Acupotomy ameliorates knee osteoarthritis-related collagen deposition and fibrosis in rabbit skeletal muscle through the TGF-β/Smad pathway

Objective:To investigate the effects of acupotomy on skeletal muscle fibrosis and collagen deposition in a rabbit knee osteoarthritis(KOA)model.Methods: Rabbits(n=18)were randomly divided into control,KOA,and KOA+acupotomy(Apo)groups(n=6).The rabbits in the KOA and Apo groups were modeled using the modified Videman's method for 6 weeks.After modeling,the Apo group was subjected to acupotomy once a week for 3 weeks on the vastus medialis,vastus lateralis,rectus femoris,biceps femoris,and anserine bursa tendons around the knee.The behavior of all animals was recorded,rectus femoris tissue was obtained,and histomorphological changes were observed using Masson staining and transmission electron microscopy.The expression of transforming growth factor-β1(TGF-β1),Smad 3,Smad 7,fibrillar collagen types I(Col-I)and III(Col-III)was detected using Western blot and real-time polymerase chain reaction(RT-PCR).Results: Histological analysis revealed that acupotomy improved the microstructure and reduced the collagen volume fraction of rectus femoris,compared with the KOA group(P=.034).Acupotomy inhibited abnormal collagen deposition by modulating the expression of fibrosis-related proteins and mRNA,thus preventing skeletal muscle fibrosis.Western blot and RT-PCR analysis revealed that in the Apo group,Col-I,and Col-III protein levels were significantly lower than those in the KOA group(both P<.01),same as Col-I and Col-III mRNA levels(P=.0031;P=.0046).Compared with the KOA group,the protein levels of TGF-β1 and Smad 3 were significantly reduced(both P<.01),as were the mRNA levels of TGF-β1 and Smad 3(P=.0007;P=.0011).Conversely,the levels of protein and mRNA of Smad 7 were significantly higher than that in the KOA group(P<.01;P=.0271).Conclusion: Acupotomy could alleviate skeletal muscle fibrosis and delay KOA progress by inhibiting collagen deposition through the TGF-β/Smad pathway in the skeletal muscle of KOA rabbits.

针刀干预后颈椎病大鼠头夹肌成纤维细胞生长因子家族及其受体的表达

背景:针刀是治疗颈椎病的有效方法,临床疗效确切,但其关键分子机制尚不明晰。目的:观察针刀干预对颈椎病大鼠头夹肌成纤维细胞生长因子家族及其受体激酶插入域蛋白受体表达的影响,分析针刀治疗颈椎病的作用机制。方法:通过检索GEO数据库,获取符合该研究的芯片数据集GSE153761,采用生物信息学方法进行靶标初筛,然后进行动物实验。选取6月龄SPF级SD大鼠24只,随机均分为4组。模型组和针刀组大鼠采用动静力失衡性颈椎病造模方法制备颈椎病大鼠模型;假手术组不切断肌肉及韧带;针刀组造模成功后采用针刀干预,每周1次,共3次;并以正常大鼠作为对照。拍摄颈椎正侧位X射线片进行模型验证;旷场实验观察大鼠行为学变化;苏木精-伊红染色观察头夹肌病理结构;荧光定量PCR法和免疫组化法分别检测头夹肌成纤维细胞生长因子家族及其受体激酶插入域蛋白受体mRNA及蛋白的表达情况。结果与结论:①生物信息学结果表明成纤维细胞生长因子家族/激酶插入域蛋白受体是激活磷脂酰肌醇3-激酶/蛋白激酶B上游的重要信号轴。②造模后大鼠椎间隙变窄,椎体前后缘、关节突骨质增生。③旷场实验中,造模后大鼠总距离、平均速度降低(P<0.05),总休息时间延长(P<0.05);治疗后针刀组大鼠总距离、平均速度大于模型组(P<0.05),总休息时间短于模型组(P<0.05)。④头夹肌病理提示颈肌受损,而针刀可改善颈肌劳损。⑤与正常组比较,模型组大鼠头夹肌成纤维细胞生长因子7、成纤维细胞生长因子9、成纤维细胞生长因子10、成纤维细胞生长因子18和激酶插入域蛋白受体mRNA及蛋白表达均升高(P<0.05);与模型组比较,针刀组以上指标均降低(P<0.05)。⑥结果说明,针刀可能通过调节成纤维细胞生长因子7、成纤维细胞生长因子9、成纤维细胞生长因子10、成纤维细胞生长因子18及其受体激酶插入域蛋白受体的表达,修复劳损颈肌,从而改善椎间盘退变,这可能是针刀治疗颈椎病的关键靶点。

针刀治疗膝骨关节炎大鼠的转录组测序及实验验证

背景:针刀治疗膝骨关节炎临床疗效确切,但针刀干预膝骨关节炎在转录组水平上的调节机制仍未明确。目的:通过针刀干预骨关节炎大鼠,对软骨样本进行转录组测序和生物信息学分析并加以验证,揭示针刀干预骨关节炎大鼠的作用机制。方法:采用随机数字表法将48只SD大鼠随机分为针刀组、模型组和假手术组,每组16只。针刀组、模型组采用内侧半月板失稳术建立骨关节炎模型,造模6周后针刀组大鼠每周进行1次针刀治疗,共治疗4周。治疗4周后,对各组大鼠膝关节进行Micro CT扫描,对关节软骨进行苏木精-伊红染色、番红O-固绿染色及Mankin评分,采用Elisa法检测血清炎症因子水平,对软骨样本进行转录组测序,采用R软件进行差异基因生物信息学分析,采用蛋白互作网络和Cytoscape软件筛选核心靶点并进行RT-qPCR验证。结果与结论:①相较于假手术组,模型组大鼠关节软骨表面粗糙不平、关节间隙狭窄,关节表层结构破坏,Mankin评分升高,血清白细胞介素6、肿瘤坏死因子α、基质金属蛋白酶13水平显著上升(P<0.05);与模型组相比,针刀组大鼠关节软骨表面较为光滑,关节间隙增宽,关节表面轻微不规则,Mankin评分降低,血清白细胞介素6、肿瘤坏死因子α、基质金属蛋白酶13水平显著降低(P<0.05)。②基因本体论及京都基因组和基因组百科全书分析涉及蛋白分解代谢、自噬、丝裂原活化蛋白激酶、核因子kB及Wnt信号通路等,蛋白互作网络及Cytoscape筛选出共济失调毛细血管扩张突变、类Myb SWIRM和MPN结构域蛋白1、热休克蛋白90α1、NIPBL粘连蛋白负载因子4个关键基因。③模型组大鼠关节软骨中共济失调毛细血管扩张突变、类Myb SWIRM和MPN结构域蛋白1、热休克蛋白90α1、NIPBL粘连蛋白负载因子mRNA表达均低于假手术组(P<0.05),针刀组大鼠关节软骨中共济失调毛细血管扩张突变、类Myb SWIRM和MPN结构域蛋白1、热休克蛋白90α1、NIPBL粘连蛋白负载因子mRNA表达均高于模型组(P<0.05)。④针刀干预可能作用于丝裂原活化蛋白激酶、核因子kB及Wnt等信号通路来促进软骨修复,并与共济失调毛细血管扩张突变、类Myb SWIRM和MPN结构域蛋白1、热休克蛋白90α1、NIPBL粘连蛋白负载因子基因的表达密切相关。

益肾壮骨活血方联合针刀疗法治疗髌骨骨性关节炎临床观察

目的探讨髌骨骨性关节炎患者采用益肾壮骨活血方联合针刀疗法的临床效果。方法从南昌市洪都中医院2021年6月—2022年6月收治的髌骨骨性关节炎患者中抽取70例作为研究对象,使用随机数字表法将其分为对照组和观察组,每组35例。对照组和观察组的治疗方法分别为常规西医治疗、益肾壮骨活血方联合针刀治疗,对比两组治疗前后的炎性因子水平和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分。结果治疗后,观察组的白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平均较对照组低(P<0.05),WOMAC评分较对照组低(P<0.05)。结论髌骨骨性关节炎患者采用益肾壮骨活血方与针刀联合治疗效果较显著,不仅能有效减轻炎症反应,还能改善关节功能,临床可进一步推广。

Observation on Ultra-micro Structure of Eggshell and Analysis of Composition of Eggshell and Feather in Great Bustard

Ultra-micro structure of eggshell was observed and compositions of eggshell and feather were analyzed. The results showed that the structure of eggshell has special characters besides common structure. The content of poisonous elements in wild great bustard(Otis talda) eggshell and feather is significant lower than that in eggshell of crested foes(Nipponis nippon) and in feather of red crown crane(Grus japonesis) because of less disturbance by people. The contents of 14 elements of female’s feather all are higher than those of male’s.

Effects of acupotomy on the activity of osteoclasts and osteoblasts in the subchondral bone of rabbits with early and mid-stage knee osteoarthritis models

Objective:To investigate whether acupotomy could inhibit subchondral bone remodeling in knee osteoarthritis(KOA)rabbits by regulating the activity of osteoblasts and osteoclasts.Methods:KOA rabbits were prepared by immobilization for 6 and 9 weeks by Videman method.Nine groups of rabbits(control,6 weeks and 9 weeks model,6 weeks and 9 weeks acupotomy,6 weeks and 9 weeks electroacupuncture,and 6 weeks and 9 weeks drug groups)received acupotomy,electroacupuncture and risedronate sodium intervention,respectively,for 3 weeks.Results:Acupotomy can inhibit the activity of osteoclasts and osteoblasts in subchondral bone by reducing the proteins expression of cathepsin K(CK)and tartrate-resistant acid phosphatase(TRAP)and decreasing the proteins expression of osteocalcin(OCN)and alkaline phosphatase(ALP),to intercept the abnormal bone resorption and bone formation of subchondral bone in 6-week and 9-week immobilization-induced KOA rabbits.Conclusion:These findings indicated that acupotomy may be more advantageous than risedronate sodium intervention in modulating subchondral bone remodeling in KOA rabbits,especially in 9-week immobilization-induced KOA rabbits.

Clinical Study on the Acupotomy for Iliotibial Band Release in the Treatment of Valgus Knee Osteoarthritis

[Objectives]To observe the clinical effect of acupotomy for iliotibial band release in the treatment of valgus knee osteoarthritis.[Methods]Sixty patients with mild valgus knee osteoarthritis who met the inclusion criteria were randomly divided into control group(n=30)and treatment group(n=30).The control group was treated with celecoxib capsule,and the treatment group was treated with acupotomy.The visual analogue score(VAS),modified American knee society score(KSS)and anatomic valgus angulation(AVA)were observed and compared between the two groups before and after treatment to evaluate the curative effect.[Results]Compared with those before treatment,there were significant differences in VAS and KSS between the two groups after treatment(P<0.05).There was no significant difference in AVA between the two groups before and after treatment.There were significant differences in the above-mentioned indexes between the two groups(P<0.05).The comprehensive curative effect of the treatment group was better than that of the control group(P<0.05),and there was significant difference between the two groups one month after treatment(P<0.05).[Conclusions]The acupotomy for iliotibial band release was effective in the treatment of valgus knee osteoarthritis,and it was found to delay the progression of knee valgus deformity through long-term observation.

Testing of the Ultra-Micro Gas Turbine Devices (1 - 10 kW) for Portable Power Generation at University of Roma 1: First Tests Results

The ever increasing development of portable electronics has led to a higher demand for compact and reliable power sources. Significant resources are being presently dedicated to the study of micro machined gas turbines, because of their remarkable power density. The paper reports the procedures and the results of a series of tests conducted at the Department of Mechanical & Aerospace Engineering of University of Roma 1, to obtain the map of an ultra-micro gas turbine device, and the head losses and the combustion efficiency of the corresponding ultra-micro combustion chamber, fed by a mixture of butane and propane. This work is a part of a research aimed at the conception, design and prototyping of an ultra-micro thermo-electrical device for portable power generation. The novelty of the research consists in the fact that the thermal engine is a (ultra-micro) gas turbine set. In a subsequent stage, several different configurations have been assessed to select the most proper geometry and structural characteristics of the most relevant components (radial compressor, radial turbine, combustion chamber, electric motor and generator, bearings, regenerative heat exchanger).

Ultrasound guided acupotomy in treating rhomboid muscle and serratus posterior superior muscle injury:a case report

Objective:The study intended to show us the effect and safety associated with ultrasound-guidance during acupotomy treatment by a case report.Methods:The research presented a case study using ultrasound-guided acupotomy in back pain.The study took place in the Department of Acupuncture and Moxibustion,China-Japan Friendship Hospital.A 56-year-old woman with paroxysmal right upper back pain for more than 10 years,who was diagnosed as the rhomboid muscle and serratus posterior superior muscle injury.Results:After two acupotomy treatments,the Visual Analogue Score(VAS)of the patient declined from7 to 2.One month later,the pain disappeared and the patient was satisfied with it.Conclusion:Ultrasound guidance can be used to observe the anatomical structures clearly to improve the safety of acupotomy treatment.

Clinical Study of Acupotomy Trinity Lysis on Cervical Spondylotic Myelopathy with Liver and Kidney Deficiency Syndrome

Objective:To compare the therapeutic effects of acupotomy trinity lysis and traditional acupotomy on cervical spondylotic myelopathy.Methods:A total of 205 patients with cervical spondylotic myelopathy of liver and kidney deficiency syndrome were randomly divided into the experimental group(105 cases)and the control group(100 cases).The experimental group was relaxed with acupotomy in three positions:Heaven(tian),Human(ren)and Earth(di).Traditional acupotomy was used to relax Ashi acupoints of the affected vertebra in the control group.One treatment was conducted in one week,and the duration of one course of treatment was three weeks.The VAS,JOA score and NDI index were observed after treatment.Results:Before and after treatment,the total treatment efficiency of the treatment group was 95.23%,and that of the control group was 80.00%,there was significant difference between the two groups,P<0.05;Before operation,there was no significant difference in JOA score,NDI index score,and VAS score between the treatment group and the control group(P>0.05);there was no significant difference after 1 week(P>0.05),but there were significant differences between the two groups 2 weeks and 3 weeks after operation(P<0.05).Conclusion:Acupotomy trinity lysis is a safe,effective and economical treatment for cervical spondylotic myelopathy.

Clinical Study of Acupotomy Trinity Lysis Combined with Rehabilitation Training for Spastic Paralysis after Stroke

Objective:To study the clinical efficacy of acupotomy trinity lysis combined with rehabilitation training in the treatment of spastic paralysis after stroke,and to provide guidance for clinical diagnosis and treatment.Methods:From July 2019 to November 2020,119 patients with post-stroke spastic paralysis who were admitted to our hospital's encephalopathy department were selected as the research objects,and 61 patients were divided into acupuncture combined with rehabilitation training group as the observation group by random number table method.58 patients were divided into the rehabilitation training group as the control group.After 21 days of treatment,they passed the modified Ashworth Spasm Scale(MAS)grading scale score,Clinical Spasm Index(clinical spasm index,CSI)assessment,Fugl,Meyer exercise function scale(FMA)Score,Modified Barthel Index Score,and compare the clinical efficacy after treatment.Results:After treatment,the total effective rate of the observation group(95.08%)was higher than that of the control group(86.21%),and the difference was statistically significant(P<0.05);Before treatment,the contrast difference of MAS,FMA,CSI scores and modified Barthel index scores of the two groups of patients is not statistically significant;After treatment,the MAS scores and CSI scores of the elbow and knee joints of the observation group[(1.52±0.81)(1.46±0.83)(5.87±2.12)]were significantly lower than those of the control group[(2.17±0.68)(2.03±0.79)(8.36±2.41)];FMA upper limb and lower limb scores and modified Barthel index[(51.87±4.41)(30.21±5.05)(72.41±5.81)]of the observation group were significantly higher than those of the control group[(44.26±4.78)(28.45±4.23)(68.65±6.09)],the difference was statistically significant(P<0.05).Conclusion:Acupotomy trinity lysis combined with rehabilitation training is effective in treating patients with post-stroke spastic paralysis.It provides a safe,reliable and clinically effective new program,which is worthy of popularization and application.

小针刀联合温针灸治疗神经根型颈椎病疗效分析

目的 探讨小针刀联合温针灸治疗神经根型颈椎病的临床疗效。方法 选取新乡医学院第三附属医院2020年1月—2022年1月收治的神经根型颈椎病患者85例,按治疗方式不同分为观察组45例和对照组40例,对照组给予常规温针灸治疗,观察组给予小针刀联合温针灸治疗。比较两组临床疗效,治疗前后简化McGill疼痛评分、颈部残障指数(NDI)评分、血清炎性指标。结果 治疗后,观察组治疗总有效率高于对照组(P<0.05)。两组患者的PRI感觉分、PRI情绪分、VAS评分、PPI均下降,观察组均低于对照组(P<0.05);两组NDI均下降,观察组低于对照组(P<0.05);两组IL-1、IL-1β、IL-6、TNF-α水平均降低(P<0.05),观察组均低于对照组患者(P<0.05)。结论 小针刀联合温针灸治疗神经根型颈椎病的疗效显著,能有效缓解疼痛,降低炎性因子。

多点注射联合紧张位针刀松解治疗粘连期肩周炎临床研究

目的:观察多点注射联合紧张位针刀松解治疗粘连期肩周炎的临床疗效。方法:选取符合粘连期肩周炎纳入标准的患者共70例,根据随机数字表法将患者随机分为观察组与对照组,每组35例,分别采用多点注射联合紧张位针刀松解治疗、常规注射联合针刀治疗。于治疗前、治疗后1个月、治疗后3个月及6个月随访时进行疼痛视觉模拟评分(VAS)、Constant-murley肩关节功能评分、肩关节活动度及临床疗效评估。结果:在6个月随访时观察组临床疗效优于对照组,差异具有统计学意义(P<0.05)。在治疗后1个月、治疗后3个月时,观察组VAS评分均低于对照组(P<0.05);在治疗后6个月,两组VAS评分差异无统计学意义。观察组在治疗后各时点的Constant-murley肩关节功能评分均高于对照组,差异有统计学意义(P<0.05)。两组肩关节活动度均较治疗前改善,在治疗后1个月、3个月时观察组肩关节前屈、外展、外旋及内旋活动度均优于对照组(P<0.05);而在治疗后6个月时,两组患者在前屈、外展及外旋活动度方面差异无统计学意义(P>0.05),但观察组肩关节内旋活动度仍优于对照组,差异有统计学意义(P<0.05)。结论:多点注射联合紧张位针刀治疗粘连期肩周炎在近远期疗效显著,可有效缓解疼痛、提高患者肩关节功能和改善患者肩关节活动度,且安全可行,值得临床推广。

注射针刀对椎间盘源性下腰痛患者疼痛程度及炎症反应的影响

目的:观察注射针刀治疗对椎间盘源性下腰痛患者的治疗效果。方法:将90例确诊为椎间盘源性下腰痛的病例随机分为注射针刀组、注射组与针刀组各30例,注射针刀组运用注射针刀治疗,注射组给予痛点局部注射治疗,针刀组给予常规小针刀治疗。于3组治疗1个月后评价患者临床疗效,通过观察疼痛直观模拟评分(VAS)、日本骨科学会腰椎疗效评分(JOA)与功能障碍指数(ODI)的变化对3组治疗后局部疼痛和整体症状的改善状况进行评价,抑郁自评量表(SDS)观察3组抑郁状态,并检测3组治疗前后血清中六酮前列腺素F1α(PGF1α)、肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)与白细胞介素-6(IL-6)水平的变化。结果:3组患者治疗前各指标比较差异无统计学意义(P>0.05);治疗结束后,注射针刀组临床疗效优于注射组和针刀组(P<0.05);与注射组、针刀组比较,注射针刀组VAS、ODI与SDS评分明显下降,JOA评分明显提升,差异有统计学意义(P<0.05),血清中PGF1α、TNF-α、IL-1β及IL-6炎症因子水平较注射组和针刀组均有明显下调,差异有统计学意义(P<0.05);注射组VAS、ODI和SDS评分及血清PGF1α、TNF-α、IL-1β及IL-6水平显著低于针刀组,JOA评分较针刀组明显提升,差异有统计学意义(P<0.05)。结论:注射针刀对椎间盘源性下腰痛具有良好的治疗效果,疗效优于局部注射和单纯小针刀治疗,其作用机制可能与降低炎性细胞因子水平、抑制炎症反应相关。

超声引导针刀松解椎枕肌群治疗颈源性眩晕的临床观察

目的观察超声引导针刀松解椎枕肌群治疗颈源性眩晕的安全性及临床疗效。方法将患者根据随机数字表法分为3组,A组采用超声引导针刀松解椎枕肌治疗;B组采用毫针针刺治疗;C组采用手法推拿椎枕肌治疗。治疗2周后将各组治疗前后的颈源性眩晕症状与功能评估量表(ESCV)评分、生活质量评分(SF-36)及左椎动脉(LVA)、右椎动脉(RVA)及基底动脉(BA)平均血流速度进行组间与组内的对比观察。结果治疗2周后各组ESCV、SF-36评分,LVA、RVA及BA平均血流速度均较治疗前改善(P<0.05),治疗2周后A组ESCV、SF-36评分,LVA、RVA及BA平均血流速度均优于B组和C组(P<0.05)。结论超声引导针刀松解椎枕肌群治疗颈源性眩晕具有较好的疗效,能够快速缓解颈源性眩晕,且治疗方法精准、安全、规范。

针刀对颈椎病兔颈后深肌硬度和纤维化的影响

目的:观察针刀干预对颈椎病兔颈后深肌群硬度和纤维化的影响。方法:健康新西兰大白兔15只(雄性)随机分为空白组、模型组和针刀组,每组5只。采用改良的长期头低位法制作兔颈椎病模型,造模周期持续8周。建模成功后,针刀组每周接受一次针刀干预治疗,共4次。治疗结束1周后,进行兔颈椎MRI成像、颈后深肌超声检查、HE和Masson染色观察颈后深肌的形态学改变。结果:普通超声显示:模型组颈后深肌的横截面积与纵向肌肉厚度均较空白组缩小(P<0.05),而针刀组则较模型组增大(P<0.01)。弹性超声可见:空白组颈后深肌肌肉轮廓相对清晰,弹性成像多呈绿色,同时伴有少量红色的低弹性图像;模型组肌肉轮廓模糊,弹性图像以蓝色为主,弹性较高;针刀组颈后深部肌肉轮廓趋于正常,弹性成像显示为中弹性图像,以蓝、绿色为主。Masson染色观察:与空白组相比,模型组颈后深肌撕裂明显,形态不规则,伴大量蓝色胶原充斥在肌细胞内,纤维间隙增大;针刀组可有效改善上述表现,且显著降低胶原容积分数(P<0.05)。另外,与空白组相比,模型组HE染色的细胞形态较混乱,胞质染色不均,细胞核增多,排列不规则,可见部分炎性细胞的浸润,伴大量肌纤维的撕裂等;而针刀组较模型组的形态学明显好转。结论:针刀干预可有效改善颈椎病兔颈后深层肌肉的组织硬度,促进慢性损伤纤维化的修复,这可能是针刀治疗颈椎病的关键所在。

超声引导下不同型号针刀联合复方倍他米松注射液治疗扳机指的疗效对比

目的:观察超声引导下不同型号针刀松解联合复方倍他米松注射液治疗扳机指的临床效果与安全性。方法:选取2020年5月至2023年5月江苏大学附属医院疼痛科诊断为扳机指患者111例为研究对象,将患者按随机数字表法进行简单随机化分为超声引导+复方倍他米松注射液组(Ⅰ组)36例、超声引导+复方倍他米松注射液+平口型针刀组(Ⅱ组)37例、超声引导+复方倍他米松注射液+V型针刀组(Ⅲ组)38例,随访为期6个月。记录3组治疗前(T1)、治疗后次日(T2)、治疗后3周(T3)、治疗后6个月(T4)的视觉模拟评分(VAS)和改良Quinnell分级,记录治疗6个月时整体改善状况(PGII)和复发率,以及手术操作时间和治疗期间不良反应。结果:①VAS评分比较:在T2时间点,Ⅱ组和Ⅲ组评分明显高于Ⅰ组(P<0.001),Ⅱ组评分明显高于Ⅲ组(P<0.05);在T3和T4时间点,Ⅱ组和Ⅲ组均明显低于Ⅰ组(P<0.05和P<0.001),Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。②改良Quinnell分级比较:在T2、T3、T4时间点,Ⅱ组和Ⅲ组分级均明显低于Ⅰ组(P<0.05和P<0.001)、Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。③治疗6个月PGII总体改善评分比较:Ⅱ组和Ⅲ组评分均明显高于Ⅰ组(P<0.001),Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。④复发率比较:Ⅱ组和Ⅲ组均明显低于Ⅰ组(P<0.05),Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。⑤操作时间比较:Ⅱ组和Ⅲ组均明显长于Ⅰ组(P<0.001),Ⅱ组时间明显长于Ⅲ组(P<0.05)。⑥3组均未见明显不良反应。结论:超声引导下针刀松解联合复方倍他米松注射液治疗扳机指效果优于单纯复方倍他米松注射液,V型针刀松解优于平口型针刀。

针刀“调筋治骨法”联合热敏灸治疗膝骨关节炎的临床研究

目的:研究针刀“调筋治骨法”联合热敏灸治疗膝骨关节炎(KOA)的临床疗效。方法:将103例风寒湿痹型KOA患者随机分为两组,对照组51例,研究组52例。对照组实施“调针治骨法”的针刀治疗,研究组在针刀基础上联合热敏灸治疗。两组治疗3个疗程后比较疗效、视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、炎症因子[C反应蛋白(CRP)、白介素6(IL-6)]水平、步行中患侧膝关节屈曲角度及不良反应情况。结果:研究组总有效率为94.23%(49/52),高于对照组的80.39%(41/51),差异具有统计学意义(P<0.05)。治疗后两组患者VAS评分、WOMAC评分较治疗前下降,且研究组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者血清CRP、IL-6水平较治疗前下降,且研究组低于对照组,差异具有统计学意义(P<0.05)。治疗后研究组最大屈曲角度大于对照组,最小屈曲角度小于对照组,差异具有统计学意义(P<0.05)。两组患者治疗期间均未发生明显全身或局部不良反应。结论:针刀“调筋治骨法”联合热敏灸能有效减轻KOA患者疼痛和炎症反应,改善症状,缓解步行中患侧膝关节屈曲角度,无明显不良反应。

超声引导下针刀神经触激术治疗神经根型颈椎病的临床观察

目的:观察在超声引导下针刀神经触激术治疗神经根型颈椎病的临床疗效。方法:按照随机数字表法将纳入的60例神经根型颈椎病患者分为观察组和对照组,各30例。观察组采取针刀神经触激术治疗,每周1次,治疗3周;对照组采取针刺治疗,每日1次,治疗3周。分别于治疗前、治疗1周和3周后观察2组患者视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)评分、田中靖久评分、尺神经与正中神经的F波出现率及传导速度变化。结果:与对照组比较,观察组在治疗1周后、3周后,VAS评分、NDI评分、颈部田中靖久评分、尺神经与正中神经F波出现率、尺神经与正中神经神经传导速度均明显优于对照组(P<0.05)。观察组总有效率为93.33%,对照组总有效率为86.66%,观察组总有效率优于对照组(P<0.05)。结论:超声引导下针刀神经触激术治疗神经根型颈椎病安全有效,优于针刺治疗。

针刀治疗痰瘀互结型痤疮的临床效果观察

目的:观察针刀治疗痰瘀互结型痤疮的临床效果。方法:选取2022年1月—2023年6月于天津市公安医院接诊的痰瘀互结型痤疮患者76例作为研究对象,随机分为对照组和试验组,各38例。对照组采用毫针治疗,试验组采用针刀治疗。比较两组皮损评分、中医证候评分、临床疗效、不良反应发生情况。结果:治疗后,两组皮损评分降低,试验组低于对照组,差异有统计学意义(P<0.05);治疗后,两组中医证候评分降低,试验组低于对照组,差异有统计学意义(P<0.05);试验组治疗总有效率高于对照组,差异有统计学意义(P=0.003);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:针刀治疗痰瘀互结型痤疮的临床效果显著,可善患者皮损状态,缓解症状,且未增加不良反应发生风险。