电针“痛敏穴”联合热敏灸对膝骨性关节炎的临床观察及对血脂水平、ADAMTS⁃4的影响

Clinical observation of electroacupuncture"Tongmin Point"combined with heat sensitive moxibustion on knee osteoarthritis and its influence on blood lipid level and ADAMTS⁃4

目的:观察电针“痛敏穴”联合热敏灸对膝骨性关节炎的临床疗效及对血脂水平、聚蛋白多糖酶4(a disintegrin and metalloprotease with thrombospondin motifs,ADAMTS-4)、基质金属蛋白酶-3(matrix metalloproteinase-3,MMPs-3)影响。方法:将80例膝骨性关节炎患者随机分为治疗组40例与对照组40例。治疗组给予电针联合热敏灸,每周6次,连续治疗4周;对照组给予关节腔内注射玻璃酸钠,每周1次,连续治疗4周。结果:两组在治疗期,视觉模拟评分量表(visual analogue scale,VAS)均呈现下降趋势,组内比较,差异具有统计学意义(P<0.05);在治疗2周、治疗4周、随访2周,治疗组得分均低于对照组(P<0.05)。两组治疗后(美国西安大略麦马斯特大学骨性关节炎指标(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)各项目得分均明显下降,治疗组疗效优于对照组(P<0.05)。治疗组在4周治疗后,总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(LDL-C)含量下降,高密度脂蛋白胆固醇(HDL-C)含量上升,其改善程度优于对照组(P<0.05)。两组治疗后ADAMTS-4、MMPs-3含量均下降,组间比较,差异有明显统计学意义(P<0.05);治疗组有效率为87.5%,对照组有效率为60.0%,治疗组疗效更佳(P<0.05)。结论:电针“痛敏穴”联合热敏灸能明显改善膝骨性关节炎患者的症状,调节血脂水平,安全性高,值得临床推广使用。

Objective:To observe the clinical effect of electroacupuncture"Tongmin point"combined with heat-sensitive moxibustion on knee osteoarthritis and its effect on blood lipid levels,a disintegrin and metalloprotease with thrombospondin mo⁃tifs(ADAMTS-4),matrix metalloproteinase-3(matrix metalloproteinase-3,MMPs-3)influence.Methods:A total of 80 patients were randomly divided into two groups,40 in treatment and 40 in control group.The treatment group was given electroacupunc⁃ture combined with heat-sensitive moxibustion,six times a week for 4 weeks;the control group was given intraarticular sodium hy⁃aluronate,once a week for 4 weeks.Results:During the treatment period,the visual analogue scale(VAS)showed a downward trend,and the difference within the group was significantly statistically significant(P<0.05);After 2 weeks of treatment,4 weeks of treatment and 2 weeks of follow-up,all the scores in the treatment group were lower than those in the control group(P<0.05).After treatment in two groups,the scores of each item(The Western Ontario and Mc Master Universities Osteoarthritis In⁃dex,WOMAC)decreased significantly,and the treatment group was better than the control group(P<0.05).After 4 weeks of treatment in the treatment group,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C)levels decreased,and high density lipoprotein(high density lipoprotein)levels decreased;the HDL-C content increased,and its degree of improve⁃ment was better than that of the control group(P<0.05).The contents of ADAMTS-4 and MMPs-3 in the two groups decreased after treatment,and the difference between the groups was statistically significant(P<0.05);the effective rate in the treatment group was 87.5%,and the effective rate in the control group was 60%,and the treatment group had better effect(P<0.05).Con⁃clusions:Electroacupuncture"Tongmin point"combined with heat-sensitive moxibustion can obviously improve the symptoms of knee osteoarthritis patients,regulate blood lipids,high security,so it is worthy of clinical application.