针刺加隔姜灸治疗膝骨关节炎疗效及对血清炎症因子和血液流变学影响

The efficacy of acupuncture plus ginger-partitioned moxibustion in the treatment of knee osteoarthritis and its influence on serum inflammatory factors and hemorheology

目的 探讨针刺加隔姜灸对膝骨关节炎患者血清炎症因子、血液流变学水平的影响。方法 选取我院2018年7月至2020年7月收治的膝骨关节炎患者104例,采用随机数表法分为对照组及研究组各52例。对照组行常规抗炎止痛治疗,研究组在对照组基础上加用针刺与隔姜灸,两组均治疗30天。比较两组治疗前后骨关节炎指数(WOMAC)、膝关节功能评分(Lysholm),比较两组血清炎症、血液流变学、血清氧化应激水平,统计治疗期间不良反应发生情况。结果 治疗后,两组WOMAC、白细胞介素-6、红细胞沉降率、超敏C-反应蛋白、全血黏度(低切、高切)、血浆黏度、红细胞聚集指数、纤维蛋白原水平均显著低于治疗前,且研究组低于对照组(P<0.05);Lysholm评分、超氧化物歧化酶、谷胱甘肽水平均显著高于治疗前,且研究组高于对照组(均P<0.05)。治疗期间两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论 膝骨关节炎患者经针刺加隔姜灸治疗后可缓解临床症状,降低体内炎症水平,改善血液流变情况,安全性较好。

Objective To investigate the influence of acupuncture plus ginger-partitioned moxibustion on serum inflammatory factors and hemorheology in patients with knee osteoarthritis.Methods One hundred and four patients with knee osteoarthritis treated in our hospital between July 2018 and July 2020 were selected. The patients were randomly divided into a control group and a study group by random number table method, 52 in each group. The control group underwent conventional treatment, and the study group was additionally given acupuncture plus ginger-partitioned moxibustion on the basis of the control group. Before and after 30 days of treatment, Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) and Knee Joint Function Score(Lysholm) were compared between the two groups. Serum inflammatory factors, hemorheology, and serum oxidative stress were also compared between the two groups. Occurrence of adverse reactions during treatment was statistically analyzed.Results After 30 days of treatment, the scores of WOMAC scale, interleukin-6(IL-6), erythrocyte sedimentation rate(ESR), high-sensitivity C-reactive protein(hs-CRP), whole blood viscosity(low-shear and high-shear), plasma viscosity, red blood cell aggregation index and fibrinogen(Fb) in the two groups were significantly lower than those before treatment, and the above indicators of the study group were lower than those of the control group(all P<0.05). Lysholm score and levels of superoxide dismutase(SOD) and glutathione(GSH) were significantly higher than those before treatment, and the above indicators were higher in the study group than those in the control group(all P<0.05). There were no significant differences in the occurrence of adverse reactions during treatment between the two groups(P>0.05).Conclusion Acupuncture plus ginger-partitioned moxibustion can relieve the clinical symptoms, reduce the inflammation levels, and improve the hemorheology in patients with knee osteoarthritis.