温针灸联合氨基葡萄糖和非甾体类抗炎药治疗膝骨关节炎的临床研究

Clinical study of warm acupuncture and moxibustion combined with glucosamine and non steroidal anti-inflammatory drugs in the treatment of knee osteoarthritis

目的:观察温针灸联合氨基葡萄糖和非甾体类抗炎药治疗膝骨关节炎(KOA)的临床疗效。方法:收集2017年1月-2018年12月收治的KOA患者360例,随机分为药针联合组、温灸组和西药组各120例。药针联合组给予温针灸治疗(隔日1次,7次为1个疗程),共3个疗程;同时口服盐酸氨基葡萄糖胶囊(0.75g/次,每日2次),共12周;口服双氯芬酸钠双释放肠溶胶囊(75 mg/次,每日1次),共3周。温灸组行温针灸,共3个疗程。西药组口服盐酸氨基葡萄糖胶囊12周和双氯芬酸钠双释放肠溶胶囊3周。用KOA严重性指数对治疗前、治疗后1周、1个月和3个月时患者的情况进行评分,以尼莫地平法评估疗效。结果:治疗结束1周、1个月和3个月时,药针联合组的显效率分别为83.33%、81.67%和79.17%,高于温灸组的66.67%、64.17%和61.67%及西药组的66.67%、63.33%和58.33%(P<0.05)。药针联合组的治愈率分别为15.00%、11.67%和12.50%,高于西药组的5.00%、5.00%和4.17%(P<0.05),温灸组分别为11.67%、10.00%和10.83%。结论:采用温针灸联合氨基葡萄糖和非甾体类抗炎药治疗KOA疗效确切,且有利于弥补单纯西药治疗或温针灸治疗的不足,值得基层临床推广应用。

Objective:To observe the clinical efficacy of warm acupuncture and moxibustion combined with glucosamine and nonsteroidal anti-inflammatory drugs in the treatment of knee osteoarthritis(KOA).Methods:Three hundred and sixty KOA patients treated in the center were collected and randomly divided into a medicine-acupuncture group,a warm moxibustion group and a western medicine group with120 cases in each group.The medicine-acupuncture group was treated by warm acupuncture and moxibustion(once every other day,7 times as a course of treatment)for a total of 3 courses;at the same time,glucosamine hydrochloride capsules(0.75 g/time,twice daily)was taken for a total of 12 weeks.The warm moxibustion group was treated by warm acupuncture and moxibustion for three courses of treatment.In the western medicine group,glucosamine hydrochloride capsules were taken orally for 12 weeks and diclofenac sodium double-release enteric-coated capsules were taken for 3 weeks.The KOA severity index was used to score the patient’s condition before treatment,1 week,1 month,and 3 months after treatment,and the efficacy was evaluated by nimodipine method.Results:After treatment of 1 week,1 month and 3 months,the effective rates were 83.33%,81.67%,and 79.17%in the medicine-acupuncture group,respectively,which were higher than those 66.67%,64.17%and 61.67%in the warm moxibustion group and those 66.67%,63.33%and 58.33%in the western medicine group(P<0.05).The cure rates were 15.00%,11.67%and 12.50%in the medicine-acupuncture group,respectively,which were higher than those 5.00%,5.00%and 4.17%in the western medicine group(P<0.05),and the warm moxibustion group was 11.67%,10.00%and 10.83%,respectively.Conclusion:Warm acupuncture and moxibustion combined with glucosamine and non-steroidal anti-inflammatory drugs is effective in treating KOA,and is helpful to make up for the deficiency of medicine treatment or warm acupuncture and moxibustion treatment,which is worthy of popularization and application at the grassroots level.