摘要
目的:通过观察毫针焠刺法对老年性膝骨关节炎疼痛程度及膝关节腔液炎性细胞因子的影响,比较毫针焠刺法与常规毫针法的疗效差异。方法:将200例患者按随机数字表随机分为治疗组和对照组,每组100例。两组同取患膝伏兔、内膝眼、外膝眼、阳陵泉、阴陵泉、梁丘、血海、膝阳关、足三里穴,治疗组采用毫针火针刺法,对照组采用常规毫针刺法,均留针30 min,隔日治疗1次,共治15次。用酶联免疫吸附法检测关节腔液中白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的水平;治疗前后两组进行病情程度评分、疼痛分级比较,综合评定两组的临床疗效。结果:两组治疗后IL-1I、L-6、TNF-α水平均较治疗前降低(P<0.01),治疗组与对照组治疗后比较差异有统计学意义(P<0.01);两组治疗后病情轻重程度评分均较治疗前有显著改善(P<0.01),治疗组优于对照组(P<0.05);两组治疗后疼痛分级评价,治疗组患者疼痛程度低于对照组(P<0.05)。综合疗效评价中,治疗组临床控制29例(29%),显效46例(46%),有效18例(18%),无效7例(7%);对照组临床控制21例(21%),显效34例(34%),有效29例(29%),无效16例(16%);治疗组疗效优于对照组(P<0.01)。结论:毫针焠刺法治疗老年性膝骨关节炎是一种比常规毫针刺法更为有效的方法,它能够有效降低炎性细胞因子在膝关节腔液中的表达水平。
Objective To observe the effect of red-hot filiform needle puncturing on the pain severity of knee ostarthritis （CA） and the inflammatory cytokine levels in the knee articular cavity （KAC）fluid in senile knee CA patients so as to find a better therapy for knee CA. Methods A total of 200 senile knee CA outpatients （who signed an informed consent） were randomized into treatment group and control group （n = 100/group） according to a random number table and their visiting sequence. Futu iLl 18）, Neixiyan （EX-LE 4）, Yanglingquan （GB 34）, Yinlingquan （SP 9）, Zusanli （ST 36）, etc. on the affected side of the body were punctured with red-hot filiform needles （cauterized on an alcohol burner） or routine filiform needles, with the needles retained for 30 min. The treatment was conducted once every other day, 15 sessions altogether. Before and after the treatment, the patients＇ KAC fluid was sampled for assaying the contents of IL-1, IL-6 and tumor necrosis factor （TNF）-α with enzyme-linked immunosorbent assay （ELISA）. The pain severity was tested by using visual analogue scale （VAS） and the comprehensive therapeutic effect was evaluated by using clinical symptoms and signs, functional activity and pain degrees. Results In comparison with pre-treatment, IL-1, IL-6 and TNF-α contents in KAC fluid were decreased significantly in both treatment and control groups （P〈0.01）. The IL-1, IL-6 and TNF-α levels were considerably lower in the treatment group than in the control group following the treatment （P〈0.01）, suggesting a marked relief of inflammation in the affected knee joint. Compared to pre-treatment, the se-verity scores of illness state of both treatment and control groups were decreased remarkably （P〈0. 01 ）, and the VAS score of the treatment group was significantly lower than that of the control group after the treatment （P〈0. 05）. Of the two 100 knee OA outpatients in the treatment and control groups, 29 （29%） and 21 （21% ） were controlled in their symptoms and signs; 46 （46%） and 34 （34%） experienced apparent improvement; 18 （18%） and 29 （29%） were effective： 7 （7%） and t6 （16%） failed in the treatment. The comprehensive therapeutic effect of the treatment group was significantly superior to that of the control group （P〈0.01）. Conclusion Red-hot filiform needle puncturing is superior to routine filiform needle puncturing in relieving senile knee OA and in reducing inflammatory cytokine levels in knee OA patients.
出处
《针刺研究》
CAS
CSCD
北大核心
2011年第2期110-115,共6页
Acupuncture Research
关键词
老年性膝骨关节炎
毫针焠刺法
常规毫针刺法
关节腔炎性细胞因子
随机对照试验
Senile knee ostarthritis
Red-hot filiform needle puncturing
Routine filiform needle puncturing
Articular inflammatory cytokines
Randomized controlled clinical trials
