温针灸联合塞来昔布对膝骨关节炎患者血清炎症因子及关节功能的影响

Effects of warm acupuncture combined with celecoxib on serum inflammatory factors and joint function in patients with knee osteoarthritis

目的探讨温针灸联合塞来昔布对膝骨关节炎患者血清炎症因子及关节功能的影响。方法80例膝骨关节炎患者,按随机数字表法分为对照组和观察组,每组40例。对照组患者单纯口服塞来昔布治疗,观察组患者给予温针灸联合塞来昔布治疗。比较两组患者临床治疗效果、不良反应发生情况及治疗前后视觉模拟评分法(VAS)评分、美国膝关节协会(AKS)评分、膝关节活动度、血清炎症因子(白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白)。结果治疗3周后,两组VAS评分低于本组治疗前,AKS膝评分、功能评分高于本组治疗前,且观察组VAS评分(2.02±0.70)分明显低于对照组的(3.66±0.84)分,AKS膝评分、功能评分分别为(90.65±4.26)、(88.14±5.63)分,明显高于对照组的(76.36±4.12)、(77.55±5.02)分,差异有统计学意义(P<0.05)。治疗3周后,观察组膝关节伸直度、屈曲度分别为(-3.12±0.30)、(127.18±19.65)°,明显高于对照组的(-4.76±0.38)、(106.40±18.76)°,差异有统计学意义(P<0.05)。治疗3周后,两组白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白均低于本组治疗前,且观察组白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白分别为(110.33±20.36)ng/L、(2.52±0.28)μg/L、(7.34±2.25)mg/L,明显低于对照组的(165.24±28.32)ng/L、(3.28±0.33)μg/L、(10.60±2.53)mg/L,差异有统计学意义(P<0.05)。观察组治疗总有效率95.0%高于对照组的77.5%,差异有统计学意义(P<0.05)。两组患者治疗过程中均未见不良反应。结论温针灸联合塞来昔布治疗膝骨关节炎能够更好地减轻膝关节疼痛程度,改善膝关节功能,提高膝关节活动度,降低炎症因子表达,进而提高临床治疗效果。

Objective To discuss the effects of warm acupuncture combined with celecoxib on serum inflammatory factors and joint function in patients with knee osteoarthritis.Methods A total of 80 patients with knee osteoarthritis were divided into control group and observation group according to the random numerical table,with 40 cases in each group.The control group was treated with oral celecoxib alone,and the observation group was treated with warm acupuncture and celecoxib.Both groups were compared in terms of clinical efficacy,occurrence of adverse reactions,visual analogue scale(VAS)score,American Knee Society(AKS)score,knee range of motion,and serum inflammatory factors(interleukin-6,tumor necrosis factor-α,high-sensitivity C-reactive protein).Results After 3 weeks of treatment,VAS score in both groups were lower than that before treatment in this group,and AKS knee and functional scores were higher than those before treatment in this group;VAS score of(2.02±0.70)points in the observation group was significantly lower than that of(3.66±0.84)points in the control group;the AKS knee and functional scores in the observation group were(90.65±4.26)and(88.14±5.63)points,which were significantly higher than those of(76.36±4.12)and(77.55±5.02)points in the control group;the differences were statistically significant(P<0.05).After 3 weeks of treatment,the knee joint straightness and flexion in the observation group were(-3.12±0.30)and(127.18±19.65)°,which were significantly higher than those of(-4.76±0.38)and(106.40±18.76)°in the control group,and the differences were statistically significant(P<0.05).After 3 weeks of treatment,the interleukin-6,tumor necrosis factor-αand high-sensitivity C-reactive protein in both groups were lower than those before treatment in this group;the interleukin-6,tumor necrosis factor-αand high-sensitivity C-reactive protein in the observation group were(110.33±20.36)ng/L,(2.52±0.28)μg/L and(7.34±2.25)mg/L,which were significantly lower than those of(165.24±28.32)ng/L,(3.28±0.33)μg/L and(10.60±2.53)mg/L in the control group;the differences were statistically significant(P<0.05).The total effective rate of the observation group was 95.0%,which was higher than that of 77.5% of the control group,and the difference was statistically significant(P<0.05).No adverse reactions were observed in both groups during treatment.Conclusion Warm acupuncture combined with celecoxib in the treatment of knee osteoarthritis can better reduce the degree of knee pain,improve the function of knee joint,increase knee range of motion,reduce the expression of inflammatory factors,and then improve the clinical treatment effect.