六点式针刀松解术配合强膝通痹汤治疗大骨节病膝关节炎的临床研究

Clinical Study of Six Point Acupotomy Combined with Qiangxi Tongbi Decoction Treating Kashin-Beck Disease with Gonitis

目的:探究六点式针刀松解术联合强膝通痹汤对大骨节病膝关节炎的作用和机理。方法:大骨节病膝关节炎患者220例随机分为针刀组和针刺组,各110例;针刀组采用六点式针刀松解术联合强膝通痹汤,针刺组采用针刺联合强膝通痹汤; 4周后观察疗效、检测指标。结果:针刀组总有效率明显高于针刺组(P <0. 05);治疗后两组WOMAC评分、ISOA积分均明显降低(P <0. 01),且针刀组明显低于针刺组(P <0. 05);经治疗后两组的血清TNF-α、IL-1β表达水平、血清NO含量均显著下降(P <0. 01)。结论:六点式针刀松解术联合强膝通痹汤,对于大骨节病所致的膝关节肿胀、疼痛、功能障碍等,能明显予以改善和缓解。其作用机理是对膝关节力学平衡予以调整和恢复,降低血清炎性细胞因子TNF-α、IL-1表达水平、NO含量等途径起作用的。

Objective ： To investigate the effects and the mechanism of six point acupotomy combined with Qiangxi TongbiDecoction on Kashin - Beck disease（KBD） with gonitis. Methods ： 220 cases of KBD with gonitis were randomly dividedinto the acupotomy group （u = 110） and the acupuncture group （u = 110）. The acupotomy group was treated with six poitacupotomy combined with Qiangxi Tongbi Decoction, and the acupuncture group was treated with acupuncture combinedwith Qiangxi Tongbi Decoction. The effects were observed and relative indexes were measured after four weeks of treat-ment. Results： The total efficiency of the acupotomy group was significantly higher than that of the acupuncture group（P 〈 0.05 ） ; The scores of WOMAC and ISOA were significantly decreased after the treatment in the two groups （ P 〈0.01） ; of which the acupotomy group was superior to the acupuncutre group （P 〈 0.05 ）. The levels of IL - 1β,TNF -α, and NO decreased significantly in the two groups after the treatment（P 〈0.01 ）. Conclusion： Six point acupo-tomy combined with Qiangxi Tongbi Decoction can effectively improve the swelling, pain and dysfunction of the kneejoints when treating KBD with gonitis, which mechanism may be related to regulating and recovering the mechanical e-quilibrium of the knee joints and reducing the levels of IL - 1β, TNF - α, and NO these inflammatory cytokines.