祛瘀生新刺络药罐法治疗膝骨性关节炎患者的临床观察

Clinical Observation on the Treatment of Patients with Knee Osteoarthritis by Quyu Shengxin Meridian Puncture and Medicine Cupping Method

目的探究祛瘀生新刺络药罐法治疗膝骨性关节炎(Knee Osteoarthritis,KOA)临床疗效。方法选取2018年4月—2019年1月期间广州中医药大学附属宝安中医院收治的72例KOA患者,按随机数表法随机分为对照组和治疗组,每组36例。对照组患者接受电针联合红外线照射治疗,治疗组患者采用祛瘀生新刺络药罐法治疗。两组患者均治疗2个疗程后,观察比较两组患者膝关节超声指标,视觉模拟疼痛量表(VAS)评分、不良反应发生率、C-反应蛋白(C-reactiveprotein,CRP)、血沉(erythrocyte sedimentation rate,ESR)、基质金属蛋白酶9(Matrix metalloprotein-9,MMP-9)、白细胞介素-18(Interleukin-18,IL-18)、白细胞介素-6(IL-6)水平及临床疗效。结果治疗后两组患者滑膜厚度、关节腔积液、滑膜血流信号指标均明显优于治疗前,差异有统计学意义(P<0.05);且治疗组治疗后滑膜厚度、关节腔积液、滑膜血流信号指标均明显优于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组患者VAS评分均明显低于治疗前,差异有统计学意义(P<0.05);且治疗组治疗后VAS评分明显低于对照组,两组比较,差异有统计学意义(P<0.05)。治疗期间对照组不良反应发生率为33.33%(12/36),治疗组为8.33%(3/36),两组比较,差异有统计学意义(P<0.05)。治疗后两组患者血清指标CRP、ESR、MMP-9水平均明显低于治疗前,差异有统计学意义(P<0.05);且治疗组治疗后血清指标CRP、ESR、MMP-9水平明显低于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-18、IL-6水平均明显低于治疗前,差异有统计学意义(P<0.05);且治疗组治疗后炎症因子IL-18、IL-6水平改善情况明显优于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后治疗组总有效率为94.44%(34/36),对照组75.00%为(27/36),两组比较,差异有统计学意义(P<0.05)。结论祛瘀生新刺络药罐法治疗KOA,可明显改善患者临床症状,降低不良反应发生率,调节血清指标及炎症因子水平,值得临床推广应用。

Objective To explore the clinical efficacy of the method of removing blood stasis and producing new puncture and medicine cupping in the treatment of knee osteoarthritis(KOA).Methods A total of 72 patients with knee osteoarthritis who were admitted to Baoan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from April 2018 to January 2019 were randomly divided into control group and treatment group by random number table method,each group 36 cases.Patients in the control group were treatd with electroacupuncture combined with infrared radiation therapy,and patients in the treatment group were treated with the method of removing blood stasis and producing new collaterals pricking medicine.After two courses of treatment for both groups of patients,the knee ultrasound indexes,VAS score,incidence of adverse reactions,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),matrix Metalloproteinase 9(MMP-9),Interleukin-18(Interleukin-18,IL-18),Interleukin-6(IL-6)levels and clinical efficacy were observed and compared.Results After treatment,the synovial thickness,joint cavity effusion,and synovial blood flow signal indicators of the two groups of patients were significantly better than those before treatment,and the difference was statistically significant(P<0.05).The synovial thickness and joints of the treatment group after treatment Lumen effusion and synovial blood flow signal indicators were significantly better than those of the control group,and the difference between the two groups was statistically significant(P<0.05).After treatment,the VAS scores of the two groups were significantly lower than before treatment,the difference was statistically significant(P<0.05);and the VAS scores of the treatment group after treatment were significantly lower than those of the control group,and the difference between the two groups was statistically significant(P<0.05).During the treatment period,the incidence of adverse reactions in the control group was 33.33%(12/36),and the treatment group was 8.33%(3/36).The difference between the two groups was statistically significant(P<0.05).After treatment,the levels of serum indexes of CRP,ESR,and MMP-9 of the two groups of patients were significantly lower than before treatment,and the difference was statistically significant(P<0.05).The levels of serum indexes of CRP,ESR,and MMP-9 of the treatment group were significantly lower after treatment.Compared with the control group,the difference between the two groups was statistically significant(P<0.05).After treatment,the levels of inflammatory factors IL-18 and IL-6 in the two groups were significantly lower than before treatment,and the difference was statistically significant(P<0.05).The levels of inflammatory factors IL-18 and IL-6 in the treatment group improved after treatment Significantly better than the control group,the difference between the two groups was statistically significant(P<0.05).After treatment,the total effective rate was 94.44%(34/36)in the treatment group and 75.00%(27/36)in the control group.The difference between the two groups was statistically significant(P<0.05).Conclusion The treatment of knee osteoarthritis with the method of removing blood stasis and producing new puncturing the collaterals can significantly improve the clinical symptoms of patients,reduce the incidence of adverse reactions,and adjust the levels of serum indicators and inflammatory factors.It is worthy of clinical application.