[1]王芹 滕金艳 高锋 金军 姚敏△.温针灸治疗轻中度膝骨关节炎及可能机制探讨[J].中国中医骨伤科杂志,2020,28(12):48-52.
 WANG Qin TENG Jinyan GAO Feng JIN Jun YAO Min.Study on the Efficacy and Possible Mechanism of Warm Acupuncturein Treating Mild and Moderate Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(12):48-52.
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温针灸治疗轻中度膝骨关节炎及可能机制探讨()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年12期
页码:
48-52
栏目:
临床论著
出版日期:
2020-12-15

文章信息/Info

Title:
Study on the Efficacy and Possible Mechanism of Warm Acupuncturein Treating Mild and Moderate Knee Osteoarthritis
文章编号:
1005-0205(2020)12-0048-05
作者:
王芹123 滕金艳123 高锋123 金军123 姚敏123△
1湖北省中医院(武汉,430061)2湖北中医药大学附属医院3湖北省中医药研究院通信作者 E-mail:61469164@qq.com
Author(s):
WANG Qin123 TENG Jinyan123 GAO Feng123 JIN Jun123 YAO Min123△
1Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, China; 2Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan 430061, China; 3Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China.
关键词:
温针灸 膝骨关节炎 关节功能 炎性因子 骨代谢因子
Keywords:
warm acupuncture knee osteoarthritis joint function inflammatory factor bone metabolic factor
分类号:
R684.3
文献标志码:
A
摘要:
目的:探讨温针灸治疗对轻中度膝骨关节炎患者膝关节功能及炎性因子的影响。方法:选取2018年9月至2019年5月30例轻中度膝骨关节炎患者,予温针灸治疗,3次/周,连续5周。比较治疗前后关节疼痛(视觉模拟评分法(VAS))、关节肿胀、关节压痛、骨关节炎指数评分表(WOMAC)、Lysholm膝关节评分、关节活动度、炎性因子(C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白介素1β(IL-1β))、骨代谢因子(Ⅰ型胶原C端异物肽(CTX-Ⅰ)、胰岛素样生长因子(IGF)和睾酮)变化。随访8个月,记录所有患者的VAS、关节肿胀评分和关节压痛评分。结果:与治疗前比,患者治疗后的关节疼痛、关节肿胀、关节压痛评分均显著降低(P<0.05),WOMAC评分明显降低(P<0.05),Lysholm及关节活动度显著提高(P<0.05),血清CRP,TNF-α,IL-1β及膝关节局部皮温水平均降低(P<0.05),血清CTX-Ⅰ降低(P<0.05),IGF及睾酮均增高(P<0.05)。治疗期间均未出现明显的不良反应,随访期间无一例失访,随访时间8个月,VAS、关节肿胀评分和关节压痛评分差异无统计学意义(P>0.05)。结论:温针灸治疗能够明显缓解膝骨关节炎患者的临床症状,改善骨内微循环、造血组织状态,从而改善患者的膝关节功能,且无明显的不良反应,远期疗效较好,可能与降低机体炎性水平和调节骨代谢因子有关。
Abstract:
To study the efficacy and possible mechanism of warm acupuncture in treating mild and moderate knee osteoarthritis(KOA)patients.Methods:30 KOA patients were treated by warm acupuncture for 3 times per week for 5 consecutive weeks from September 2018 to May 2019.The joint pain(visual analogue scale(VAS)), joint swelling, joint tenderness, osteoarthritis index scale(WOMAC), Lysholm knee joint score, joint range of motion, inflammatory factors(C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β)), bone metabolism factor(type Ⅰ collagen C-telopeptide(CTX-Ⅰ), insulin like growth factor(IGF)and testosterone)were compared before and after the treatment.All patients were followed up for 8 months, and the VAS, joint swelling score and joint tenderness score of all patients were documented.Results: Compared with these indexes before treatment, the scores of joint pain, joint swelling, and joint tenderness were significantly reduced(P<0.05), and the WOMAC score was significantly reduced(P<0.05), Lysholm and joint range of motion were significantly increased(P<0.05), serum CRP, TNF-α, IL-1β and local skin temperature of the knee joint were reduced(P<0.05), and serum CTX-Ⅰ was reduced(P<0.05), IGF and testosterone were increased(P<0.05)after treatment.There were no significant adverse reactions during the treatment, and no case was lost during the follow-up period.There was no significant difference in VAS, joint swelling score and joint tenderness score(P>0.05)during the follow-up period of 8 months.Conclusion: Warm acupuncture could improve clinical symptom and knee joint function by adjusting the state of intraosseous microcirculation and hematopoietic tissue, which may involve the regulation of inflammation and bone metabolism factors.The warm acupuncture shows satisfied long-term efficacy without obvious side-effects as well.

参考文献/References:

[1] 徐方琼,于德宁,石立鹏,等.中医药治疗膝骨关节炎研究进展[J].中医临床研究,2018,10(10):140-143.
[2] 孙士全,谭涛.针灸治疗膝骨关节炎的作用机制探讨[J].中国医药导报,2017,14(10):127-130.
[3] SONG G M,TIAN X,JIN Y H, et al.Moxibustion is an alternative in treating knee osteoarthritis:the evidence from systematic review and meta-analysis[J].Medicine(Baltimore), 2016,95(6):e2790.
[4] MACPHERSON H, VERTOSICK E A, FOSTER N E, et al.The persistence of the effects of acupuncture after a course of treatment:a meta-analysis of patients with chronic pain[J].Pain, 2017,158(5):784-793.
[5] LIU S R, QIU J Q, ZHANG L Y.Warming acupuncture combined with moxibustion at Yongquan(KI 1)for knee osteoarthritis with kidney-marrow deficiency:a randomized controlled trial[J].Chinese Acupuncture,2019,39(8):799-803.
[6] 肖平,周钢.局部肌肉振动联合氨糖软骨素钙片对膝骨关节炎患者关节功能的影响[J].中国医药,2020,15(6):923-926.
[7] 赵岩,武虎.美沙拉嗪联合温针灸治疗溃疡性结肠炎疗效及对肠黏膜组织炎症因子及Th17、Th22亚群的影响[J].现代中西医结合杂志,2020,29(1):55-59.
[8] 中华医学会骨科医学会.骨关节炎诊治指南(2007年版)[J].中华关节外科杂志,2007,1(4):281-285.
[9] 国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:349-353.
[10] 沈金明,封蕾,陈杰,等.温针灸联合非甾体类消炎药治疗膝骨关节炎的临床研究[J].湖南中医药大学学报,2017,37(9):1008-1012.
[11] LUZ-SANTOS C, RIBEIRO CAMATTI J, BARBOSA PAIXAO A, et al.Additive effect of tDCS combined with peripheral electrical stimulation to an exercise program in pain control in knee osteoarthritis:study protocol for a randomized controlled trial[J].Trials, 2017,18(1):609.
[12] 梁超,崔家铭,徐斌.温针灸配合新型膝关节艾灸箱治疗膝骨关节炎的临床研究[J].中华中医药杂志,2016,31(8):3344-3347.
[13] 徐琛,高亚南,杨华升.温针灸配合耳穴贴压及药物治疗膝骨关节炎的疗效观察[J].上海针灸杂志,2018,37(11):1286-1290.
[14] 唐琼.针灸治疗骨关节炎的临床效果分析[J].现代诊断与治疗,2018,29(17):2711-2712.
[15] SILVINATO A, BERNARDO W M.Inflammatory arthritis or osteoarthritis of the knee-efficacy of intra-joint infiltration of methylprednisolone acetate versus triamcinolone acetonide or triamcinolone hexacetonide[J].Rev Assoc Med Bras(1992),2017,63(10):827-836.
[16] 安军伟,吴海波,张继伟,等.温针灸和电针治疗膝骨关节炎的临床概况[J].中医药临床杂志,2016,28(9):1345-1347.
[17] 王晓玲,王芗斌,侯美金,等.温针灸治疗膝骨关节炎:随机对照研究[J].中国针灸,2017,37(5):457-462.
[18] 李素丹.温针灸结合康复训练治疗膝骨关节炎的远期疗效及对患者VAS评分的影响[J].中国医药科学,2019,9(24):52-54.
[19] 赵鲜艳.温针灸结合康复训练治疗膝骨关节炎远期疗效观察[J].淮海医药,2018,36(2):165-167.
[20] 封百玉,侯书伟.温针灸治疗膝骨关节炎的临床研究[J].湖北中医药大学学报,2015,17(1):83-84.
[21] FU J,SHANG H C,WANG L Y, et al.Crossbow needle therapy of the Miao ethnic minority group for knee osteoarthritis:study protocol for a randomized controlled trial[J].Trials, 2018,19(1):338.
[22] 龚利,邵盛,李建华,等.名老中医手法治疗膝骨关节炎的经验荟萃[J].中国中医骨伤科杂志,2017,25(1):66-68.
[23] MALHOTRA R, JAIN V, KUMAR V, et al.Evaluation of running knotless barbed suture for capsular closure in primary total knee arthroplasty for osteoarthritis-a prospective randomized study[J].Int Orthop, 2017,41(10):2061-2066.
[24] 孙宁,李永婷,林璐璐,等.不同针灸疗法治疗膝骨关节炎的比较与分析[J].中华中医药杂志,2017,32(7):3253-3255.
[25] 张其镇,苗雨,王大力,等.独活寄生汤配合温针灸治疗风寒湿痹型膝骨关节炎患者的疗效及对血清疼痛介质、炎症介质、白三烯的影响[J].中国实验方剂学杂志,2018,24(18):153-158.
[26] 张利达,王帆竞,汪珍,等.近5年针刺治疗膝骨关节炎的临床应用与机制研究[J].山西中医学院学报,2017,18(2):76-79.
[27] 李丽文.温针灸与推拿联合治疗膝关节骨性关节炎的疗效研究[J].名医,2020(5):24-27.
[28] 杨永光.补肾活血通络方结合温针灸治疗膝关节骨性关节炎临床观察[J].实用中医药杂志,2020,36(2):152-153.
[29] 苏丹萍,宋玉娟,王雪冰,等.“双固一通”温针灸治疗膝骨性关节炎疗效观察及对血清炎性因子表达的影响[J].山东中医杂志,2020,39(4):378-381.
[30] 聂雯雯.补肾调经汤联合温针灸治疗多囊卵巢综合征的效果及对患者性激素水平的影响[J].中国民康医学,2020,32(8):94-95.

更新日期/Last Update: 2020-12-15