艾灸治疗膝骨性关节炎疗效与血清和关节液中透明质酸含量关系的临床研究

Effect of Moxibustion in Treating Knee Joint Osteoarthritis and Its Relation with Contents of Hyaluronic Acid in Serum and Synovial Fluid

目的探讨艾灸治疗膝骨性关节炎(osteoarthritis,OA)临床疗效,同时检测治疗前后患者血清及膝关节滑液透明质酸(hyaluronic acid,HA)水平的变化并评价其意义。方法OA组30例治疗采用艾灸患侧内、外膝眼及阿是穴,每天1次,每次灸10min,每周5次,共治疗3个月;观察艾灸对膝OA患者的疗效;采用放射免疫法,测定OA组治疗前及治疗3个月后的血清及膝关节滑液HA浓度,并与30例无膝关节疾病的成人血清及膝关节滑液HA浓度作对照。结果OA组30例中痊愈19例(20膝),显效8例(10膝),有效3例(4膝),治愈率63.3%。OA组膝关节滑液HA浓度(g/L)治疗前(0.98±0.17)与对照组(1.62±0.30)比较显著降低(P<0.01),血清HA浓度(μg/L)治疗前(122.87±34.10)较对照组(68.32±21.48)显著升高(P<0.01);治疗后OA组膝关节滑液HA浓度(1.58±0.26)较治疗前显著升高(P<0.01),血清HA浓度(70.29±27.30)较治疗前显著降低(P<0.01);与对照组比较,血清及膝关节滑液HA浓度差异均无统计学意义(P>0.05)。结论艾灸是治疗膝骨性关节炎的有效方法,血清及膝关节滑液HA浓度可作为OA患者病情判断的量化指标。

Objective To investigate the clinical effects of moxibustion（Mox）in treating knee joint osteoarthritis,and to detect the change of hyaluronic acid（HA）level in serum and synovial fluid（SF）for evaluating its significance.Methods Thirty OA patients were treated with Mox applied on inner and outer hsiyens and Ashi point for 10 min once a day,5 times a week for 3 months and the therapeutic efficacy was evaluated.Serum and SF levels of HA were measured by radio-immunoassay before and after the 3-month treatment,and compared with those from 30 non-OA persons for normal control.Results After treatment,19 patients（20 joints）out of the 30 patients were cured,the efficacy of Mox was evaluated as markedly effective in 8 patients on 10 joints,and as effective in 3 patients on 4 joints,the cure rate being 63.3%.Before treatment,HA level in serum（122.87±34.10 μg/L）was higher and in SF（0.98±0.17 g/L）was lower in OA patients than those in the normal controls（68.32±21.48 μg/L and 1.62±0.30 g/L,P〈0.01）,whereas after treatment,both the serum and SF levels of HA in patients changed toward normal range（70.29±27.30 μg/L and 1.58±0.26 g/L）,showing insignificant difference as compared with those in the controls（P〈0.01）.Conclusion Mox is an effective approach for treatment of OA,and the levels of HA in serum and SF can be taken as the quantitative indicators for evaluating the pathogenetic condition of OA patients.