摘要
目的研究针刺对老年膝骨关节炎(knee osteoarthritis,KOA)患者的疗效。方法选取2013年6月—2016年6月KOA患者130例,随机分为观察组67例和对照组63例。其中男性45例,女性85例,年龄65~80岁,平均(67.3±13.0)岁。观察组针刺血海、内膝眼、外膝眼和阳陵泉4穴,低频脉冲治疗仪疏密波连接20 min,每周治疗2次。对照组口服盐酸氨基葡萄糖480 mg,每日3次。2组疗程均为4周,治疗前后采用骨性关节炎指数WOMAC评分、视觉模拟评分法(visual analogue scale,VAS)评估KOA的疗效。同时检测炎症因子白细胞介素-1β(interleukin-1 beta,IL-1)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、前列腺素E2(prostaglandins E2,PGE2)和基质金属蛋白酶13(matrix metalloproteinase 13,MMP-13)在膝关节液中的表达水平。结果治疗后与对照组相比,治疗组WOMAC评分更低[(48.25±10.52)vs(33.36±6.26),P<0.05],VAS评分更低[(2.86±1.10)vs(5.23±1.66),P<0.05]。IL-1β含量更低[42.59±6.72)pg/mL vs(89.68±12.86)pg/mL,P<0.05],IL-6含量更低[(126.38±37.25)pg/mL vs(199.26±35.58)pg/mL,P<0.05],TNF-αα含量更低[(6.50±1.02)pg/mL vs(14.22±3.00)pg/mL,P<0.05],PGE2含量更低[(102.50±25.58)pg/mL vs(306.69±49.5)pg/mL,P<0.05],MMP13含量更低[(324.65±45.20)pg/mL vs(462.79±56.68)pg/mL,P<0.05]。结论针刺能改善老年KOA患者的相关症状,减少炎症因子含量,适合临床推广。
Objective To explore the effect of acupuncture on the elderly with knee osteoarthritis （KOA）. Methods130 elderly with KOA were selected and randomly divided into2 groups： observation group（n=67） and control group（ =63）;acupuncture at the acupoints of Xue-hai, inner Xi-yan, outer Xi-yan and Yangling-quan plus low frequency pulse with dila-tational wave for 20 minutes was performed on the elderly in observation group, once every other day; oral administrationof glucosamine hydrochloride was made to the elderly in control group, 480 mg once, 3 times a day; the courses for bothgroups lasted for 4 weeks; WOMAC and visual analogue scale （VAS） were applied to the elderly in both groups before andafter treatment and the curative effect was assessed with the scores; the expression levels of IL-1 （interleukin-1 beta）, IL-6（interleukin-6）, TNF- （tumor necrosis factor-alpha）, PGE2 （prostaglandins E2） and MMP-13 （matrix metalloproteinase13） in knee joint fluid were detected. Results After treatment, the score of WOMAC in observation group （48.25±10.52）was lower than that in control group （33.36±6.26）, as well as the score of VAS [（2.86±1.10） （5.23±1.66）（ P〈0.05）;the contents of IL-1β, IL-6, TNF-α, PGE2 and MMP13 in observation group were all lower than those in control group：[42.59±6.72） pg/mL （89.68±12.86） pg/mL, P〈0.05],[（126.38±37.25）pg/mL （199.26±35.58）pg/mL, P〈0.05],[（6.50±1.02） pg/mL （14.22±3.00） pg/mL, P〈0.05],[（102.50±25.58） pg/mL （306.69±49.5） pg/mL, P〈0.05]and [（324.65±45.20） pg/mL （462.79±56.68） pg/mL,P〈0.05]. Conclusion Acupuncture can improve the related in-flammatory symptoms of the elderly with KOA and reduce thecontents of inflammatory factors, it is worthy of wide clinicalapplication.
出处
《老年医学与保健》
CAS
2017年第5期389-391,395,共4页
Geriatrics & Health Care
基金
国家中医药管理局十二五重点专科建设项目(国中医药医政发[2012]2号)(沪卫中医[2012]11号)
上海市卫生中医药科研基金支撑项目(2012L033A)
上海市进一步加快中医药事业发展三年行动计划(ZY3-CCCX-3-3011)
上海市中西医结合临床重大项目(ZY3-LCPT-2-2003)
上海市老年医学临床重点实验室(13dz2260700)
中医特色诊疗技术建设项目(TSJS2016001)
上海市科学技术委员会科研计划项目(13401907000)
关键词
针刺
骨关节炎
膝
白细胞介素-6
肿瘤坏死因子-
基质金属蛋白酶13
acupuncture
osteoarthritis, knee
IL-6 （interleukin-6）
TNF-α（tumor necrosis factor-alpha）
MMP-13 （matrix metalloproteinase 13）
