等速肌力训练联合时空针灸灵龟八法治疗老年肝肾亏虚型膝骨关节炎的疗效及对血清细胞因子的影响

Isokinetic Muscle Strength Training Combined with Time-Space Acupuncture Linggui Eight Methods in the Treatment of Elderly with Liver and Kidney Deficiency Knee Osteoarthritis and its Effect on Serum Cytokines

目的:观察老年肝肾亏虚型膝骨关节炎(KOA)患者经时空针灸灵龟八法联合等速肌力训练治疗后疗效情况及血清细胞因子的变化。方法:此次临床研究病例为从2019年7月~2021年7月间我院老年医学科收治的100例老年肝肾亏虚型KOA患者。将患者根据随机数字表法分为研究组(50例,基础治疗及等速肌力训练联合时空针灸灵龟八法)、对照组(50例,基础治疗及等速肌力训练)。比较两组中医临床疗效,中医证候评分,视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数量表(WOMAC)评分、Lysholm膝关节评分,膝关节伸肌、屈肌峰力矩(PT)、总功量(TW),血清白细胞介素-18(IL-18)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果:研究组的临床总有效率较对照组明显升高(P<0.05)。研究组治疗后Lysholm膝关节评分高于对照组,中医证候、WOMAC、VAS评分低于对照组(P<0.05)。研究组治疗后IL-6、TNF-α、IL-18低于对照组(P<0.05)。研究组治疗后膝关节伸肌、屈肌PT、TW高于对照组(P<0.05)。结论:等速肌力训练联合时空针灸灵龟八法治疗老年肝肾亏虚型KOA患者疗效显著,可改善临床症状,促进膝关节功能恢复,同时还可有效降低血清IL-6、IL-18、TNF-α水平,具有一定临床应用价值。

Objective: To observe the curative effect situation and the changes of serum cytokines in elderly patients with liver and kidney deficiency knee osteoarthritis(KOA) after time-space acupuncture Linggui eight methods combined with isokinetic muscle strength training. Methods: The clinical study cases were 100 elderly patients with liver and kidney deficiency KOA who were treated in the geriatric medicine department of our hospital from July 2019 to July 2021. According to the random number table method, the patients were divided into study group(50 cases, basic treatment and isokinetic muscle strength training combined with time-space acupuncture Linggui eight methods) and control group(50 cases, basic treatment and isokinetic muscle strength training). The clinical efficacy of traditional Chinese medicine, traditional Chinese medicine symptom score, visual pain simulation(VAS) score, McMaster University Osteoarthritis Index Scale(WOMAC), Lysholm knee score, knee extensor, flexor peak torque(PT), total work(TW), serum interleukin-18(IL-18), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) levels were compared between the two groups. Results:The total clinical effective rate of the study group was significantly higher than that of the control group(P<0.05). After treatment, the Lysholm knee score of the study group was higher than that of the control group, while traditional Chinese medicine symptom, WOMAC and VAS scores were lower than those of the control group(P<0.05). After treatment, IL-6, TNF-α and IL-18 of the study group were lower than those of the control group(P<0.05). The PT and TW of knee extensor and flexor of the study group were higher than those of the control group(P<0.05). Conclusion: Isokinetic muscle strength training combined with time-space acupuncture Linggui eight methods in the treatment of elderly patients with liver and kidney deficiency KOA has a significant effect, which can improve clinical symptoms,promote the recovery of knee joint function, and effectively reduce the levels of serum IL-6, IL-18 and TNF-α, which has certain clinical application value.