首页|热敏针灸联合温经通痹汤外敷治疗寒湿痹阻型膝骨关节炎患者的临床疗效

热敏针灸联合温经通痹汤外敷治疗寒湿痹阻型膝骨关节炎患者的临床疗效

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目的 探讨热敏针灸联合温经通痹汤外敷治疗寒湿痹阻型膝骨关节炎(Knee osteoarthritis,KOA)患者的临床疗效.方法 选取2020年6月-2022年6月期间河南省南阳市中医院收治的90例KOA患者,采用随机数字表法分为对照组和观察组,每组各45例.对照组给予常规西药治疗,观察组给予热敏针灸联合温经通痹汤外敷治疗,均连续治疗4周.观察比较两组患者临床疗效,治疗前后中医证候积分、美国特种外科医院(Hospital for special surgery,HSS)评分及美国 Western Ontario 和 McMaster 大学骨关节炎指数评分(Western ontario and mcMaster universities osteoarthritis index,WOMAC)、视觉模拟量表(Visual analogue scale,VAS)评分、肿瘤坏死因子 α(Tumour necrosis factor alpha,TNF-α)、白介素 1 β(Interleukin 1β,IL-1β)、基质金属蛋白酶组织抑制因子 1(Matrix metalloproteinase tissue inhibitory factor 1,TIMP-1)及基质金属蛋白酶 3(Matrix metalloproteinase 3,MMP-3)水平.结果 治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P<0.05).治疗后两组患者HSS评分较治疗前明显升高,WOMAC评分较治疗前明显降低,差异有统计学意义(P<0.05);且观察组HSS评分明显高于对照组,WOMAC评分明显低于对照组,差异有统计学意义(P<0.05).治疗后两组患者VAS评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组VAS评分明显低于对照组,差异有统计学意义(P<0.05).治疗后两组患者TNF-α、IL-1β、TIMP-1及MMP-3水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组TNF-α、IL-1 β、TIMP-1及MMP-3水平明显低于对照组,差异有统计学意义(P<0.05).治疗后观察组总有效率90.48%(38/42)明显高于对照组74.42%(32/43),差异有统计学意义(P<0.05).结论 热敏针灸联合温经通痹汤外敷治疗KOA能够显著减轻患者关节疼痛等临床症状,促进功能恢复,临床疗效显著,其机制可能与该方案能有效下调KOA患者相关炎性因子表达,减轻炎症反应,减少软骨破坏,抑制OA病理变化有关,且安全性高,值得推广.
Clinical Efficacy of Heat-Sensitive Acupuncture and Moxibustion Combined with Wenjing Tongbi Decoction on Knee Osteoarthritis of Cold Dampness Obstruction Type
Objective To explore the clinical efficacy of heat-sensitive acupuncture and moxibustion combined with Wenjing Tongbi Decoction in treating knee osteoarthritis(KO A)of cold dampness obstruction type.Method Ninety KOA patients admitted to Nanyang City Hospital of Traditional Chinese Medicine between June 2020 and June 2022 were selected as the research subjects and were divided into the control group and the observation group according to the random number table method,with 45 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with heat-sensitive acupuncture and moxibustion combined with external application of Wenjing Tongbi decoction,with both groups treated continuously for four weeks.The TCM syndrome score,Hospital for Special Surgery(HSS)score,Western Ontario and McMaster University Osteoarthritis Index score(WOMAC),visual analogue scale(VAS)score,TNF-α,IL-1 β,TIMP-1,and MMP-3 levels before and after treatment of the two groups of patients were observed and compared.Results ①Compared with the scores before treatment,the TCM symptom scores in the two groups significantly decrease after treatment,with differences of statistical significance(P<0.05).Additionally,the TCM symptom score of the observation group is lower than that of the control group,with differences of statistical significance(P<0.05).②Compared to the scores before treatment,the HSS scores of the two groups notably increase,and the WOMAC scores of both groups remarkably decrease after treatment,with differences of statistical significance(P<0.05).③Com-pared with the scores before treatment,the VAS scores of both groups after treatment are significantly low(P<0.05).④The TNF-α,IL-1 β,TIMP-1,and MMP-3 levels of both groups after treatment are significantly lower than those be-fore treatment,with statistically significant differences(P<0.05).⑤The TNF-α,IL-1 β,TIMP-1,and MMP-3 levels of the observation group are notably lower than those of the control group,with differences of statistical significance(P<0.05).The total effective rate of the observation group after treatment is remarkably higher than that of the control group,with a statistically significant difference(P<0.05).Conclusion Heat-sensitive acupuncture and moxibustion combined with Wenjing Tongbi Decoction for KO A treatment can significantly alleviate clinical symptoms such as joint pain of pa-tients.Meanwhile,this can promote function recovery and has a significant clinical effect.The mechanism may be related to the scheme's downregulation of related inflammatory factor expression,the reduction of inflammatory response and cartilage damage,and inhibition of OA pathological changes in KOA patients,which features high safety and deserves populariza-tion.

Heat-Sensitive Acupuncture and MoxibustionWenjing Tongbi DecoctionKnee Osteoarthritis

于小普、李冉、李刚、李培真、邵素菊

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河南省南阳市中医院针灸推拿科,河南南阳 473000

河南中医药大学第三附属医院针灸科,河南郑州 450000

热敏针灸 温经通痹汤 膝骨关节炎

2024

世界中西医结合杂志
中华中医药学会

世界中西医结合杂志

CSTPCD
影响因子:1.053
ISSN:1673-6613
年,卷(期):2024.19(11)