摘要
目的:探讨电针联合理筋手法治疗膝骨关节炎的临床疗效及对软骨磁共振T2信号的影响。方法:选择2015年1月—2017年12月本院收治的120例膝骨关节炎患者作为观察对象,根据随机数字表法将120例患者随机分为观察组(n=60)和对照组(n=60)。对照组患者予以塞来昔布胶囊口服治疗,观察组患者予以电针联合理筋手法治疗,两组患者的治疗周期均为14 d。比较治疗前后两组患者的血清相关细胞因子(IL-6、IL-1β、TNFsR-Ⅰ、TNFsR-Ⅱ、TNF-α、Apelin)水平变化情况,同时采用WOMAC骨关节炎评分、VAS评分对两组患者的膝关节功能及关节疼痛情况进行评估,并比较两组患者的关节软骨T2值变化情况。结果:治疗前,两组患者的血清IL-6、IL-1β、TNFsR-Ⅰ、TNFsR-Ⅱ、TNF-α、Apelin水平、WOMAC总评分、VAS评分及髌骨、股骨内侧髁、股骨外侧髁、胫骨内侧髁、胫骨外侧髁、股骨关节面、胫骨关节面浅层及深层T2值比较,P>0.05。治疗后,观察组及对照组的血清IL-6、IL-1β、TNFsR-Ⅰ、TNF-α、Apelin水平、WOMAC总评分、VAS评分及髌骨、股骨内侧髁、股骨外侧髁、胫骨内侧髁、胫骨外侧髁、股骨关节面、胫骨关节面浅层及深层T2值均明显低于治疗前,且观察组明显低于对照组,均有P<0.05,观察组及对照组治疗后的血清TNFsR-Ⅱ水平与治疗前比较,P>0.05。结论:电针联合理筋手法治疗膝骨关节炎疗效确切,可有效改善患者的临床症状,可能与机体对细胞因子表达的调控作用有关;软骨磁共振T2信号可作为膝骨关节炎关节软骨病变的评估指标,对病情预后的评估具有十分重要的意义。
Objective:To investigate the clinical efficacy of electroacupuncture combined with reasonable tendon manipulation in the treatment of knee osteoarthritis and its effect on the magnetic resonance T2 signal of cartilage. Methods:120 patients with knee osteoarthritis admitted to our hospital from January 2015 to December 2017 were enrolled. 120 patients were randomly assigned to the observation group(n=60)and the control group according to the random number table method(n=60). The patients in the control group were treated with celecoxib capsules orally. The patients in the observation group were treated with electroacupuncture and rational fascia. The treatment period of the two groups was 14 days.The levels of serum-related cytokines(IL-6,IL-1β,TNFsR-I,TNFsR-II,TNF-α,apelin)in the two groups were compared before and after treatment. WOMAC osteoarthritis score and VAS score were used to compare the two groups of patients. The knee function and joint pain were evaluated and the changes in articular cartilage T2 values were compared between the two groups. Results:Before treatment,serum IL-6,IL-1β,TNFsR-I,TNFsR-II,TNF-α,apelin levels,WOMAC total score,VAS score and medial tibia,femoral medial malleolus,lateral femoral condyle,medial tibia T2 values of the iliac crest,lateral tibial iliac crest,femoral articular surface,superficial tibial articular surface and deep layer were compared,P>0.05.After treatment,serum IL-6,IL-1β,TNFsR-I,TNF-α,apelin levels,WOMAC total score,VAS score and tibia,medial femoral condyle,lateral femoral condyle,medial condyle of the tibia,and lateral humerus were observed in the observation group and the control group. The T2 values of iliac crest,femoral articular surface,superficial temporal layer and deep layer of tibia were significantly lower than those before treatment,and the observation group was significantly lower than the control group,P<0.05. Compared with before treatment,serum TNFsR-II level in the observation group and control group,with significantly difference P>0.05. Conclusion:Electroacupuncture combined with reasonable tendon manipulation for knee osteoarthritis is effective,can effectively improve the clinical symptoms of patients,can significantly improve the clinical symptoms of patients,may be related to the body’s regulation of cytokine expression;cartilage magnetic resonance T2 signal can as an evaluation index of articular cartilage lesions of knee osteoarthritis,it is of great significance to evaluate the prognosis of the disease.
作者
李焕峰
谭丽双
LI Huanfeng;TAN Lishuang(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine ,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2019年第3期106-109,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家中医药管理局课题基金项目(GZY-KJS-2017-08)
关键词
膝骨关节炎
电针疗法
理筋手法
软骨磁共振T2信号
WOMAC
knee osteoarthritis
electroacupuncture
rational manipulation
cartilage magnetic resonance T2 signal
WOMAC
