MG score(P<0.05),and the observation group had significantly greater reductions than the control group(P<0.05).After treatment,both groups had significant reductions in the levels of IL-1β,TNF-α,and IL-6 in synovial fluid and the serum levels of COX-2 and MMP-3(P<0.05),and the observation group had significantly greater reductions than the control group(P<0.05).The observation group had a significantly better clinical outcome than the control group(P<0.05).Conclusion Kidney-tonifying,blood-activating,and collateral-dredging acupuncture combined with TCM fumigation and washing can significantly improve clinical symptoms,alleviate pain,and improve knee function in patients with KOA.

关 键 词：补肾活血通络法 针刺 中药熏洗疗法 膝骨关节炎 

分 类 号：R593.21[医药卫生—内科学]