补肾活血通络法针刺联合富血小板血浆治疗膝骨关节炎患者疗效及对血清炎症水平的影响

Effect of kidney-tonifying,blood-activating and collateral-dredging acupuncture combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis and the impact on serum inflammation level

目的:观察补肾活血通络法针刺联合富血小板血浆(PRP)治疗膝骨关节炎(KOA)患者的疗效及对血清炎症因子水平的影响。方法:选取2022年1月~2024年1月于本院治疗的KOA患者82例,随机分成两组,对照组(n=41)采用PRP治疗,联合组(n=41)采用补肾活血通络法针刺联合PRP治疗,观察比较两组患者治疗疗效、血清炎症因子水平、软骨修复相关细胞因子水平与膝关节功能恢复情况。结果:治疗后两组中医证候积分明显下降,联合组较对照组更低(P<0.05);联合组治疗总有效率明显高于对照组(P<0.05)。治疗后两组环氧化酶(COX)-2、基质金属蛋白酶(MMP)-3、肿瘤坏死因子(TNF)-ɑ水平均有明显下降,联合组较对照组更低(P<0.05);两组转化生长抑因子(TGF)-β1水平下降,护骨素(OPG)与骨钙素(BGP)水平有所升高,联合组TGF-β1水平更低,OPG与BGP水平更高(P<0.05);两组骨性关节炎指数可视化量表(WOMAC)与Lequesne MG评分均有明显下降,联合组较对照组更低(P<0.05)。结论:补肾活血通络法针刺与PRP联合治疗KOA患者疗效较好,能有效改善血清炎症因子、软骨修复相关细胞因子水平以及膝关节疼痛与功能。

Objective:To observe the effect of kidney-tonifying,blood-activating and collateral-dredging acupuncture combined with platelet-rich plasma(PRP)in the treatment of knee osteoarthritis(KOA),and the impact on serum inflammatory factor levels.Methods:A total of 82 patients with KOA who were treated in the hospital from January 2022 to January 2024 were selected and randomly divided into two groups.Patients in the control group(n=41)were treated with PRP and those in the combination group(n=41)were treated with kidney-tonifying,blood-activating and collateral-dredging acupuncture combined with PRP.Therapeutic effects,serum inflammatory factor levels,cartilage repair related cytokine levels and knee function recovery in the two groups were observed and compared.Results:After treatment,there were significant decreases in TCM syndrome scores in both groups,and the decreases were greater in the combination group than in the control group(P<0.05).The total effective rate of treatment in the combination group was significantly higher than that in the control group(P<0.05).After treatment,there were significant decreases in the levels of cyclooxygenase-2(COX-2),matrix metalloproteinase-3(MMP-3)and tumor necrosis factor(TNF)-ɑin both groups,and the levels were lower in the combination group(P<0.05).There were decreases in transforming growth factor(TGF-β1)levels,and increases in the levels of osteoprotegerin(OPG)and bone gla protein(BGP)in both groups.Compared with the control group,the combination group had lower TGF-β1 level,and higher levels of OPG and BGP(P<0.05).The Western Ontario and McMaster Universities Arthritis Index(WOMAC)scores and Lequesne MG scores of both groups were significantly reduced,and the combination group had significantly lower scores(P<0.05).Conclusion:Kidney-tonifying,blood-activating and collateral-dredging acupuncture combined with PRP is effective to treat patients with KOA,which can effectively improve the levels of serum inflammatory factors and cartilage repair related cytokines as well as knee pain and function.