毫火针经筋刺法结合运动针法治疗膝骨性关节炎疗效观察

Therapeutic Effect on Knee Osteoarthritis Treated with Combination of Filiformfire Needling,Muscular Region-acupuncture and Kinematic-acupuncture

目的观察毫火针经筋刺法结合运动针法治疗膝骨性关节炎的临床疗效。方法将104例膝骨性关节炎患者随机分为对照组和观察组,每组各52例。对照组采用双氯芬酸钠肠溶片及附桂骨痛胶囊口服治疗,观察组采用毫火针结合运动针法治疗,两组均治疗1个月,共2个疗程。观察治疗前后及治疗后4个月两组视觉模拟量表评分(VAS)、膝骨性关节炎量表(WOMAC)及奎森功能演算指数(Lequesne)评分,白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)水平和临床疗效。结果治疗组临床总有效率(96.15%),明显高于对照组(82.69%)(P<0.05);治疗后及治疗后4个月,两组VAS、WOMAC、Lequesne评分均明显降低,且观察组评分明显优于对照组(P<0.05);治疗后及治疗后4个月,两组IL-6、IL-1β、TNF-α、MMP-3水平明显降低,且观察组炎性介质水平变化明显优于对照组(P<0.05)。结论毫火针经筋刺法结合运动针法治疗膝骨性关节炎疗效确切,可有效缓解疼痛,改善膝关节功能,通过抑制促炎因子水平表达以达到抗炎镇痛效果,值得在临床应用。

Objective To observe the therapeutic effect on knee osteoarthritis treated with combination of filiform-fire needling,muscular region-acupuncture and kinematic-acupuncture.Methods 104 patients with knee osteoarthritis disease were randomly divided into control group and observation group,with 52 cases in each group.The control group was treated with diclofenac sodium enteric-coated tablets and Fugui Gutong Capsules(附桂胃痛胶囊)orally,and the observation group was treated with acupuncture combined with filiform-fire needling,muscular region-acupuncture and kinematic-acupuncture.Both groups were treated for 1 month with a total of 2 courses.To observe the visual analog scale score(VAS),knee osteoarthritis scale(WOMAC),Quesson functional calculus index(Lequesne)scores,interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),matrix metalloproteinase-3(MMP-3)levels of the two groups before and after treatment and 4 months after treatment and the clinical efficacy of the two groups.Results The total clinical effective rate of the treatment group was 96.15%,which was significantly higher than that of the control group(82.69%)(P<0.05);after treatment and 4 months after treatment,the VAS,WOMAC and Lequesne scores of the two groups were significantly reduced,and the observation group scores were significantly better than the control group(P<0.05);after treatment and 4 months after treatment,the levels of IL-6,IL-1β,TNF-α,and MMP-3 in the two groups were significantly reduced,and the changes in the levels of inflammatory mediators in the observation group were significantly better in the control group(P<0.05).Conclusion The combination of filigree-fire needle meridian acupuncture and exercise acupuncture is effective in treating knee osteoarthritis.It can effectively relieve pain,improve knee joint function,and achieve anti-inflammatory and analgesic effects by inhibiting the expression of pro-inflammatory factors.It is worthy of clinical application.