温泉泡浴联合电针推拿治疗早中期膝骨关节炎的临床疗效研究  

Clinical efficacy of hot spring bathing combined with electroacupuncture and massage in treating early-middle-stage knee osteoarthritis

作　　者：郑小华 谭凤华[1,2] 段智飞 任群峰 杨萍[1,3] 胡政 ZHENG Xiao-hua;TAN Feng-hua;DUAN Zhi-fei;REN Qun-feng;YANG Ping;HU Zheng

机构地区：[1]湘南学院第一临床学院,郴州市第一人民医院,湖南郴州423000 [2]郴州市第一人民医院,转化医学研究所,湖南郴州423000 [3]郴州市第一人民医院康复医院,湖南郴州423000

出　　处：《中国疗养医学》2025年第5期19-23,共5页Chinese Journal of Convalescent Medicine

基　　金：郴州市国家可持续发展议程创新示范区建设专项(2019sfq04)。

摘　　要：目的探讨郴州地区温泉泡浴联合电针推拿对早中期中老年性膝骨关节炎患者临床疗效以及复发率。方法选取2021年11月至2024年5月郴州市第一人民医院收治的180例早中期膝骨关节炎患者作为研究对象,按照随机数字表分成三组:A组(口服艾瑞昔布+氨基葡萄糖胶囊)、B组(电针结合推拿)、C组(电针推拿+温泉泡浴),每组60例。对纳入研究的患者,分别于治疗前、治疗3周、随访1个月时评估患者疼痛程度与关节功能,并在前2个时间点通过多重微球流式免疫荧光发光法检测血清炎症因子水平。结果治疗前,三组患者视觉模拟评分(VAS)、西安大略和麦克马斯特大学(WOMAC)量表评分和炎症因子包括肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β以及IL-6水平差异无统计学意义(P>0.05)。治疗3周后,三组患者VAS评分较治疗前显著降低(P<0.05),随访时,B、C组VAS评分与治疗前相比显著降低(P<0.05)。治疗3周后,B、C组患者WOMAC量表评分较治疗前均显著降低(P<0.05),而A组评分差异无统计学意义;随访时,与治疗前相比,三组都显著降低,且C组<B组<A组,差异有统计学意义(P<0.05)。治疗3周时,3组患者血清炎症因子均较治疗前显著降低(P<0.05);B、C两组三种炎症因子水平与A组相比显著降低,且C组IL-1β和IL-6水平与B组相比差异有统计学意义(P<0.05)。三组复发率,A组>B组>C组,差异有统计学意义(P<0.05)。结论温泉泡浴联合电针推拿治疗膝骨关节炎,可有效缓解疼痛,改善关节功能,降低炎症因子的表达,且可以降低复发率。Objective To investigate the clinical efficacy and recurrent rate of hot spring bathing combined with electroacupuncture and massage in treating middle-aged and older adults with early-middle-stage knee osteoarthritis(KOA)in Chenzhou.Methods A total of 180 patients with early-stage and middle-stage KOA treated in The First People's Hospital of Chenzhou from November 2021 to May 2024,were randomly divided into three groups using the random number table:group A(oral imrecoxib+aminoglucose capsules),group B(electroacupuncture+massage),and group C(electroacupuncture+massage+hot spring bathing),with 60 patients in each group.Pain levels and joint function were assessed before treatment,3 weeks after treatment,and 1 month of follow-up.Serum inflammatory cytokine levels were measured before treatment and 3 weeks after treatment using multiplex microsphere flow immunofluorescence.Results Before treatment,there were no significant differences in the visual analogue scale(VAS)scores,the Western Ontario and McMaster Universities Arthritis Index(WOMAC),and TNF-α,IL-1β,and IL-6 levels among the three groups(P>0.05).After 3 weeks of treatment,the VAS scores significantly decreased in all groups(P<0.05).At the follow-up,the VAS scores in group B and group C significantly decreased compared to those before treatment(P<0.05).After 3 weeks of treatment,the WOMAC scores significantly decreased in group B and group C than those before treatment(P<0.05),but similar in group A.At the follow-up,the WOMAC scores significantly decreased in all groups,and the most pronounced reduction was observed in group C,followed by group B and group A(P<0.05).Inflammatory cytokine levels significantly decreased in all groups after 3 weeks of treatment(P<0.05),and the reductions were significantly pronounced in group B and group C than group A.There were significant differences in IL-1βand IL-6 levels at 3 weeks of treatment between group C and group B(P<0.05).Recurrent rate was significantly higher in group A,followed by group B and group C(P<0.05

关 键 词：温泉浴 电针 推拿 膝骨关节炎 

分 类 号：R684.3[医药卫生—骨科学]