摘要
目的观察银质针导热配合热罨包外敷治疗肾阳虚型膝骨关节炎的临床疗效。方法选择膝骨关节炎患者150例,抽签法随机分为三组,观察组50例采用银质针导热疗法配合热罨包外敷,对照1组50例采用银质针导热疗法,对照2组50例采用透明质酸钠关节腔内注射。5周后,观察各组治疗前后HSS膝关节评分及关节滑液中IL-1β、IL-6、INF-α的变化。结果各组患者膝关节疼痛评分、功能评分、活动度评分、稳定性评分、屈曲畸形评分及总评分治疗后较治疗前明显提高,治疗后观察组疼痛评分[(25.50±2.90)分比(23.20±2.99)分、(21.30±3.16)分,P<0.05]、屈曲畸形评分[(9.28±0.97)分比(8.76±1.25)分、(8.08±1.18)分,P<0.05]、总评分[(87.60±6.14)分比(83.60±5.56)分、(77.20±7.37)分,P<0.05]明显高于两对照组;各组治疗后关节液中IL-1β、IL-6、TNF-α含量明显低于治疗前(P均<0.01);其中治疗后观察组IL-1β[(0.030±0.004)ng/m L比(0.038±0.005)ng/m L、(0.044±0.006)ng/m L,P<0.05]、TNF-α[(4.80±0.56)ng/m L比(5.03±0.56)ng/m L、(5.26±0.51)ng/m L,P<0.05]明显低于两对照组(P<0.01),对照1组又低于对照2组(P<0.05)。观察组与对照1组的IL-6低于对照2组(P<0.05)。结论银质针导热疗法配合热罨包外敷的综合疗法能有效缓解肾阳虚型膝骨关节炎患者的临床症状。
Objective To investigate the clinical efficacy of thermal conductivity of silver needle combined with external application of heat foment package in the treatment of kidney-yang deficiency type of knee osteoarthritis.Methods One hundred and fifty patients with knee osteoarthritis were randomly divided into 3 groups： observation group receiving thermal conductivity of silver needle combined with external application of heat foment package（n=50）, control group 1 with thermal treatment of silver needle（n=50）, and control group 2 with intra-articular injection of sodium hyaluronate（n =50）. After 5-week treatment, each group was observed HSS knee score and the change of IL-1β, IL-6, TNF-α levels in synovial fluid before and after treatment. Results After treatment, pain score, function score, activity score and total score of knee in each groupwas significantly higher than that before treatment; among these scores, pain score, flexion deformity and total score in observation group were significantly higher then that of control group 1 and 2（25.50±2.90 vs 23.20±2.99 and 21.30±3.16; 9.28±0.97 vs 8.76±1.25 and8.08±1.18; 87.60±6.14 vs 83.60±5.56 and 77.20±7.37; P 〈0.05, P 〈0.01）. The IL-1β, IL-6, TNF-α levels in synovial fluid of each group were significantly different before and after treatment（all P 〈0.01）. After treatment the levels of IL-1β and TNF-α of the observation group were significantly lower than those of control group 1 and 2（0.030±0.004ng/m L vs 0.038±0.005ng/m L and 0.044±0.006ng/m L; 4.80±0.56ng/m L vs 5.03±0.56ng/m L and 5.26±0.51ng/m L; P 〈0.01） and control group 1 was significantly lower than those of control group 2（P 〈0.05）. Conclusion The thermal conductivity of silver needle combined with external applicationof heat foment package could effectively alleviate the clinical symptoms of kidney-yang deficiency type of knee osteoarthritis.
出处
《浙江中西医结合杂志》
2015年第11期1006-1009,1013,共5页
Zhejiang Journal of Integrated Traditional Chinese and Western Medicine
关键词
骨关节炎
肾阳虚
银质针
热罨包
osteoarthritis
kidney-yang deficiency
silver needle
heat foment package
