基于经筋理论TEAS治疗膝关节骨性关节炎的临床疗效探讨

Discussion on the Clinical Efficacy of TEAS Based on the Aponeurotic System Theory in the Treatment of Knee Osteoarthritis

目的研究基于经筋理论经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的临床疗效.方法选取2019年6月—2020年11月该院收治的80例KOA患者为研究对象,采用随机数字表法分为对照组(n=40)和观察组(n=40),对照组接受传统针刺治疗,观察组接受TEAS治疗,比较两组的临床疗效、中医证候积分、疼痛程度、膝关节功能、血清炎症因子水平以及不良反应发生率.结果治疗后,观察组的总有效率为90.00%,高于对照组的70.00%,差异有统计学意义(P<0.05).观察组的中医证候积分、疼痛视觉模拟评分(visual analogue scale,VAS)低于对照组,美国纽约特种外科医院(hospital for special surgery,HSS)评分高于对照组,组间差异有统计学意义(P<0.05).观察组血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-10(interleukin-10,IL-10)水平均显著低于对照组,组间差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).结论基于经筋理论TEAS治疗KOA的疗效显著,可有效改善患者的膝关节功能障碍,其作用机制可能与降低炎性因子水平有关.

Objective To study the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)based on the aponeurotic system theory in the treatment of knee osteoarthritis(KOA).Methods 80 patients with KOA admitted to the hospital from June 2019 to November 2020 were selected as the research objects,and they were divided into a control group(n=40)and an observation group(n=40)using a random number table method.The control group received traditional acupuncture treatment,and the observation group received TEAS treatment.The clinical efficacy,TCM symptom score,pain degree,knee joint function,the level of serum inflammatory factor and incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate of the observation group was 90.00%,which was higher than 70.00%of the control group,and the difference was statistically significant(P<0.05).The TCM syndrome scores and pain visual analogue scale(VAS)score of the observation group were lower than those of the control group,and the hospital for special surgery(HSS)score was higher than that of the control group,the differences between the groups were statistically significant(P<0.05).The levels of serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)in the observation group were significantly lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion TEAS based on the aponeurotic system theory is effective in treating KOA and can effectively improve the patients'knee dysfunction.Its mechanism of action may be related to lowering the level of inflammatory factors.