针刺联合坐位调膝法对退行性膝关节炎患者中医证候积分和膝关节活动度的影响

Effect of acupuncture plus sitting-position knee adjustment on the TCM symptom score and knee range of motion in patients with degenerative knee arthritis

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中文摘要：目的观察针刺联合坐位调膝法对退行性膝关节炎患者中医证候积分和膝关节活动度的影响.方法将 100 例退行性膝关节炎患者随机分为观察组和对照组,每组 50例.对照组行坐位调膝法治疗,观察组在对照组基础上联合针刺运动穴位治疗.观察两组治疗前后中医证候积分、退行性病变指标[基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶-1(matrix metalloproteinase-1,MMP-1)、组织蛋白酶D(cathepsin D,CAT-D)和基质金属蛋白酶组织抑制因子-1(tissue inhibitor of metalloproteinase-1,TIMP-1)]、血清炎症因子[白介素-1(interleukin-1,IL-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)]、疼痛视觉模拟量表(visual analog scale,VAS)评分及膝关节功能[Lysholm 膝关节评分系统(Lysholm knee score scale,LKSS)评分和膝关节最大活动度]的影响.结果两组治疗后关节肿胀、关节活动度和膝周压痛评分均显著降低(P＜0.05),且观察组低于对照组(P＜0.05).两组治疗后血清MMP-9、MMP-1、CAT-D和TIMP-1 水平均显著降低(P＜0.05),且观察组低于对照组(P＜0.05).两组治疗后血清IL-1、TNF-α和IL-6水平低于治疗前,且观察组低于对照组(P＜0.05).两组治疗后VAS评分显著降低(P＜0.05),膝关节活动度和LKSS评分升高(P＜0.05);观察组治疗后VAS评分低于对照组(P＜0.05),膝关节活动度和LKSS评分高于对照组(P＜0.05).结论针刺联合坐位调膝法可降低退行性膝关节炎患者炎症因子水平及疼痛程度,改善膝关节功能、退行性病变程度及活动度.

外文摘要：Objective To observe the effect of acupuncture plus sitting-position knee adjustment on the TCM symptom score and knee range of motion in patients with degenerative knee arthritis.Methods One hundred patients with degenerative knee arthritis were randomized to observation and control groups,with 50 cases in each group.The control group received sitting-position knee adjustment and the observation group,acupuncture at exercise acupoints in addition.The TCM symptom score,degenerative change indicators[matrix metalloproteinase-9(MMP-9),matrix metalloproteinase-1(MMP-1),cathepsin D(CAT-D)and tissue inhibitor of matrix metalloproteinase-1(TIMP-1)],serum inflammatory factors[interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)],the visual analog scale(VAS)score and knee joint function[the Lysholm knee score scale(LKSS)score and maximum knee range of motion]were observed in the two groups before and after treatment.Results After treatment,the joint swelling,joint range of motion and perigenual tenderness scores decreased significantly in the two groups(P＜0.05)and were lower in the observation group than in the control group(P＜0.05).After treatment,serum MMP-9,MMP-1,CAT-D and TIMP-1 decreased significantly in the two groups(P＜0.05)and were lower in the observation group than in the control group(P＜0.05).After treatment,serum IL-1,TNF-α and IL-6 levels decreased in the two groups compared with before and were lower in the observation group than in the control group(P＜0.05).After treatment,the VAS score decreased significantly and the knee range of motion and the LKSS score increased in the two groups(P＜0.05)and the VAS score was lower and the knee range of motion and the LKSS score were higher in the observation group than in the control group(P＜0.05).Conclusions Acupuncture plus sitting-position knee adjustment can reduce inflammatory factors levels and pain severity in patients with degenerative knee arthritis,improve knee function and range of motion and decrease the degree of degenerative change.

外文关键词：

Acupuncture therapyKnee adjustmentOsteoarthritis,KneeKnee range of motion

作者：

丁成俊、张春健、韦镇余、胡舒然

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作者单位：

淮安市中医院,淮安 223001

关键词：

针刺疗法调膝法骨关节炎,膝膝关节活动度

出版年：

2025

DOI：