艾灸联合藤药粉对膝关节炎患者关节功能及免疫的影响

Effect of moxibustion combined with rattan powder on joint function and immunity in patients with knee arthritis

目的研究艾灸联合藤药粉对膝关节炎患者疗效、关节功能及T淋巴细胞的作用。方法选择2017年8月至2018年9月在郑州市骨科医院中医骨科进行住院治疗的膝关节炎患者84例,按照随机数字表分为Ra组(玻璃酸钠注射液治疗)和Rb组(玻璃酸钠注射液、艾灸联合藤药粉治疗)各42例。观察Ra组和Rb组患者治疗效果、关节功能、T淋巴细胞及炎性水平的差异性。结果Rb组痊愈17例,总有效40例,而Ra组无效患者8例高于Rb组2例,从治疗效果上来看,Rb组的疗效更好(Z=2.022,P=0.043);在治疗后Ra组、Rb组患者关节疼痛和僵硬的数值较治疗前下降幅度大(P<0.05);且与Ra组相比,Rb组关节功能各项指标更低,两组差异有统计学意义(P<0.05);治疗后,CD_(3)^(+)和CD_(4)^(+)表达水平较治疗前升高(P<0.05),CD_(4)^(+)/CD_(8)^(+)、CD_(8)^(+)与治疗前比较差异无统计学意义(P>0.05);治疗后,Rb组的CD_(3)^(+)、CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)都较Ra组有所升高;治疗后Ra组和Rb组患者各项评分较治疗前均有所下降(P<0.05),与Ra组相比,Rb组患者Lequesne评分降低(P<0.05);Ra组和Rb组在治疗后,超敏C-反应蛋白(hs-CRP)、白细胞介素-1(IL-1β)指标均有下降(P<0.05),且Rb组患者IL-1β、hs-CRP水平显著低于Ra组(P<0.05)。结论艾灸联合藤药粉治疗膝关节炎患者疗效显著,能有效改善患者关节功能及炎性水平,对T淋巴细胞有一定调节作用。

Objective To study the therapeutic effect,joint function,and T lymphocyte function of moxibustion combined with rattan powder on patients with knee arthritis.Methods From August 2017 to September 2018,84 patients with knee arthritis who were hospitalized in the Traditional Chinese Orthopedics Department of Zhengzhou Orthopedics Hospital were randomly divided into two groups:the Ra group(treated with sodium hyaluronate injection)and the Rb group(treated with sodium hyaluronate injection combined with moxibustion and rattan powder),with 42 patients in each group.The differences in treatment efficacy,joint function,T lymphocytes,and inflammatory levels between the Ra and Rb groups of patients were observed.Results The number of patients who recovered in the Rb group was 17,and the number of effective patients reached 40.However,the number of ineffective patients in the Ra group was 8,which was higher than that in the Rb group.From the perspective of treatment effectiveness,the Rb group had better efficacy(Z=2.022,P=0.043);After treatment,the values of joint pain and stiffness in the Ra and Rb groups decreased significantly compared to before treatment(P<0.05);Compared with the Ra group,the Rb group had lower joint function indicators,and there was a significant difference between the two groups(P<0.05);After treatment,the expression levels of CD_(3)^(+)and CD_(4)^(+)increased compared to before treatment(P<0.05),while there was no statistically significant difference in CD_(4)^(+)/CD_(8)^(+),CD_(8)^(+)compared to before treatment(P>0.05);After treatment,the levels of CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)in the Rb group increased compared to the Ra group;After treatment,the scores of patients in the Ra and Rb groups decreased compared to before treatment(P<0.05),while the Lequesne scores of patients in the Rb group decreased compared to the Ra group(P<0.05);After treatment,the Ra and Rb groups showed all indicators of hypersensitive C-reactive protein(hs-CRP)and interleukin-1(IL-1β)levels decreased(P<0.05),and the levels of IL-1βand hs-CRP in the Rb group were significantly lower than those in the Ra group(P<0.05).Conclusion Moxibustion combined with rattan powder is effective in the treatment of knee arthritis patients,which can effectively improve the joint function and inflammatory level of patients,and has a certain regulatory effect on T lymphocytes.