循经筋阿是穴排刺法联合独活寄生汤加减治疗膝骨关节炎疗效观察

Clincal observation on row needling at Ashi points along meridians combined with Modified Duhuo Jisheng Decoction in treatment of knee psteoarthritis

目的观察循经筋阿是穴排刺法联合独活寄生汤加减治疗膝骨关节炎(KOA)的疗效。方法将我院78例KOA患者随机分为对照组与观察组各39例。对照组患者口服双氯芬酸钠缓释片治疗,观察组患者采用循经筋阿是穴排刺法联合独活寄生汤加减治疗。比较两组患者临床疗效、症状积分、血清中炎症因子及膝关节液基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)的水平。结果观察组患者总有效率显著高于对照组(P<0.05);治疗后,两组患者疼痛、晨僵和功能障碍积分均下降,且观察组积分均低于对照组(P<0.05);两组患者白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-(TNF-)水平均下降,且观察组均低于对照组(P<0.05);两组患者膝关节液MMP-3、MMP-9水平均下降,且观察组均低于对照组(P<0.05)。结论循经筋阿是穴排刺法联合独活寄生汤加减治疗KOA患者疗效显著,能明显缓解症状,降低血清中炎症因子及膝关节液的中基质金属蛋白酶的表达。

Objective To observe the curative effect of row needling at Ashi points along meridians combined with Modified Duhuo Jisheng Decoction in treatment of knee osteoarthritis(KOA). Methods A total of 78 KOA patients were randomly divided into control group and observation group,with 39 cases each. Control group took diclofenac sodium sustainedrelease tablets,and observation group was treated with row needling method at Ashi points along meridians combined with Modified Duhuo Jisheng Decoction. The total effective rate,symptom score,serum inflammatory factors,and the levels of matrix metalloproteinase-3(MMP-3)and MMP-9 in knee joint fluid were compared between the two groups. Results The total effective rate of observation group was higher than that of control group(P<0.05);after treatment,the pain,morning stiffness,and dysfunction scores of both groups decreased;and were lower in observation group than those in control group(P<0.05);the levels of interleukin-1(IL-1),IL-6,tumor necrosis factor-(TNF-)in both groups decreased on average,and were lower in observation group than those in control group(P<0.05);the levels of MMP-3 and MMP-9 in knee joint fluid of both groups decreased,and were lower in observation group than those in control group(P<0.05). Conclusion Row needling at Ashi points along meridians combined with Modified Duhuo Jisheng Decoction has significant effects in treatment of KOA,significantly relieves symptoms,and reduces serum inflammatory factors and the expression of MMP in knee joint fluid.