温针灸联合推拿治疗膝骨关节炎的临床疗效及对血清炎症因子与骨代谢指标的影响

Clinical efficacy of warm needling moxibustion plus tuina for knee osteoarthritis and its effects on the serum inflammatory factors and bone metabolism Tndex

目的观察温针灸联合推拿治疗膝骨关节炎(KOA)的临床效果及对血清炎症因子与骨代谢指标的影响。方法将100例KOA患者随机分为2组。对照组50例予温针灸联合特定电磁波治疗仪(TDP)照射治疗;治疗组50例予温针灸联合推拿治疗。2组均治疗4周,比较2组治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟评分法(VAS)、Lequesne-Mery评分情况,以及血清骨保护素(OPG)、降钙素(CT)、骨钙素(BGP)、白细胞介素1(IL-1)、肿瘤坏死因子α(TNF-α)、基质金属蛋白酶3(MMP-3)水平变化情况,并统计疗效。结果治疗组总有效率96.00%,对照组总有效率78.00%,治疗组疗效优于对照组(P<0.05)。2组治疗后VAS、Lequesne-Mery及WOMAC评分均较本组治疗前降低(P<0.05),治疗后治疗组疼痛VAS、Lequesne-Mery及WOMAC评分均低于对照组(P<0.05)。2组治疗后OPG、BGP水平均较本组治疗前升高(P<0.05),且均高于对照组(P<0.05)。2组治疗前后CT水平组内及组间比较差异均无统计学意义(P>0.05)。2组治疗后IL-1、TNF-α、MMP-3水平均较本组治疗前降低(P<0.05),且低于对照组治疗后(P<0.05)。结论温针灸结合推拿治疗KOA能有效改善患者临床症状,降低IL-1、TNF-α、MMP-3水平,促进骨生成,临床疗效确切。

Objective To observe the effects of warm needling moxibustion plus tuina for knee osteoarthritis(KOA) and its effects on the the serum inflammatory factors and bone metabolism index Methods 100 patients with KOA were randomly divided into two groups.50 cases in control group were treated by warm needling moxibustion with specific electromagnetic wave therapy instrument(TDP),and 50 cases in treatment group were treated by warm needling moxibustion plus tuina,continuously treatment for two weeks.The scores of Xi'an ontario and Mc Master university osteoarthritis Index(WOMAC),visual analogue scale(VAS),Lequesne-Mery,and levels of serum osteoprotegerin(OPG),calcitonin(CT) and Osteocalcin(BGP) and IL-1 and TNF-α,MMP-3 before and after treatment were observed in two groups,and statistical the clinical effect.Results The total effective rate in control and treatment group was 96.00% and 78.00% respectively,the curative effect in treatment group was superior to that in control group(P < 0.05).The scores of VAS,Lequesne-Mery and WOMAC after treatment were significantly lower than those before treatment(P < 0.05),and the scores of VAS,Lequesne-Mery and WOMAC in the treatment group after treatment were lower than those in the control group after treatment(P < 0.05).The levels of OPG and BGP after treatment in the two groups were higher than before treatment(P < 0.05).The levels of OPG and BGP after treatment in the treatment group were higher than those in the control group(P < 0.05).There was no significant difference on CT between before and after treatment and has no difference between the two groups(P < 0.05).The levels of IL-1,TNF-αand MMP-3 in the two groups after treatment were lower than before treatment(P < 0.05).The levels of IL-1,TNF-αand MMP-3 in the treatment group were lower than those in the control group after treatment(P < 0.05).Conclusion Warm needling moxibustion plus tuina can effectively improve the clinical symptoms of patients,reduce the levels of IL-1,TNF-α,MMP-3,promote bone formation and has exact effects on the treatment of KOA.