恢刺温针灸联合经筋手法治疗膝关节骨性关节炎的临床研究

Clinical Study on Lateral Needle-Warming Moxibustion Combined with Meridian-Sinew Manipulations in Treatment of KOA

目的:观察恢刺温针灸联合经筋手法对膝关节骨性关节炎(KOA)的临床疗效。方法:将患者随机分为对照组21例和观察组21例,对照组施以普通针刺,观察组予恢刺温针灸联合经筋手法。以视觉模拟疼痛(VAS)评分、膝关节功能Lysholm评分、可视化量表WOMAC评分和血清中炎症因子(IL-1β和TNF-ɑ)为观察指标,观察两组治疗前后各指标评分及临床疗效,并对血清中炎症因子水平进行了比较。结果:治疗前两组KOA患者的VAS评分、血清中炎症因子(IL-1β和TNF-ɑ)等各项观察指标比较差异无统计学意义(P>0.05),与治疗前比较,治疗后两组患者VAS评分均显著降低,Lysholm显著升高、WOMAC评分显著降低,血清中IL-1β和TNF-ɑ水平显著降低,差异均具有统计学意义(P<0.05),且观察组各项指标优于对照组,观察组总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论:恢刺温针灸联合经筋手法治疗膝关节骨性关节炎可能通过降低KOA患者血清中IL-1β和TNF-ɑ水平以缓解疼痛、改善关节功能和提高生活质量,临床疗效显著,且明显优于普通针刺组。

Objective:To observe the clinical effect of lateral needle-warming moxibustion combined with meridian-sinew manipulations in treatment of knee osteoarthritis(KOA).Methods:KOA patients were randomly divided into the control group(n=21)and the observation group(n=21).The control group was treated with conventional needling,whereas the observation group was treated with lateral needle-warming moxibustion combined with meridian-sinew manipulations.The scores of VAS,Lysholm and WOMAC,as well as the serum inflammatory factors of IL-1βand TNF-αwere observed before and after the treatment in the two groups.Clinical efficacy was compared between the two groups.Results:There were no statistical differences in the scores of VAS,Lysholm and WOMAC,as well as in the levels of IL-1βand TNF-αbetween the two groups before the treatment(P>0.05).The scores of VAS and WOMAC were decreased,the score of Lysholm was increased,and the levels of IL-1βand TNF-αwere reduced after the treatment compared with those before the treatment in the two groups(P<0.05),of which the improvements were more significant in the observation group than those in the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Lateral needle-warming moxibustion combined with meridian-sinew manipulations can alleviate pain,improve knee joint function and life quality of the KOA patients through decreasing the serum levels of IL-1βand TNF-α,with a more significant therapeutic effect than conventional needling.