火针膝周密刺法结合针刺治疗早中期膝骨关节炎患者的疗效分析

Therapeutic efficacy of fire needling around the knee combined with acupuncture in early and middle stages of knee osteoarthritis

目的探究火针膝周密刺法结合针刺治疗早中期膝骨关节炎患者的疗效及对美国特种外科医院(HSS)膝关节评分和血清白细胞介素-1β(IL-1β)、基质金属蛋白酶-3(MMP-3)的影响。方法选取2017年1月—2019年1月在乌鲁木齐市中医医院诊治的早中期膝骨关节炎患者100例,按随机数字表法分为实验组和对照组,每组50例。对照组行针刺治疗,实验组行火针膝周密刺法结合针刺治疗,两组均连续治疗2周。比较两组HSS评分、临床疗效、安全性及血清IL-1β、MMP-3水平。结果两组患者的功能、疼痛、肌力、活动度、屈膝畸形、稳定性评分及HSS总分在不同时间、不同组间及变化趋势上有差异(P<0.05)。实验组治疗总有效率高于对照组(P<0.05)。实验组治疗后血清IL-1β、MMP-3水平低于对照组(P<0.05);实验组治疗前后血清IL-1β、MMP-3的差值高于对照组(P<0.05)。所有患者治疗期间均未发生不良反应。结论火针膝周密刺法结合针刺治疗早中期膝骨关节炎患者安全可靠,能够缓解症状,改善膝关节功能,提高临床疗效,其机制可能与调节IL-1β、MMP-3水平有关。

Objective To investigate the therapeutic efficacy of fire needling around the knee combined with acupuncture in early and middle stages of knee osteoarthritis and to observe its effects on Hospital for Special Surgery(HSS)knee score,serum interleukin-1β(IL-1β)and matrix metalloproteinase-3(MMP-3).Methods One hundred patients with early and middle stages of knee osteoarthritis who were diagnosed and treated in our hospital from January 2017 to January 2019 were enrolled and divided into two groups according to the random number table method,with 50 cases in each group.The control group received acupuncture treatment,while the experimental group received acupuncture treatment with fire needling around the knee.All the patients were treated continuously for 2 weeks.The HSS knee scores,clinical efficacy and safety,and serum IL-1βand MMP-3 levels were compared between the two groups.Results The function,pain,muscle strength,range of motion,knee flexion deformity,stability scores and total HSS knee score were different between the two groups and altered at different time points with distinct changing trends(P<0.05).The overall effective rate of treatment in the experimental group was higher than that in the control group(P<0.05).The serum IL-1βand MMP-3 levels in the experimental group were lower than those in the control group after treatment(P<0.05).The differences of serum IL-1βand MMP-3 levels before and after the treatment in the experimental group were higher than those in the control group(P<0.05).No adverse reaction occurred in all patients during the treatment.Conclusion The combination of fire needling around the knee and acupuncture is safe and reliable for the treatment of early and middle stages of knee osteoarthritis.It can not only relieve symptoms,but improve knee function and clinical efficacy.The mechanism may be related to the regulation of IL-1βand MMP-3 levels.