热敏灸对膝骨性关节炎患者疼痛及TNF-α、IL-1表达的影响

Effect of Heat-Sensitive Moxibustion on Pain and Expressions of TNF-αand IL-1 in Patients with KOA

目的:探究热敏灸对膝骨性关节炎(KOA)患者疼痛及TNF-α、IL-1表达的影响。方法:选取2016年7月—2019年6月我院收治的KOA患者100例,按随机数字表法将其分为对照组(n=50)和观察组(n=50)。两组患者治疗期间均给予常规药物治疗,对照组同时给予常规艾灸治疗,观察组同时给予热敏灸治疗,两组均连续治疗4个疗程。统计两组治疗后临床疗效,比较观察组与对照组患者治疗前后膝关节疼痛、肿胀与功能评分的差异,比较两组患者治疗前后血清TNF-α、IL-1和IL-6水平变化,比较两组患者治疗期间安全性。结果:治疗后观察组患者的临床总有效率为92.00%(46/50),对照组患者的临床总有效率为74.00%(37/50),观察组显著高于对照组(P<0.05);与治疗前比较,治疗后两组患者膝关节疼痛、肿胀与功能评分、血清TNF-α、IL-1和IL-6水平均下降(P<0.05),且观察组上述指标均较对照组低(P<0.01);治疗后观察组患者的不良反应发生率为6.00%(3/50),对照组患者的不良反应发生率分别为20.00%(10/50),观察组显著低于对照组(P<0.05)。结论:热敏灸可有效缓解KOA患者临床症状,降低TNF-α、IL-1和IL-6水平和不良反应发生率,且疗效优于常规艾灸治疗。

Objective:To explore the effect of heat-sensitive moxibustion on pain and expressions of TNF-αand IL-1 in patients with knee osteoarthritis(KOA).Methods:100 patients with KOA were randomly divided into the control group(n=50)and the observation group(n=50).On the basis of routine medication,the control group was treated with conventional moxibustion,whereas the observation group was treated with heat-sensitive moxibustion.Both groups were treated for four consecutive courses.The clinical efficacy was compared between the two groups.Knee pain,swelling and functional scores were compared between before and after the treatment in the two groups.The changes of serum levels of TNF-α,IL-1 and IL-6 before and after the treatment were observed and the therapy safety was assessed in the two groups.Results:The total effective rate was 92.00%(46/50)in the observation group,which was significantly higher than 74.00%(37/50)in the control group(P<0.05).The levels of knee pain,swelling and function scores,as well as serum levels of TNF-α,IL-1 and IL-6 decreased after the treatment in the two groups;the decreases in the observation group were more significant(P<0.05,P<0.01).The incidence of adverse reactions was 6.00%(3/50)in the observation group,which was significantly lower than 20.00%(10/50)in the control group(P<0.05).Conclusion:Heat-sensitive moxibustion can effectively alleviate the clinical symptoms of KOA patients,reduce the serum levels of TNF-α,IL-1 and IL-6 and the incidence of adverse reactions,and the curative effect is better than conventional moxibustion treatment,which is worthy of clinical application.