基于关节液代谢组学变化研究刺络药物罐疗法治疗膝骨性关节炎的机制

Study on the Mechanism of the Treatment of Knee Osteoarthritis with Drug Canister Acupuncture Based on Metabolomic Changes of Joint Fluid

目的:基于关节液代谢组学变化分析刺络药物罐疗法治疗膝骨性关节炎(KOA)的作用机制。方法:选取2018年4月至2019年5月深圳市宝安区中医院收治的KOA患者98例作为研究对象,按照治疗方法不同分为西药观察组(n=52)和刺络药物罐疗法组(n=46);比较所有患者治疗前后VAS评分和WOMAC评分;统计不同手段治疗前后血尿酸、C反应蛋白和红细胞沉降率;分离来自膝骨关节的关节液进行NMR分析。结果:治疗前,刺络药物罐疗法组和西药观察组VAS和WOMAC评分以及血尿酸、C反应蛋白和红细胞沉降率差异无统计学意义(P>0.05);治疗后,刺络药物罐疗法组和西药观察组VVAS和WOMAC评分以及血尿酸、C反应蛋白含量和红细胞沉降率均降低,其中刺络药物罐疗法降低幅度更大,差异有统计学意义(P<0.05);治疗后,刺络药物罐疗法组和西药观察组异丁酸和葡萄糖增加,羟脯氨酸,天冬酰胺,丝氨酸和尿苷均降低,差异有统计学意义(P<0.05)。结论:刺络药物罐疗法可以有效地改善KOA患者的治疗效果和身体功能。

Objective:To analyze the mechanism of the treatment of knee osteoarthritis(KOA)with drug canister acupuncture based on the changes of metabolomics in synovial fluid.Methods:A total of 98 patients with KOA admitted to Bao′an Traditional Chinese Medicine Hospital Group from April 2018 to May 2019 were selected as the research objects,and were divided into a control group(n=52)and an observation group(n=46).The control group was treated with Western medicine,and the observation group was treated with drug canister acupuncture therapy.VAS scores and WOMAC scores of all patients before and after treatment were compared.Blood uric acid,C-reactive protein and erythrocyte sedimentation rate before and after treatment were calculated.NMR analysis was performed on the joint fluid isolated from the knee joint.Results:Before treatment,there were no statistical differences in VAS and WOMAC scores,serum uric acid,C-reactive protein and erythrocyte sedimentation rate between the drug canister acupuncture therapy group and the Western medicine treatment group(P>0.05).After treatment,the VVAS and WOMAC scores,the content of serum uric acid,C-reactive protein and erythrocyte sedimentation rate in both groups decreased,and the treatment of drug canister acupuncture was decreased more sharply(P<0.05),which indicated that the drug canister acupuncture was more effective in treating KOA.After treatment,isobutyric acid and glucose increased,and hydroxyproline,asparagine,serine and uridine decreased in the drug canister acupuncture therapy group and the Western medicine treatment group(P<0.05).Conclusion:By detecting metabolomics changes of joint fluid,drug canister acupuncture therapy can effectively improve the therapeutic effects and body function of patients with KOA.