透刺配合热补针法治疗风寒湿阻型膝关节滑膜炎疗效及对红细胞沉降率、C反应蛋白、前列腺素E2和滑膜动脉血流指数的影响

Effect of penetration needling combined with hot tonic needling on erythrocyte sedimentation rate, C-reactive protein, prostaglandin E2 level and local blood circulation in patients with rheumatoid arthritis with wind-cold-damp retention type

目的观察透刺配合热补针法对风寒湿阻型膝关节滑膜炎患者红细胞沉降率(ESR)、C反应蛋白(CRP)、前列腺素E2(PGE2)水平及局部血液循环的影响。方法将136例风寒湿阻型膝关节滑膜炎患者随机分为2组。对照组68例予热补针法治疗;治疗组68例在对照组治疗基础上加用透刺治疗。2组均治疗40 d。比较2组疗效;观察2组治疗前后ESR、CRP、PGE2水平变化,中医证候评分变化,疼痛视觉模拟评分法(VAS)、Lysholms评分变化,滑膜动脉血流阻力指数变化。结果治疗组总有效率88.24%,对照组总有效率70.59%,治疗组疗效优于对照组(P<0.05)。2组治疗后ESR、CRP、PGE2水平均较本组治疗前降低(P<0.05),且治疗组减低更明显(P<0.05)。2组治疗后中医证候评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后疼痛VAS均较本组治疗前降低(P<0.05),Lysholms评分较本组治疗前升高(P<0.05),且治疗组疼痛VAS降低更明显(P<0.05),Lysholms评分升高更明显(P<0.05)。2组治疗后滑膜动脉血流阻力指数均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论透刺配合热补针法治疗风寒湿阻型膝关节滑膜炎,能显著降低患者体内炎性反应,缓解疼痛,促进膝关节周围血液循环,改善患者症状、体征。

Objective To observe the effect of penetration needling combined with hot tonic needling on erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), prostaglandin E2(PGE2) level and local blood circulation in patients with rheumatoid arthritis with wind-cold-damp retention type. Methods 136 patients with rheumatoid arthritis were randomly divided into two groups. 68 cases in control group were treated by heat tonifying acupuncture. 68 cases in treatment group were treated by penetrating acupuncture on the basis of the control group. Both groups were treated for 40 days. The efficacy of the two groups were compared. The changes of ESR, CRP, PGE2, TCM syndrome score, visual analogue score of pain(VAS) score, lysholms score and the index of blood flow resistance of synovial artery were observed before and after treatment. Results The total effective rate was 88.24% in treatment group and 70.59% in control group. The effect of the treatment group was better than that of the control group(P<0.05). The levels of ESR, CRP and PGE2 in the two groups after treatment were lower than those in the group before treatment(P<0.05), and the decrease in the treatment group was more significant(P<0.05). After treatment, the TCM syndrome score and total score of the two groups were lower than those in the group before treatment(P<0.05), and the decrease in the treatment group was more significant(P<0.05). After treatment, the VAS score of pain in the two groups was lower than that in the group before treatment(P<0.05), lysholms score was higher than that in the group before treatment(P<0.05), and the VAS score of pain was decreased significantly in the treatment group(P<0.05), lysholms score was increased significantly(P<0.05). After treatment, the blood flow resistance index of synovial artery in the two groups was lower than that in the group before treatment(P<0.05), and the decrease in the treatment group was more significant(P<0.05). Conclusion The penetration needling combined with hot tonic needling can significantly reduce the inflammatory reaction, relieve the pain, promote the blood circulation around the knee joint, and improve the symptoms and signs of the patients.