补肾活血方联合针灸治疗膝关节骨性关节炎疗效观察及对血清NTXI、COMP表达的影响

Therapeutic Effect of Applying Bushen Huoxue Prescription Combined with Acupuncture and Moxibustion in the Treatment of Knee Osteoarthritis and Its Influences on the Expression of Serum NTXI and COMP

目的:探讨补肾活血方联合针灸治疗膝关节骨性关节炎(KOA)疗效观察及对血清I型胶原交联氨基端末肽(NTXI)、软骨寡聚基质蛋白(COMP)表达的影响。方法:选取本院2017年8月~2019年6月接收的80例KOA患者,随机分为两组。随机分组方法为使用EXCEL函数生成1~80个随机数,按患者入院顺序依次分配,奇、偶数分别设为对照组、研究组。所有患者均给予常规西医治疗,在此基础上对照组40例应用补肾活血方治疗,研究组采取补肾活血方联合针灸治疗。于治疗前、治疗1个月后采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)对两组患者病情状况进行评价,检测两组血清骨软骨标志物[软骨寡聚基质蛋白(COMP)、I型胶原交联氨基端末肽(NTXI)]、炎性因子[白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)],同时于治疗1个月后判定疗效。结果:研究组治疗总有效率95.00%明显较对照组的80.00%高(P<0.05);治疗后两组WOMAC各项评分及总分、血清IL-1、TNF-α、COMP、NTXI水平与同组治疗前相比均明显降低(P均<0.05),且研究组均明显较同期对照组低(P均<0.05)。结论:对KOA患者实施补肾活血方联合针灸治疗,其疗效较佳,可显著改善症状及膝关节功能,并能通过有效下调炎性因子水平及骨软骨标志物水平而保护关节软骨免受破坏。

Objective:To investigate the therapeutic effect of applying Bushen Huoxue Prescription combined with acupuncture and moxibustion in the treatment of knee osteoarthritis(KOA)and its influences on the expression of serum N-telopeptide of typeⅠcollagen(NTXI)and cartilage oligomeric matrix protein(COMP).Methods:A total of 80 patients with KOA in our hospital from August 2017 to June 2019 were selected and randomly divided into two groups.The random grouping method was to use Excel function to generate 1~80 random numbers,which were assigned according to the order of admission,odd and even numbers were set as a reference group and a study group respectively.All patients were given conventional western medicine treatment,on this basis,40 cases in the reference group were treated with Bushen Huoxue Prescription,while the study group were treated with Bushen Huoxue Prescription combined with acupuncture.Western Ontario and McMaster University Osteoarthritis Index(WOMAC)were used to evaluate the condition of the two groups before and 1 month after treatment,serum osteochondral markers(COMP,NTXI),inflammatory factors[interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)]were detected in the two groups,at the same time,the curative effect was evaluated after 1 month of treatment.Results:The total effective rate of the study group was 95.00%,which was significantly higher than 80.00%of the reference group(P<0.05).After treatment,WOMAC scores and total score,serum levels of IL-1,TNF-α,COMP and NTXI in the two groups were significantly lower than those before treatment(all P<0.05),and those in the study group were significantly lower than those in the reference group in the same period(all P<0.05).Conclusion:Bushen Huoxue Prescription combined with acupuncture and moxibustion has a good effect on KOA patients,which can significantly improve symptoms and knee joint function,and protect articular cartilage from damage by effectively reducing the levels of inflammatory factors and osteochondral markers.