摘要
【目的】观察温针灸联合子午流注针法治疗膝骨性关节炎的临床疗效。【方法】将126例膝骨性关节炎患者随机分为治疗组和对照组,每组各63例。对照组给予膝关节温针灸治疗,治疗组给予温针灸联合子午流注针法治疗,7 d为1个疗程,连续治疗3个疗程。治疗3周后,评价2组临床疗效,观察2组患者治疗前后视觉模拟量表(VAS)评分的变化情况,以及西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分的情况。比较2组患者治疗前后血清环氧化酶2(COX-2)、基质金属蛋白酶3(MMP-3)水平的变化情况。【结果】(1)研究过程中,治疗组失访4例,对照组失访3例。最终治疗组59例、对照组60例纳入疗效统计。(2)治疗组总有效率为94.91%(56/59),对照组为81.67%(49/60),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的VAS评分明显改善(P<0.05),且治疗组在改善VAS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的膝关节疼痛评分、僵硬评分、日常生活难度评分方面均明显改善(P<0.05),且治疗组在改善膝关节疼痛评分与日常生活难度评分方面明显优于对照组,差异有统计学意义(P<0.05)。治疗组患者的僵硬评分稍优于对照组,但与对照组比较,差异无统计学意义(P>0.05)。(5)治疗后,2组患者的血清COX-2、MMP-3水平均明显改善(P<0.05),且治疗组在改善血清COX-2、MMP-3水平方面明显优于对照组,差异均有统计学意义(P<0.05)。【结论】温针灸联合子午流注针法治疗膝骨性关节炎,能有效降低血清COX-2及MMP-3水平,缓解患者的疼痛症状,降低细胞外基质的降解,疗效显著。
Objective To observe the clinical efficacy of warm-needle moxibustion combined with midnight-noon ebb-flow acupuncture therapy on knee osteoarthritis(KOA).Methods A total of 126 patients with KOA were randomly divided into treatment group and control group,with 63 cases in each group.The control group was treated with warm-needle moxibustion,while the treatment group was treated with warm-needle moxibustion combined with midnight-noon ebb-flow acupuncture therapy,7 days as a course of treatment and the treatment lasted for 3 continuous courses.After 3 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Visual Analogue Scale(VAS)scores and Western Ontario and Mcmaster Universityies Osteoarthritis Index(WOMAC)were observed before and after treatment.The changes of serum cyclooxygenase 2(COX-2)and matrix metalloproteinase 3(MMP-3)levels in two groups were compared before and after treatment.Results(1)During the study,4 cases in the treatment group and 3 cases in the control group were lost to followup.Finally,59 cases in the treatment group and 60 cases in the control group were included in the efficacy statistics.(2)The overall effective rate was 94.91%(56/59)in the treatment group and 81.67%(49/60)in the control group,and the efficacy of the treatment group was superior to that of the control group,the difference being statistically significant(P<0.05).(3)After treatment,the VAS scores of the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving VAS scores,the difference being statistically significant(P<0.05).(4)After treatment,the knee pain scores,stiffness scores and daily living difficulty scores of the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving knee pain scores and in daily living difficulty scores,the difference being statistically significant(P<0.05).The stiffness scores of patients in the treatment group were slightly superior to that of the control group,but the difference was not statistically significant when compared with the control group(P>0.05).(5)After treatment,the serum COX-2 and MMP-3 levels of patients in both groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving serum COX-2 and MMP-3 levels,the difference being statistically significant(P<0.05).Conclusion The combination of warm-needle moxibustion and midnight-noon ebb-flow acupuncture therapy for KOA was effective in reducing serum COX-2 and MMP-3 levels,relieving patient’s pain symptoms and reducing the degradation of extracellular matrix with remarkable efficacy.
作者
王岳玲
陈家平
王玲
胡钧捷
WANG Yue-Ling;CHEN Jia-Ping;WANG Ling;HU Jun-Jie(The First Rehablitation Department,Traditional Chinese Hospital of LuAn,Lu’an 237007 Anhui,China)
出处
《广州中医药大学学报》
CAS
2022年第5期1078-1083,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
安徽中医药大学临床科研资助项目(编号:LAZD006)
安徽省自然科学基金资助项目(编号:2008085MH267)
关键词
温针灸
子午流注针法
膝骨性关节炎
环氧化酶2
基质金属蛋白酶3
临床观察
warm-needle moxibustion
midnight-noon ebb-flow acupuncture therapy
knee osteoarthritis(KOA)
COX-2
MMP-3
clinical observation
