温针治疗绝经后骨质疏松疼痛患者临床研究

Clinical research on warm acupuncture therapy for pain in postmenopausal osteoporosis

目的:观察温针治疗绝经后骨质疏松疼痛的临床疗效,探讨其作用机制。方法:将90例绝经后骨质疏松患者随机均分为温针组、电针组及药物组,各30例。温针组、电针组均取双侧大杼、肾俞、悬钟穴,分别行温针、电针治疗,每天1次,共治疗30天;药物组采用口服钙尔奇D片600mg,每天1次,服用30天。观察3组治疗前后骨密度T值、视觉模拟量表(visual analogue scale,VAS)疼痛评分及血清中胰岛样生长因子(IGF-1)、白介素6(IL-6)及肿瘤坏死因子(TNF-α)水平变化情况。结果:①3种方法治疗30天后,患者骨密度T值未见明显变化;②VAS疼痛评分在治疗后均有所降低,其中温针组降低最明显(前后比较:6.73±0.24vs 4.43±0.26),治疗后分别与电针组(5.13±0.31)、药物组(5.17±0.33)比较差异有统计学意义(均P<0.05);③温针组治疗后可提高血清IGF-1水平[(119.5±20.1)ng/mL vs(156.5±23.9)ng/mL],较电针组[(136.3±24.5)]ng/mL、药物组[(127.7±22.1)ng/mL]提高明显(均P<0.05),在降低血清IL-6、TNF-α方面亦较其他两组有优势(均P<0.05)。结论:温针治疗绝经后骨质疏松疼痛效果显著,其机制可能与增加体内IGF-1水平,降低IL-6、TNF-α水平,促进骨形成,抑制骨吸收有关。

Objective To observe the clinical efficacy on pain in postmenopausal osteoporosis treated with the warm acupuncture therapy and discuss its effect mechanism. Methods Ninety cases of postmenopausal osteoporosis were randomized into a warm acupuncture group, an electroacupuncture group and a medication group, 30 cases in each group. In the warm acupuncture group and the electroacupuncture group, Dazhu （BL 11）, Shenshu （BL 23） and Xuanzhong （GB 39） were selected bilaterally and stimulated with the warm acupuncture and electroa- cupuncture therapies respectively, once a day for 30 days totally. In the medication group, caltrate-D tablets were prescribed, 600 mg, once a day for 30 days totally. The changes in the bone density T value, visual analogue scale （VAS） score, serum insulin like growth factor 1 （IGF-1）, interleukin 6 （IL-6） and tumor necrosis factor （TNF-a） were observed before and after treatment in the three groups. Results （DThe bone density T value in the patients of postmenopausal osteoporosis did not change obviously after 30 days treatment with the three therapies; ②VAS score was all reduced after treatment, in which, the result in the warm acupuncture group was the most obvious （6.73±0.24 before treatment vs 4.43±0.26 after treatment）. The value after treatment in the warm acupuncture group was different significantly as compared with the electroacupuncture group （5.13±0.31） and the medication group （5.17±0.33, both P〈0.05）. ③The level of serum IGF-1 was improved after treatment in the warm acu- puncture therapy [（119.5±20.1） ng/mL before treatment vs （156.5±23.9） ng/mL after treatment], which was more apparent as compared with the electroacupuncture group [ （136.3±24.5） ng/mL] and the medication group [（127.7±22.1） ng/mL, all P〈0.05]. Concerning to reducing the levels of IL-6 and TNF-a in serum, the results in the warm acupuncture group were superior to the other two groups （all P〈0.05）. Conclusion The warm acu-puncture therapy achieves the significant efficacy on pain in postmenopausal osteoporosis, which could be related to increasing the level of IGF-1, decreasing the levels of IL-6 and TNF-a, promoting bone formation and inhibting bone absorption.