水筋针治疗痛风性膝关节炎疗效观察

Therapeutic efficacy of water sinew acupuncture on gouty knee osteoarthritis

目的 观察水筋针治疗痛风性膝关节炎的临床疗效。方法 将2020年10月—2022年4月南部战区总医院收治的120例痛风性膝关节炎患者随机分为药物组、关节灌洗组和水筋针组,每组各40例。药物组给予塞来昔布和非布司他治疗,关节灌洗组在药物治疗基础上联合关节灌洗治疗,水筋针组在药物治疗基础上联合水筋针治疗,3组均治疗7 d。观察治疗前、治疗第3天和治疗第7天3组患者关节疼痛视觉模拟评分(VAS)、Lysholm膝关节功能评分及血尿酸(UA)、血沉(ESR)、C反应蛋白(CRP)水平,随访6个月内3组患者痛风复发情况。结果 3组患者治疗后VAS评分、Lysholm膝关节功能评分及ESR、CRP、UA水平均较治疗前明显改善(P均<0.05),水筋针组治疗第3天及第7天VAS评分、Lysholm评分改善情况均明显优于药物组和关节灌洗组(P均<0.05)。治疗第3天,水筋针组血清CRP水平明显低于药物组(P<0.05)。治疗第7天,水筋针组ESR、CRP及UA水平均明显低于药物组和关节灌洗组(P均<0.05)。随访6个月,水筋针组患者的复发率明显低于药物组和关节灌洗组(P均<0.05)。结论 水筋针治疗痛风性膝关节炎能有效缓解关节疼痛,改善关节功能,远期疗效较好。

Objective It is to observe the clinical efficacy of water sinew acupuncture in the treatment of gouty knee osteoarthritis.Methods One hundred and twenty patients with gouty knee osteoarthritis treated in General Hospital of Southern Theater Command from October 2020 to April 2022 were randomly divided into drug group,joint lavage group and water sinew acupuncture group,with 40 cases in each group.The drug group was treated with celecoxib and febuxostat,the joint lavage group was treated with joint lavage on the basis of drug therapy,and the water sinew acupuncture group was treated with water sinew acupuncture on the basis of drug therapy,and all the three groups were treated for 7 days.The scores of joint pain visual analog scale(VAS),Lysholm knee function scale,and the levels of blood urea(UA),ESR,C-reactive protein(CRP)of patients in the three groups were observed before treatment,on the the 3rd and 7th day of treatment,and the gout recurrence within 6 months in the three groups was followed-up.Results The VAS scores,Lysholm knee function scores,and the levels of ESR,CRP and UA of patients in the three groups were improved significantly after treatment compared with those before treatment(all P<0.05),and the improvements of VAS scores and Lysholm scores of the water sinew acupuncture group were more significant than those of the drug group and joint lavage group on the 3rd and 7th days of treatment(all P<0.05).On the 3rd day of treatment,the serum level of CRP of the water water sinew acupuncture group was significantly lower than that of the drug group(P<0.05).On the 7th day of treatment,the levels of ESR,CRP and UA of the water sinew acupuncture group were all significantly lower than those of the drug group and joint lavage group(all P<0.05).At 6 months of follow-up,the recurrence rate of patients in the water sinew acupuncture group was significantly lower than that of the drug group and joint lavage group(both P<0.05).Conclusion Water sinew acupuncture can effectively relieve joint pain and improve joint function,and its long-term efficacy is better in the treatment of gouty knee osteoarthritis.