双氯芬酸钠联合针灸治疗对老年膝关节骨性关节炎患者WOMAC评分、生活质量及炎症因子水平的影响

Effect of diclofenac sodium combined with acupuncture on WOMAC score,quality of life and inflammatory factors in elderly patients with knee osteoarthritis

目的:探讨双氯芬酸钠联合针灸治疗对老年膝关节骨性关节炎(knee osteoarthritis,KOA)患者骨关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)评分、生活质量及炎症因子水平的影响。方法:选择94例老年KOA患者为研究对象,采取随机数字表法均分为两组,各47例。对照组患者接受口服双氯芬酸钠治疗,治疗组患者进一步联合应用针灸治疗,比较两组患者治疗前后疼痛、WOMAC评分及生活质量的变化,同时比较血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及白细胞介素-6(interleukin-6,IL-6)水平的变化。结果:治疗后,血清TNF-α、IL-6水平在两组患者均有明显下降,且治疗组降低更加明显,差异均有显著性(P<0.05);治疗后,视觉模拟评分法(Visual Analogue Scale,VAS)及WOMAC在两组患者均有明显下降,且治疗组降低更加明显,差异均有显著性(P<0.05);治疗后,两组患者生活质量综合评定问卷(Generic Quality of Life Inventory-74,GQOL-74)中社会功能、心理功能、物质生活、躯体功能4个维度评分各均有明显升高,且治疗组升高更加明显,差异均有显著性(P<0.05)。结论:双氯芬酸钠联合针灸治疗老年KOA可以降低血清炎症因子水平,显著缓解疼痛症状及改善膝关节功能,提高患者的生活质量。

Objective:To investigate the effect of diclofenac sodium combined with acupuncture on the score of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),quality of life and inflammatory factors in elderly patients with knee osteoarthritis(KOA).Methods:Ninety-four elderly patients with KOA were selected and divided into two groups through random number table method,47 cases in each group.The control group was treated with diclofenac sodium,and the treatment group was further treated with acupuncture.The changes of pain,WOMAC score and quality of life were compared between the two groups before and after treatment,and the serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were also compared.Results:After treatment,serum TNF-α,IL-6 levels in the two groups were decreased significantly,and the treatment group decreased more significantly(P<0.05);visual analogue scale(VAS)and WOMAC score in the two groups were significantly decreased,and the treatment group decreased more significantly(P<0.05);the scores of social function,psychological function,material life and physical function of generic quality of life inventory-74(GQOL-74)in the two groups were significantly increased,and the treatment group increased more significantly(P<0.05).Conclusion:Diclofenac sodium combined with acupuncture in the treatment of elderly patients with KOA can reduce the level of serum inflammatory factors,significantly relieve pain symptoms and improve knee joint function,and improve the quality of life.