基于膝关节功能、疼痛程度及生活质量评价温针灸辅助治疗膝关节骨性关节炎的疗效

Efficacy of Warm Acupuncture and Moxibustion in Adjuvant Treatment of KOA Patients Based on Knee Function,Pain Degree and Quality of Life

目的 探讨温针灸在膝关节骨性关节炎(knee osteoarthritis, KOA)患者治疗中的应用效果。方法 此次60例研究对象均为医院收治的KOA(knee osteoarthritis)患者中进行选取,选例时间控制在2020年3月—2022年3月,分为对照组和观察组,依据随机数字表法进行分组,每组30例。对照组采用常规西药治疗,观察组于上述基础上,采用温针灸治疗,两组均治疗2周。对比两组治疗前后中医症状评分、VAS(visual analog scale)、Lysholm、生活质量评分、骨代谢指标、炎性因子水平,治疗后临床疗效。结果 治疗后,临床总有效率与对照组比,观察组处于更高水平;与治疗前比,治疗后两组中医症状各项评分、VAS评分、血清IL-17(interleukin-17)、MMP-3(matrix metalloproteinase 3)、hs-CRP(hypersensitivity C-reactive protein)、IL-8(interleukin-8)、COMP(cartilage oligomeric matrix protein)、CTX-Ⅱ(typeⅡcollagen carboxy terminal peptide)水平均降低,观察组低于对照组,血清IGF-1(insulin-like growth factor-1)、OPG(osteoprotegerin)、FGF-2(fibroblast growth factor-2)水平、Lysholm评分、生活质量评分均升高,同时与对照组比较,观察组相对更高,差异具有统计学意义(P<0.05)。结论 温针灸辅助治疗KOA患者可有效提高其生活质量,改善膝关节功能及疼痛等多种临床症状,还可降低机体炎性因子水平,稳定骨代谢相关指标水平。

Objective To explore the effect of warm acupuncture and moxibustion in the treatment of patients with knee osteoarthritis(KOA).Methods A total of 60 subjects were selected from KOA patients admitted to the hospital from March 2020 to March 2022.They were divided into the control group and the observation group according to the random number table method,30 cases in each group.The control group was treated with conventional western medicine.On the basis of the above,the observation group was treated with warm acupuncture and moxibustion,both groups were treated for 2 weeks.The TCM symptom scores,visual analog scale(VAS),Lysholm,quality of life score,bone metabolism index,inflammatory factor level before and after treatment,and the clinical efficacy after treatment were compared between the two groups.Results After treatment,the total clinical effective rate of the observation group was at a higher level than that of the control group.After treatment,the scores of TCM symptoms,VAS scores,serum levels of interleukin-17(IL-17),matrix metalloproteinase 3(MMP-3),hypersensitivity C-reactive protein(hs-CRP),interleukin-8(IL-8),cartilage oligomeric matrix protein(COMP)and type II collagen carboxy terminal peptide(CTX-Ⅱ)of the two groups decreased,and those of the observation group were lower than those of the control group.The levels of serum insulin-like growth factor-1(IGF-1),fibroblast growth factor-2(FGF-2),osteoprotegerin(OPG),Lysholm score and quality of life score of the two groups increased.At the same time,compared with those of the control group,those of the observation group were relatively higher,and the significant difference existed(P<0.05).Conclusion Warm acupuncture and moxibustion can effectively improve the quality of life of KOA patients,improve knee joint function,pain and other clinical symptoms,but also can reduce the levels of inflammatory factors and stabilize the level of bone metabolism related indicators.