摘要
目的:比较毫火针联合运动疗法与普通针刺治疗早期膝关节骨性关节炎(KOA)患者的临床疗效及可能的分子机制。方法:将60例早期KOA患者随机分为治疗组(30例)和对照组(30例),治疗组采用毫火针联合运动疗法治疗(开、闭链肌力训练),隔日1次,4次为一疗程,共治疗2个疗程。对照组采用普通针刺治疗,每次留针30 min,日1次,7次为一疗程,共治疗2个疗程。观察两组治疗前后及治疗后1个月随访时膝关节疼痛视觉模拟量尺(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及健康调查量表(SF-36)评分,并对临床疗效及血清一氧化氮(NO)水平进行比较。结果:治疗前两组患者的VAS、WOMAC、SF-36评分及血清NO水平比较差异无统计学意义(P>0.05);与治疗前比较,治疗后及治疗后1个月随访时两组患者VAS、WOMAC评分降低明显,SF-36评分提高显著,血清NO水平明显下降,差异具有统计学意义(P<0.05),且治疗组患者的各项评分改善的程度更大,NO水平下降更为显著,明显优于对照组,差异具有统计学意义(P<0.05);与治疗后比较,治疗后1个月随访两组患者VAS、WOMAC、SF-36评分和血清NO水平差异均无统计学意义(P>0.05);治疗组总有效率93.3%(28/30),对照组总有效率76.67%(23/30),治疗组明显高于对照组(P<0.05)。结论:毫火针联合运动疗法可能通过降低KOA患者的血清NO水平以缓解疼痛、改善关节功能、提高生活质量,治疗早期KOA临床疗效显著,且明显优于普通针刺。
Objective:To compare the clinical efficacy of fire filiform needling combined with exercise therapy and common needling in the treatment of knee osteoarthritis(KOA)of early stage and to explore its possible mechanism.Methods:60 cases of early KOA were randomly divided into the treatment group(n=30)and the control group(n=30).The treatment group was treated with fire filiform needling combined with exercise therapy(open and closed-chain muscle training),once every other day,four times were taken as one course.The control group was treated with common needling Neixiyan(EX-LE4),Liangqiu(ST34),Dubi(ST35),Xuehai(SP10),Heding(EX-LE2),Yanglingquan(GB34),Zusanli(ST36),Yinlingquan(SP9)and Ashi points,once per day,7 times were taken as one course.After two courses of treatment,VAS scores of knee joint,WOMAC scores and SF-36 scores were observed,and the clinical efficacy and serum level of NO were compared between the two groups.Results:There were no statistical differences in the scores of VAS,WOMAC and SF-36,as well as in serum level of NO between the two groups before the treatment(P>0.05).VAS scores and WOMAC scores were significantly decreased and SF-36 score was significantly increased,NO level was obviously reduced after the treatment and one months after the treatment compared to those before the treatment(P<0.05);of which the improvements were more significant in the treatment group(P<0.05).There were no significant differences in the scores of VAS,WOMAC and SF-36,as well as in NO level between after the treatment and one month after the treatment in the two groups(P>0.05).The total effective rate was 93.3%(28/30)in the treatment group,which was significantly higher than 76.67%(23/30)in the control group(P<0.05).Conclusion:Fire filiform needling combined with exercise therapy can reduce pain in patients with KOA by reducing serum NO level,it can improve knee function and improve the life quality of the patients with KOA of early stage.The therapy is superior to common acupuncture.
作者
蔡国锋
蔡国梁
庄哲
马喜强
郭霞
孙宏
孙波
全爱君
梁洪文
王亚楠
许胜男
冯宇飞
张金鹏
CAI Guofeng;CAI Guoliang;ZHUANG Zhe;MA Xiqiang;GUO Xia;SUN Hong;SUN Bo;QUAN Aijun;LIANG Hongwen;WANG Yanan;XU Shengnan;FENG Yufei;ZHANG Jinpeng(The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001, China;Heilongjiang Academy of Chinese Medical Sciences, Harbin 150036, China;Harbin Institute of Physical Education, Harbin 150001, China;Heilongjiang University of Chinese Medicine, Harbin 150040, China)
出处
《针灸临床杂志》
2020年第7期20-25,共6页
Journal of Clinical Acupuncture and Moxibustion
基金
国家自然科学基金,编号:81703944
黑龙江省中医药科研项目,编号:ZHY16-027。
