摘要
目的:比较针刺结合刺络拔罐与单纯针刺治疗气滞血瘀型膝骨关节炎(KOA)的临床疗效,寻求临床治疗KOA安全有效的治疗方案。方法:将70例气滞血瘀型KOA患者随机分为对照组和治疗组,每组35例,其中治疗组脱落1例,对照组脱落2例。对照组予针刺治疗,治疗组在针刺结束后予以刺络拔罐疗法,两组均隔日1次,共治疗4周。以疼痛视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-13(MMP-13)含量为观察指标,通过WOMAC评分下降率评价两组患者的临床疗效。结果:治疗后,治疗组有效率为88.24%(30/34),显著高于对照组的81.82%(27/33)(P<0.05);两组VAS、WOMAC评分和血清IL-1β、TNF-α、MMP-13含量均较治疗前显著降低(P<0.05),且治疗组均显著低于对照组(P<0.05)。结论:采用针刺结合刺络拔罐可改善气滞血瘀型KOA患者的关节功能、降低疼痛感,且疗效优于单纯针刺,可能与抑制NF-κB信号通路,降低血清IL-1β、TNF-α、MMP-13含量有关。
Objective:To compare the clinical efficacy of acupuncture combined with pricking collaterals and cupping with acupuncture alone in the treatment of knee osteoarthritis with qi stagnation and blood stasis,and to seek a safe and effective treatment scheme for knee osteoarthritis(KOA).Methods:A total of 70 patients with KOA of qi stagnation and blood stasis were randomly divided into treatment group and control group,with 35 cases in each group,including 1 case in treatment group and 2 cases in control group dropped.The control group was treated with acupuncture,and the treatment group was treated with pricking collaterals and cupping after acupuncture.Both groups were treated every other day for 4 weeks.The visual analogue scale(VAS),the Western Ontario and McMaster Universities Arthritis Index(WOMAC)and the contents of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-a)and matrixmetallo proteinase-13(MMP-13)in serum were used as observation indexes,and the clinical efficacy of the two groups was evaluated by the decline rate of WOMAC score.Results:After treatment,the effective rate of the treatment group was 88.24%(30/34),which was significantly higher than that of the control group(81.82%)(27/33)(P<0.05).The scores of VAS and WOMAC and the contents of serum IL-1β,TNF-αand MMP-13 in both groups were significantly lower than those before treatment(P<0.05),and those in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:Acupuncture combined with pricking collaterals and cupping can improve the joint function and reduce the pain of KOA patients with qi stagnation and blood stasis,and the curative effect is better than that of acupuncture alone,which may be related to inhibiting NF-B signaling pathway and reducing the contents of IL-1β,TNF-αand MMP-13 in serum.
作者
牟成林
逯子衡
蔡青城
赵鑫
王艳君
MU Chenglin;LU Ziheng;CAI Qingcheng;ZHAO Xin;WANG Yanjun(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China;The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang 050011,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2023年第8期3944-3947,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家重点研发计划(No.2018YFC1707803)
河北省中医药管理局科研计划重点项目(No.Z2022009)
河北中医学院科技能力提升项目(No.KTY2019010)。
关键词
刺络拔罐
针刺
络病理论
膝骨关节炎
Pricking collaterals and cupping
Acupuncture
Collateral disease theory
Knee osteoarthritis
