温针灸治疗膝关节骨关节炎的效果及对OPG、MMP-3水平的影响

Study on Significance of MMP-3 level of OPG after Warming Acupuncture and Moxibustion in Treatment of Knee Osteoarthritis

目的:研究温针灸治疗膝关节骨关节炎的效果及对血清骨保护素(OPG)、骨钙素、基质金属蛋白酶-3(MMP-3)水平的影响。方法:选取膝关节骨关节炎患者86例,43例采用常规治疗(对照组),其余43例在常规治疗基础上加用温针灸治疗(观察组),分析两组患者治疗后的临床效果。结果:治疗前,两组患者西安大略和麦马斯特大学骨关节炎指数可视化量表(WOMAC)评分、骨代谢等因子水平、关节腔积液及滑膜厚度比较无统计学意义(P>0.05)。治疗后,观察组患者国际KOAWOMAC量表评分比低于对照组,OPG、骨钙素、成纤维生长因子(FGF-2)水平高于对照组,MMP-3、血管内皮细胞生长因子(VEGF)、促血管生成素Ⅰ水平低于对照组,关节腔积液及滑膜厚度低于对照组(P<0.05)。结论:温针灸治疗膝关节骨关节炎可改善临床症状和骨代谢情况,降低MMP-3、VEGF的表达,减轻关节腔积液及滑膜增厚程度。

Objective:To study the significance of serum osteoprotegerin(OPG),osteocalcin and matrix metalloproteinase-3(MMP-3)levels in patients with knee osteoarthritis treated with warm acupuncture.Methods:86 patients with osteoarthritis of knee joint were treated with routine therapy(control group).The remaining 43 patients were treated with warm acupuncture and moxibustion on the basis of routine treatment.The clinical effect after treatment was compared.Results:Before treatment,there was no significant difference in the visual osteoarthritis index(WOMAC)score,bone metabolism and synovial thickness between the two groups(P>0.05).After treatment,the scores of international KOAWOMAC scale were lower in the observation group than those in the control group.The levels of osteocalcin,fibroblast growth factor(FGF-2),vascular endothelial growth factor(VEGF)and angiopoietinⅠwere lower than those in the control group.The joint cavity effusion and synovial thickness were lower than those in the control group(P<0.05).Conclusion:Warming acupuncture and moxibustion treatment of knee osteoarthritis can improve clinical symptoms and bone metabolism,reduce the expression of MMP-3 and VEGF,and alleviate synovial thickening and effusion.