摘要
目的观察温针联合刺络拔罐治疗膝骨关节炎(KOA)的临床疗效。方法选取KOA患者90例为研究对象,按就诊顺序编号随机分为观察组、对照组,每组45例。对照组采取常规西医疗法,观察组在此基础上予以温针联合刺络拔罐治疗,比较两组总有效率、治疗前后病情严重程度[Lequesne指数、膝关节西安大略和麦克马斯特大学骨关节炎指数量表(WOMAC)]、疼痛度(简化McGill疼痛量表)、膝关节血流信号分级、关节滑液相关因子水平[白介素-1(IL-1)]、肿瘤坏死因子-a(TNF-a)、基质金属蛋白酶-3(MMP-3)、不良反应。结果观察组总有效率(95.6%)明显高于对照组(82.2%)(P<0.05);观察组治疗后Lequesne、WOMAC、McGill评分均低于对照组(P<0.01);治疗后3个月,观察组血流信号分级低于对照组(P<0.05);治疗后3个月,观察组关节滑液IL-1、TNF-a、MMP-3含量下降幅度大于对照组(P<0.05);观察组不良反应发生率(2.2%)低于对照组15.6%(P<0.05)。结论在西医治疗基础上采用温针联合刺络拔罐治疗优于单纯西医治疗,可明显改善患者病情、膝关节血流,减少疼痛及不良反应,可能通过下调IL-1、TNF-a、MMP-3含量而发挥作用。
Objective To investigate the efficacy of warm needling plus pricking-cupping bloodletting in treating knee osteoarthritis （KOA）. Method Ninety KOA patients were enrolled as subjects and allocated, in order of visits, to observation and control groups, 45 cases each. The control group received conventional Western medical treatment and the observation group, warm needling plus pricking-cupping bloodletting. The total efficacy rates, and pre-treatment and post-treatment disease severities [the Lequesne index and the Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC）], pain severities （the simplified McGill Pain Questionnaire）, knee blood flow signal grades, synovial fluid levels of related factor [interleukin-1（IL-1）], tumor necrosis factor-α （TNF-α）, matrix metalloproteinase-3 （MMP-3） and adverse reactions were compared between the two groups. Result The total efficacy rate was significantly higher in the observation group （95.6%） than in the control group （82.2%） （P〈0.05）. Post-treatment Lequesne index, WOMAC and McGill Pain Questionnaire score were lower in the observation group than in the control group （P〈0.01）. After three months of treatment, blood flow signal grade was lower and synovial IL-1, TNF-α and MMP-3 contents decreased more in the observation group than in the control group （P〈0.05）. The adverse reaction rate was lower in the observation group （2.2%） than in the control group （15.6%） （P〈0.05）. Conclusion Warm needling plus pricking-cupping bloodletting is more effective than conventional Western medical treatment. It can markedly improve the patient’s condition and knee blood flow, relieve the pain and reduce adversereactions. It may play a role through down-regulating IL-1, TNF-α and MMP-3 contents.
作者
胡立丹
郭佳娜
HU Li-dan;GUO Jia-na(Wenzhou Hospital of Traditional Chinese and Western Medicine,Wenzhou 325000,China)
出处
《上海针灸杂志》
2018年第12期1428-1432,共5页
Shanghai Journal of Acupuncture and Moxibustion
