经皮神经电刺激联合通络祛痹膏外敷对膝骨性关节炎疗效及关节滑液免疫细胞的影响  

Clinical Effects of Transcutaneous Electrical Nerve Stimulation and Collateral-dredging Arthralgia-removing Ointment for External Application in the Treatment of Knee Osteoarthritis and Its Influence on Synovial Immune Cells

作　　者：陈转艮 陈志[1] 廖敦[1] CHEN Zhuan′gen;CHEN Zhi;LIAO Dun(Dongguan People′s Hospital,Dongguan 523059,China)

机构地区：[1]东莞市人民医院,广东东莞523059

出　　处：《西部中医药》2024年第8期148-152,共5页Western Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20221413)。

摘　　要：目的:探究经皮神经电刺激(transcutaneous electrical nerve stimulation,TENS)联合通络祛痹膏外敷治疗膝骨性关节炎(knee osteoarthritis,KOA)疗效及对关节滑液免疫细胞和膝关节功能的影响。方法:将KOA患者60例按随机数字表法分为对照组A、对照组B及观察组各20例。对照组A予TENS治疗,对照组B予通络祛痹膏外敷+扶他林治疗,观察组予通络祛痹膏外敷+TENS治疗,各组均治疗6周。比较3组患者治疗前后关节滑液中白细胞介素1(interleukin-1,IL-1)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、干扰素γ(interferon-γ,IFN-v)、一氧化氮(nitric oxide,NO)、超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malondialdehyde,MDA)的表达水平,并采用疼痛视觉模拟量表(visual analogue score,VAS)评分和膝关节康复量表(lysholm knee score scale,LKSS)评分评估膝关节恢复情况。结果:治疗后观察组VAS评分低于对照组A及对照组B(P<0.05),LKSS评分高于对照组A及对照组B(P<0.05);治疗后观察组IL-1、IL-6、TNF-α、IFN-γ表达水平均降低,与对照组A及对照组B比较,差异有统计学意义(P<0.05);治疗后观察组NO、MDA表达水平降低,SOD表达水平升高,与对照组A及对照组B比较,差异有统计学意义(P<0.05)。结论:TENS联合通络祛痹膏治疗KOA疗效明显,止痛效果显著,能有效减轻患者关节炎症及氧化应激反应。Objective:To explore curative effects of transcutaneous electrical nerve stimulation(TENS)and collateral-dredging arthralgia-removing ointment for external application in the treatment of knee osteoarthritis and its influence on synovial immune cells and knee function.Methods:Sixty KOA patients were divided into the control group A,the control group B and the observation group with 20 cases in each group according to random number table method,the control group A was treated by TENS,the control group B by external use of collateraldredging arthralgia-removing ointment+diclofenac sodium enteric-coated tablets,and the observation group by external use of collateral-dredging arthralgia-removing ointment+TENS,all the groups were treated for six weeks.To compare the expressions of IL-1,IL-6,TNF-α,IFN-γ,NO,SOD and MDA before and after the treatment in the three groups,VAS and LKSS were applied to assess the recovery conditions of knee joint.Results:After the treatment,VAS scores of the observation group were lower than these of the control group A and the control group B(P<0.05),LKSS scores higher than these of the control group A and the control group B(P<0.05);after the treatment,the levels of IL-1,IL-6,TNF-α,IFN-γwere lowered in the observation group,the difference had statistical meaning when compared with the control group A and the control group B(P<0.05);after the treatment,the expressions of NO and MDA were lowered,while the levels of SOD were increased in the observation group,the difference had statistical meaning when compared with the control group A and the control group B(P<0.05).Conclusion:TENS and collateral-dredging arthralgia-removing ointment are effective in the treatment of knee osteoarthritis eivdently,and could effectively relieve joint inflammation and oxidative stress response with noticeable effects of relieving pain.

关 键 词：骨性关节炎 膝 经皮神经电刺激 通络祛痹膏 扶他林 炎症因子 

分 类 号：R274.9[医药卫生—中西医结合]