针刀疗法联合除痹逐瘀汤治疗膝骨关节炎临床研究

Clinical Study on Acupotomy Combined with Decoction for EliminatingRheumatism and Removing Stasis in the Treatment of Knee Osteoarthritis

目的:观察针刀疗法联合除痹逐瘀汤治疗膝骨关节炎(knee osteoarthritis, KOA)的临床疗效。方法:将98例KOA患者按照随机数字表法分为对照组和观察组,每组各49例。对照组给予针刀治疗,观察组在对照组治疗的基础上联合除痹逐瘀汤治疗。比较两组患者治疗前后炎性因子水平[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin, IL)-1β、IL-6、IL-17、IL-23]、血液流变学指标、膝关节功能、步态运动学及生活质量评分变化情况。结果:两组患者治疗后TNF-α、IL-1β、IL-6、IL-17、IL-23等炎性因子水平均低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后纤维蛋白原、红细胞聚集指数、红细胞沉降率均低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后疼痛或不适、最长步行距离、日常生活功能障碍等膝关节功能评分均低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后步频、步速、步长均大于本组治疗前,且治疗后观察组大于对照组(P<0.05)。两组患者治疗后症状、躯体、社会、影响、工作等生活质量评分高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。结论:针刀疗法联合除痹逐瘀汤治疗KOA,可改善患者的炎性因子水平及血液流变学指标,促进膝关节功能及步态恢复至正常水平,提高患者生活质量。

Objective:To observe the clinical efficacy of acupotomy combined with Decoction for Eliminating Rheumatism and Removing Stasis on knee osteoarthritis(KOA).Methods:A total of 98 patients with KOA were divided into the control group and the observation group according to the random number table method,with 49 cases in each group.The control group was given acupotomy treatment,while the observation group was given Decoction for Eliminating Rheumatism and Removing Stasis on the basis of the control group.The levels of inflammatory factors[inclulding tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6,IL-17,IL-23],hemorheology in-dexes,knee function,gait kinematics and quality of life scores before and after treatment were compared between the two groups.Re-sults:After treatment,the levels of inflammatory factors such as TNF-α,IL-1β,IL-6,IL-17 and IL-23,etc.in the two groups were lower than those before treatment,and the observation group′s above levels were lower than those of the control group(P<0.05);The fibrin-ogen,erythrocyte aggregation index and erythrocyte sedimentation rate in the two groups were lower than those before treatment,and the observation group′s above indexes were lower than those of the control group(P<0.05);The scores of knee function such as pain or discomfort,the longest walking distance and daily life dysfunction in the two groups were lower than those before treatment,and the ob-servation group′s above indexes were lower than those of the control group(P<0.05);The step frequency,step speed and step length of the two groups were greater than those before treatment,and the observation group′s above indexes were greater than those of the con-trol group(P<0.05);The quality of life scores such as symptoms,body,society,influence and work of the two groups were higher than those before treatment,and the observation group′s above indexes were higher than those of the control group(P<0.05).Conclusion:Conclusion:Acupotomy combined with Decoction for Eliminating Rheumatism and Removing Stasis for KOA can improve the levels of inflammatory factors and hemorheology indexes of patients,promote the knee joint function and gait to return to normal level,and im-prove the quality of life.