针药结合治疗膝骨关节炎的疗效及对血清炎症疼痛介质的影响  

Effect of Acupuncture Combined with Traditional Chinese Medicine Decoction in Treatment of Knee Osteoarthritis and Its Effect on Serum Inflammatory Pain Mediators

作　　者：刘艳伟[1] 沈健 于瑞杰[1] 孟爱霞 LIU Yanwei;SHEN Jian;YU Ruijie;MENG Aixia(Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《中华中医药学刊》2025年第2期216-219,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省中医药类科研计划项目(2021203)。

摘　　要：目的研究针灸联合中药汤剂治疗膝骨关节炎的疗效及对血清炎症疼痛介质的影响。方法将2020年8月—2022年1月承德医学院附属医院膝骨关节炎80例患者作为研究对象,根据随机数字表法均分为两组,对照组40例、治疗组40例。对照组单纯应用火针治疗,治疗组应用火针联合中药汤剂治疗。治疗8周后,比较两组患者疗效,炎症因子白介素-1(Interleukin-1,IL-1)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平,膝关节疼痛及活动度,骨关节炎指数,不良反应情况。结果治疗组总有效率为97.50%(39/40)显著高于对照组(80.00%,32/40),差异有统计学意义(P<0.05)。治疗前,两组患者炎症因子IL-1、IL-6、TNF-α水平差异无统计学意义(P>0.05),治疗后,两组患者炎症因子IL-1、IL-6、TNF-α水平均显著下降(P<0.001),并且治疗组炎症因子IL-1、IL-6、TNF-α水平显著低于对照组(P<0.001)。治疗前两组膝关节疼痛视觉模拟评分(visual analogue scale,VAS)、主动活动及被动活动度差异均无统计学意义(P>0.05),治疗后,两组患者VAS评分显著降低、主动活动及被动活动度显著增加(P<0.001),并且治疗组VAS评分、主动活动及被动活动度显著优于对照组(P<0.05)。治疗前两组西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)评分差异无统计学意义(P>0.05),治疗后,两组患者WOMAC评分显著下降(P<0.001),并且治疗组WOMAC评分显著低于对照组(P<0.05)。治疗组、对照组不良反应发生率分别为7.50%(3/40)、10.00%(4/40),差异无统计学意义(P>0.05)。结论针灸联合中药汤剂治疗膝骨关节炎的疗效显著,能够降低炎症因子水平,更好地缓解患者膝关节疼痛、增加膝关节活动度,从而改善膝关节状况,具有良好的应用价值。Objective To study the effect of acupuncture combined with traditional Chinese medicine decoction on knee osteoarthritis and its effect on serum inflammatory pain mediators.Methods From August 2020 to January 2022,80 patients with knee osteoarthritis in the Affiliated Hospital of Chengde Medical College were divided into two groups according to the random number table method,40 cases in the control group and 40 cases in the observation group.The control group was treated with fire acupuncture alone,and the treatment group was treated with acupuncture combined with traditional Chinese medicine decoction.After 8 weeks of treatment,the efficacy,the levels of inflammatory factors interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),knee joint pain and activity,osteoarthritis index and adverse reactions were compared between the two groups.Results The total effective rate of the treatment group was 97.50%(39/40),which was significantly higher than that of the control group(80.00%,32/40),and the difference was statistically significant(P<0.05).After treatment,the levels of inflammatory factors(IL-1,IL-6,TNF-α)in the two groups were significantly decreased(P<0.001),and the levels in the treatment group were significantly lower than those in the control group(P<0.001).Before treatment,there was no significant difference in visual analogue scale(VAS),active activity and passive activity between the two groups(P>0.05).After treatment,the VAS scores of the two groups were significantly decreased,and the active activity and passive activity were significantly increased(P<0.001).The VAS scores,active activity and passive activity of the treatment group were significantly better than those of the control group(P<0.05).There was no significant difference in Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores between the two groups before treatment(P>0.05).After treatment,the WOMAC scores of the two groups decreased significantly(P<0.001),and the WOMAC score of the treatment group

关 键 词：膝骨关节炎 针灸 中药 汤剂 炎症因子 疗效 不良反应 

分 类 号：R246.2[医药卫生—针灸推拿学] R274.984.3[医药卫生—中医临床基础]