筋针联合体外冲击波治疗早中期膝骨关节炎临床研究
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R684.3;R245.3

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浙江省基础公益研究计划项目(LGF19H170006);丽水市科技计划项目(2019GYX20)


Clinical Study on Sinew Acupuncture Combined with Extracorporeal Shock Wave for Knee Osteoarthritis in Early and Middle Stage
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    摘要:

    目的:观察筋针联合体外冲击波治疗早中期膝骨关节炎(KOA) 的疗效及对关节液中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α) 表达的影响。方法:将80 例早中期KOA 患者按随机数字表法分为观察组和对照组各40 例。对照组口服艾瑞昔布联合体外冲击波治疗,观察组采用筋针联合体外冲击波治疗。比较2 组临床疗效及治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC) 评分、关节液中IL-1β、TNF-α 含量变化情况。结果:观察组总有效率为95.00%,对照组为77.50%,2 组比较,差异有统计学意义(P<0.05)。治疗前,2 组WOMAC 评分中关节疼痛、僵硬及功能评分比较,差异无统计学意义(P>0.05)。治疗后,2 组WOMAC 评分中关节疼痛、僵硬及功能评分均低于治疗前,且观察组WOMAC 评分中关节疼痛、僵硬及功能评分均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2 组关节液中IL-1β、TNF-α 含量比较,差异无统计学意义(P>0.05)。治疗后,2 组关节液中IL-1β、TNF-α 含量较治疗前下降(P<0.05),且观察组关节液中IL-1β、TNF-α含量低于对照组(P<0.05)。观察组不良反应发生率为7.50%,低于对照组25.0%,差异有统计学意义(P<0.05)。结论:筋针联合体外冲击波治疗早中期KOA 具有较好的临床疗效,可以改善关节功能,降低关节液中炎症因子水平,且安全性高。

    Abstract:

    Abstract:Objective:To observe the curative effect of sinew acupuncture combined with extracorporeal shock wave for knee osteoarthritis(KOA) in early and middle stage, and its effect on the expression of interleukin 1β(IL- 1β) and tumor necrosis factor α(TNF- α) in synovial fluid. Methods:A total of 80 patients with KOA in early and middle stage were divided into the observation group and the control group according to the random number table method,40 cases in each group. The control group was given the oral administration of imrecoxib combined with extracorporeal shock wave,and the observation group was given sinew acupuncture combined with extracorporeal shock wave. The clinical effect was compared between the two groups. Before and after treatment, the changes in the score of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) and the contents of IL- 1β and TNF- α in synovial fluid were compared between the two groups. Results: The total effective rate was 95.00% in the observation group, and 77.50% in the control group, the difference being significant(P<0.05). Before treatment,when compared the scores of pain,stiffness,and function of join in WOMAC between the two groups, there was no significance in the difference(P>0.05). After treatment, the scores of pain,stiffness,and function of join in WOMAC in the two groups were lower than those before treatment,and the three scores above in the observation group were lower than those in the control group, differences being significant(P<0.05). Before treatment,when compared the contents of IL-1β and TNF-α in synovial fluid between the two groups,there was no significance in the difference(P>0.05). After treatment,the contents of IL-1β and TNF-α in synovial fluid in the two groups were decreased when compared with those before treatment(P<0.05),and the two contents above in the observation group were lower than those in the control group(P<0.05). The incidence of adverse reactions was 7.50% in the observation group, lower than that of 25.0% in the control group,the difference being significant(P<0.05). Conclusion:The therapy of sinew acupuncture combined with extracorporeal shock wave has a good clinical effect in the treatment of KOA in early and middle stage,which can improve joint function and reduce the levels of inflammatory factors in synovial fluid,with high safety.

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朱慧梅,俞坤强,吴李秀,戴梦圆.筋针联合体外冲击波治疗早中期膝骨关节炎临床研究[J].新中医,2021,53(13):157-160

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  • 在线发布日期: 2021-07-11
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