摘要
目的:观察温通调神针灸法联合化湿生骨方治疗激素性股骨头坏死(SONFH)的临床疗效及对患者疼痛、焦虑状态和血清炎症因子的影响,并探讨其可能机制。方法:70例SONFH患者随机均分为对照组和观察组。对照组(35例)采用化湿生骨方治疗,1剂/d,早晚分服,每周服药5 d,共治疗3个月;观察组(35例)在口服化湿生骨方基础上联合温通调神针灸法治疗,1次/d,每次治疗30 min,每周治疗5 d,共治疗3个月。治疗前和治疗3个月后,随访观察两组VAS、HAMA、HAMD-17评分、血清IL-6、IL-1β及TNF-α水平,并评估疗效。结果:与治疗前比较,两组治疗3个月后VAS、HAMA及HAMD-17评分和血清IL-6、IL-1β及TNF-α水平较治疗前均下降,差异具有统计学意义(P<0.05);治疗3个月后,观察组VAS、HAMA及HAMD-17评分和血清IL-6、IL-1β及TNF-α水平均低于对照组,差异具有统计学意义(P<0.05)。两组治疗后总有效率观察组91.18%(31/34),高于对照组的84.85%(28/33),差异具有统计学意义(P<0.05)。结论:温通调神针灸法联合化湿生骨方可减轻SONFH患者疼痛,改善焦虑状态,提高临床疗效,结合血清IL-6、IL-1β和TNF-α水平下降趋势,推测可能与神经免疫调节和炎症水平改善有关。
Objective:To observe the clinical efficacy of Wentong Tiaoshen acupuncture and moxibustion combined with Huashi Shenggu Formula in treatment of steroid-induced osteonecrosis of femoral head(SONFH),to assess its effects on pain,anxiety status,and serum inflammatory factors,and to explore its potential mechanisms.Methods:A total of 70 patients with SONFH were randomly divided into the control group(n=35,2 cases dropped out)and the observation group(n=35,1 case dropped out).The control group was treated with Huashi Shenggu Formula,one dose daily,taken in the morning and evening,5 days per week,for a total of 3 months;on which basis,the observation group was also treated with Wenton Tiaoshen acupuncture and moxibustion,once daily,30 minutes per session,5 days per week,for 3 months.The scores of VAS,HAMA,and HAMD-17,as well as the serum levels of IL-6,IL-1β,and TNF-αwere recorded before treatment and after 3 months of treatment in both groups.The therapeutic efficacy was evaluated.Results:Compared with baseline,the scores of VAS,HAMA,and HAMD-17,as well as the serum levels of IL-6,IL-1β,and TNF-αwere all decreased in both groups after 3 months of treatment(P<0.05);which were lower in the observation group than the control group(P<0.05).The total effective rate was 91.18%(31/34)in the observation group,which was higher than 84.85%(28/33)in the control group(P<0.05).Conclusion:Wentong Tiaoshen acupuncture and moxibustion combined with Huashi Shenggu Formula can alleviate pain,improve anxiety,and enhance clinical efficacy in patients with SONFH.Considering the downward trends in serum levels of IL-6,IL-1β,and TNF-α,the therapeutic effects may be related to neuroimmune regulation and improvement of inflammatory status.
作者
张胜杰
阎晓霞
谢亚威
李骏巍
韩崇涛
ZHANG Shengjie;YAN Xiaoxia;XIE Yawei;LI Junwei;HAN Chongtao(Henan University of Chinese Medicine,Zhengzhou 450046,China;Luoyang Orthopedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopedic Hospital,Zhengzhou 450047,China;Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450008,China)
出处
《针灸临床杂志》
2025年第11期23-28,共6页
Journal of Clinical Acupuncture and Moxibustion
基金
河南省科技攻关专项,编号:232102310423
河南省中医药科学研究重大专项课题,编号:2022ZYZD14。
关键词
激素性股骨头坏死
针灸
疼痛
焦虑状态
炎症因子
Steroid-induced osteonecrosis of femoral head
Acupuncture and moxibustion
Pain
Anxiety status
Inflammatory factors
