针刀治疗膝骨关节炎临床研究
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R684.3

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Clinical Study on Needle Knife for Knee Osteoarthritis
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    摘要:

    目的:观察针刀治疗膝骨关节炎(KOA) 的临床疗效。方法:纳入78 例KOA 患者,按随机数字表法分为试验组和对照组各39 例。试验组给予针刀治疗,对照组给予针刺治疗,2 组疗程均为4 周。比较2 组视觉模拟评分法(VAS) 评分及临床疗效,治疗前后检测2 组血清及关节液中透明质酸(HA) 和白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α) 水平。结果:治疗后,2 组静止、走路及爬楼梯时的VAS 评分均较治疗前降低(P<0.05);试验组走路及爬楼梯时的VAS 评分均低于对照组(P<0.05),静止VAS 评分与对照组比较,差异无统计学意义(P>0.05)。试验组总有效率97.4%,对照组总有效率79.5%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2 组血清HA、IL-1β、IL-6 及TNF-α 水平均较治疗前下降(P<0.05);试验组血清HA 水平低于对照组(P<0.05);血清IL-1β、IL-6、TNF-α 水平与对照组比较,差异均无统计学意义(P>0.05)。治疗后,2 组关节液HA 水平均较治疗前升高(P<0.05),且试验组HA 水平高于对照组(P<0.05);2 组关节液IL-1β、IL-6、TNF-α 水平均较治疗前降低,且试验组上述3 项指标水平均低于对照组(P<0.05)。结论:针刀治疗KOA 临床疗效优于针刺治疗,能更有效地缓解疼痛,其可能的作用机制为通过调节血清和关节液HA、IL-1β、IL-6 及TNF-α 水平发挥作用。

    Abstract:

    Abstract:Objective:To observe the clinical effect of needle knife for knee osteoarthritis(KOA). Methods:A total of 78 cases of KOA patients were divided into the experiment group and the control group according to the random number table method,39 cases in each group. The experiment group was treated with needle knife,and the control group was treated with acupuncture. Both groups were treated for four weeks. The clinical effect and the scores of Visual Analogue Scale(VAS) in the two groups were compared; the levels of hyaluronic acid(HA), interleukin- 1β(IL- 1β), interleukin- 6(IL- 6) and tumor necrosis factor-α(TNF-α) in serum and synovial fluid in the two groups were detected. Results:After treatment,VAS scores in the two groups when staying still,walking and climbing stairs respectively were all decreased when compared with those before treatment(P<0.05);VAS scores in the experiment group when walking and climbing stairs were lower than those in the control group(P<0.05);the comparison of VAS scores when staying still between the two groups showed no significance difference(P>0.05). The total effective rate was 97.4% in the experiment group and 79.5% in the control group, the difference being significant(P<0.05). After treatment,the levels of HA,IL-1β,IL-6 and TNF-α in serum in the two groups were significantly decreased(P<0.05);the level of HA in serum in the experiment group was lower than that in the control group(P<0.05); there was no significant difference being found in the comparisons of IL- 1β, IL- 6 and TNF- α in serum between the two groups(P>0.05). After treatment, the levels of HA in synovial fluid in the two groups were significantly increased(P<0.05), the level of HA in synovial fluid in the experiment group was higher than that in the control group(P< 0.05);the levels of IL- 1β,IL- 6 and TNF- α in synovial fluid in the two groups were significantly decreased(P<0.05),the above three indexes in the experiment group were lower than that in the control group(P<0.05). Conclusion:The application of needle knife has better clinical effect in treating KOA than that of acupuncture, and can relieve pain more effectively, whose possible mechanism may be making a difference by ragulating the levels of HA,IL-1β,IL-6 and TNF-α in serum and synovial fluid.

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王洋,王妞,乔媛媛,段雨飞.针刀治疗膝骨关节炎临床研究[J].新中医,2020,52(14):116-119

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  • 在线发布日期: 2020-07-20
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