雷火灸联合独活寄生汤对膝骨关节炎患者膝关节功能、疼痛及血清炎症因子的影响

Effects of Moxibustion with Immediate Effect Combined with Duhuo Jisheng Tang on Knee Joint Function,Pain and Serum Inflammatory Factors in Patients with Knee Osteoarthritis

【目的】观察雷火灸联合独活寄生汤对脾肾亏虚、湿注关节型膝骨关节炎患者膝关节功能、疼痛及血清炎症因子的影响。【方法】将94例脾肾亏虚、湿注关节型膝骨关节炎患者随机分为治疗组和对照组,每组各47例。对照组给予氨基葡萄糖口服联合关节腔注射药物治疗,治疗组在对照组治疗的基础上给予雷火灸联合独活寄生汤治疗。连续治疗5周。治疗5周后,观察2组患者治疗前后西安大略和麦克马斯特大学关节炎指数(WOMAC)评分的变化情况,以及膝关节活动范围(ROM)与Lysholm膝关节量表评分的变化情况。比较2组患者治疗前后血清白细胞介素1β(IL-1β)及肿瘤坏死因子α(TNF-α)的变化情况。【结果】(1)研究过程中,治疗组剔除1例、脱落1例,对照组剔除1例、脱落2例。最终治疗组45例、对照组44例纳入疗效统计。(2)治疗后,2组患者的WOMAC指数评分均明显改善(P<0.05),且治疗组在改善WOMAC指数评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的主动屈膝ROM、Lysholm膝关节评分均明显改善(P<0.05),且治疗组在改善主动屈膝ROM、Lysholm膝关节评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的血清IL-1β及TNF-α水平均明显改善(P<0.05),且治疗组在改善血清IL-1β及TNF-α水平方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】在西医治疗的基础上应用雷火灸联合独活寄生汤能明显改善脾肾亏虚、湿注关节型膝骨关节炎患者的疼痛症状,提高患者膝关节功能、改善患者血清炎症因子的水平,从而提高患者生活质量,疗效显著。

Objective To observe the effects of moxibustion with immediate effect combined with Duhuo Jisheng Tang on knee joint function,pain and serum inflammatory factors in patients with knee osteoarthritis of spleenkidney deficiency and damp attacking joint type.Methods A total of 94 patients with knee osteoarthritis of spleenkidney deficiency and damp attacking joint type were randomly divided into treatment group and control group,47cases in each group.The control group received oral use of glucosamine combined with articular cavity injection of medicine,and the treatment group received moxibustion with immediate effect combined with Duhuo Jisheng Tang on the basis of the treatment of the control group.The treatment lasted 5 weeks.After 5 weeks of treatment,the changes in Western Ontario and Mc Master University arthritis index(WOMAC)score,knee flexion range of motion(ROM)and Lysholm knee scale score were observed in the two groups before and after treatment.The changes in serum interleukin 1β(IL-1β)and tumor necrosis factorα(TNF-α)were compared between the two groups before and after treatment.Results(1)During the trial,one case was got rid of and one case drop out from the treatment group,one case was got rid of and 2 cases drop out from the control group.Ultimately,45 cases in the treatment group and 44 cases in the control group were included in statistics analysis.(2)After treatment,the WOMAC index scores were significantly improved in the two groups(P<0.05),and the improvement in WOMAC index scores of the observation group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(3)After treatment,the ROM and Lysholm scores of active knee flexion were significantly improved in the two groups(P<0.05),and the improvement in ROM and Lysholm scores of active knee flexion of the observation group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(4)After treatment,the serum IL-1βand TNF-αlevels were significantly improved in the two groups(P<0.05),and the improvement in serum IL-1βand TNF-αlevels of the observation group was significantly superior to that of the control group,the difference being statistically significant(P<0.05)Conclusion On the basis of Western medicine treatment,the application of moxibustion with immediate effect combined with Duhuo Jisheng Tang can significantly improve the pain symptoms of the patients with knee osteoarthritis of spleen-kidney deficiency and damp attacking joint type,promote the knee joint function,and improve the levels of serum inflammatory factors,thus improve the quality of life of the patients.