膝三针温针灸配合微波照射治疗KOA的疗效及对微循环、血管炎症的影响  

Effect of knee three needles warming acupuncture and moxibustion combined with microwave irradiation in treating knee osteoarthritis and its influence on microcirculation and vascular inflammation

作　　者：李聪 万玉[1] 王梦[1] 乔昱音 储小宁 王婵[1] LI Cong;WAN Yu;WANG Meng;QIAO Yuyin;CHU Xiaoning;WANG Chan(Department of Hydrotherapy and Physiotherapy,Shiyan Municipal Taihe Hospital,Shiyan,Hubei 442000,China)

机构地区：[1]湖北省十堰市太和医院水疗理疗科,湖北十堰442000

出　　处：《检验医学与临床》2024年第12期1790-1794,1800,共6页Laboratory Medicine and Clinic

基　　金：湖北省十堰市太和医院科研项目(21Y37)。

摘　　要：目的探讨膝三针温针灸配合微波照射治疗膝关节骨性关节炎(KOA)的疗效及对微循环、血管炎症的影响。方法将2021年1月至2022年3月该院收治的104例KOA患者按随机数字表法分为观察组和对照组,每组52例。对照组采用微波照射治疗,观察组在其基础上联合膝三针温针灸治疗。比较两组治疗疗效、膝关节功能[采用Lysholm-Ⅱ量表(Lysholm得分)进行评估]、不良反应,治疗前后血清骨代谢[Ⅰ型胶原C-末端肽(CTX-Ⅰ)、软骨寡聚基质蛋白(COMP)、基质金属蛋白酶-3(MMP-3)]、炎症指标[白细胞介素-7R(IL-7R)、白细胞介素-1β(IL-1β)、Toll样受体4(TLR4)、核因子-κB p65(NF-κB p65)]以及患侧腿股内侧肌微循环指标[血细胞浓度(CMBC)、微血管血流灌注量(MBP)、血细胞平均运动速度(AVBC)增加率]变化。结果观察组治疗总有效率为86.54%,高于对照组的69.23%(P<0.05)。重复测量方差分析结果显示,两组Lysholm得分存在时间效应、组间效应及交互效应(P<0.001),故进一步做单独效应分析。单因素重复测量方差分析结果显示,观察组与对照组不同时间点Lysholm得分比较,差异均有统计学意义(F=178.205、150.612,P<0.001)。两组Lysholm得分均表现为治疗前<治疗后2周<治疗后4周<治疗后6周,且任意两个时间比较,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,观察组治疗后2周、4周、6周Lysholm得分均高于对照组(F=10.500、13.252、18.120,P<0.001)。治疗后,两组血清COMP、MMP-3及CTX-Ⅰ水平均较治疗前降低(P<0.05);且治疗后观察组血清COMP、MMP-3及CTX-Ⅰ水平低于对照组(P<0.05)。治疗后,两组血清TLR4、NF-κB p65、IL-1β水平均较治疗前降低(P<0.05),IL-7R水平较治疗前升高(P<0.05);且治疗后观察组血清TLR4、NF-κB p65、IL-1β水平低于对照组(P<0.05),IL-7R水平高于对照组(P<0.05)。治疗后,两组MBP、CMBC增加率均较治疗前升高(P<0.05),AVBC增加率与治疗前比较,差Objective To explore the effect of knee three needles warming acupuncture and moxibustion combined with microwave irradiation in treating knee osteoarthritis(KOA)and its influence on microcirculation and vascular inflammation.Methods A total of 104 patients with KOA admitted and treated in this hospital from January 2021 to March 2022 were divided into the observation group and control group according to the random number table method,52 cases in each group.The control group was treated by microwave irradiation,while the observation group was treated by combined with knee three needles warming acupuncture and moxibustion on the basis of the control group.The therapeutic efficacy,knee joint function(Lysholm score),adverse reactions,serum bone metabolism before and after treatment[typeⅠcollagen C-terminal peptide(CTX-Ⅰ),cartilage oligomeric matrix protein(COMP),matrix metalloproteinase-3(MMP-3)],inflammatory indexes[interleukin-7R(IL-7R),interleukin-1β(IL-1β),Toll like receptor 4(TLR4),nuclear factor-κB p65(NF-κB p65)]and microcirculation indexes of medial femoris muscle of lateral leg[blood cell concentration(CMBC),microvascular blood perfusion volume(MBP)and average blood cell velocity(AVBC)increase rate]before and after treatment were compared between the two groups.Results The total effective rate in the observation group was 86.54%,which was higher than 69.23%in the control group(P<0.05).The repeated measures analysis of variance showed that there were the time effects,inter-group effects and interaction effects(P<0.001)in the Lysholm scores of the two groups,therefore the separate effect analysis was further performed.The univariate repeated measures analysis of variance showed that the differences of Lysholm scores in the the observation group and the control group among different time points were statistically significant(F=178.205,150.612,P<0.001).The Lysholm scores of the two groups before treatment<2 weeks after treatment<4 weeks after treatment<6 weeks after treatment,and the difference was stat

关 键 词：膝关节骨性关节炎 膝三针温针灸 微波照射 微循环 血管炎症 骨代谢 

分 类 号：R245.8[医药卫生—针灸推拿学] R446.11[医药卫生—中医临床基础]