毫火针联合TDP治疗膝骨关节炎的疗效观察  

Efficacy observation of filiform fire needling plus TDP for knee osteoarthritis

作　　者：王雪[1] 曲一诺 谭奇纹[1] WANG Xue;QU Yinuo;TAN Qiwen(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;The Affiliated Hospital of Shandong University of TCM,Jinan 250014,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学附属医院,济南250014

出　　处：《上海针灸杂志》2024年第11期1177-1183,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：山东省中医药科技项目(Q-2022069)。

摘　　要：目的观察毫火针联合电磁波(electromagnetic waves,TDP)治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法将141例膝骨关节炎随机分为针刺组、电针组和毫火针组,每组47例。针刺组采用针刺治疗,电针组采用电针治疗,毫火针组采用毫火针点刺治疗,3组均联合TDP治疗。比较3组治疗前后数字评定量表(numerical rating scale,NRS)、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster University osteoarthritis index,WOMAC)、中医证候积分以及血清炎症指标[C反应蛋白(C-reactive protein,CRP),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1(interleukin-1,IL-1)和红细胞沉积率(erythrocytesedimentationrate,ESR)]水平,骨关节功能恢复指标[基质金属蛋白酶-3(matrix metalloproteinase-3,MMP-3)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinases-1,TIMP-1)和MMP-9/TIMP-1]水平,并比较3组的临床疗效。结果治疗后,3组NRS评分、WOMAC总分和中医证候积分低于治疗前(P<0.05),毫火针组NRS评分和WOMAC总分低于电针组和针刺组(P<0.05),电针组NRS评分和WOMAC总分低于针刺组(P<0.05),毫火针组中医证候积分低于电针组及针刺组(P<0.05)。治疗后,3组血清CRP、IL-1、TNF-α和ESR水平低于治疗前(P<0.05),毫火针组血清CRP、IL-1、TNF-α和ESR水平低于电针组和针刺组(P<0.05),电针组血清CRP、IL-1、TNF-α和ESR水平低于针刺组(P<0.05)。治疗后,3组血清MMP-3、MMP-9、TIMP-1水平和MMP-9/TIMP-1低于治疗前(P<0.05),毫火针组血清MMP-3、MMP-9和TIMP-1水平低于电针组和针刺组(P<0.05),电针组血清MMP-3、MMP-9和TIMP-1水平低于针刺组(P<0.05),毫火针组MMP-9/TIMP-1水平低于针刺组和电针组(P<0.05)。毫火针组总有效率高于电针组和针刺组,差异有统计学意义(P<0.05)。结论相较于针刺和电针治疗,毫火针联合TDP治疗KOA的效果更好。Objective To observe the clinical efficacy of filiform fire needling plus specific electromagnetic waves(TDP)in treating knee osteoarthritis(KOA).Method A total of 141 KOA patients were randomized into an acupuncture group,an electroacupuncture group,and a filiform fire needling group,with 47 cases in each group.The acupuncture group received acupuncture treatment,the electroacupuncture group received electroacupuncture treatment,and the filiform fire needling group was offered filiform fire needling treatment.TDP was given to all three groups.Before and after the treatment,the numerical rating scale(NRS)score,Western Ontario and McMaster Universities osteoarthritis index(WOMAC),symptom score of traditional Chinese medicine(TCM),serum inflammatory indicator levels[C-reactive protein(CRP),tumor necrosis factor-a(TNF-a),interleukin-1(IL-1),and erythrocyte sedimentation rate(ESR)],and joint function recovery indexes[matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinases-1(TIMP-1),and MMP-9/TIMP-1]were compared.The clinical efficacy was also compared among the three groups.Result After the treatment,the NRS,WOMAC total and TCM symptom score dropped in the three groups(P<0.05),the NRS and WOMAC total scores were lower in the filiform fire needling group than in the other two groups and were lower in the electroacupuncture group than in the acupuncture group(P<0.05),and the TCM symptom score was lower in the filiform fire needling group than in the other two groups(P<0.05).After the treatment,the serum levels of CRP,IL-1,TNF-a,and ESR dropped in the three groups(P<0.05),the serum levels of CRP,IL-1,TNF-a,and ESR were lower in the filiform fire needling group than in the other two groups(P<0.05)and were lower in the electroacupuncture group than in the acupuncture group(P<0.05).After the treatment,the serum levels of MMP-3,MMP-9,TIMP-1 and MMP-9/TIMP-1 dropped in the three groups(P<0.05),the serum levels of MMP-3,MMP-9 and TIMP-1 were lower in the filiform fire needlin

关 键 词：针刺疗法 电针 火针疗法 TDP 骨关节炎 膝 

分 类 号：R246.2[医药卫生—针灸推拿学]