改良青龙摆尾针法对膝关节骨性关节炎MMP-3、MMP-9水平的影响及疗效观察
|
摘要
目的:观察改良青龙摆尾针法与普通针刺手法对膝关节骨性关节炎患者基质金属蛋白(MMP)-3、MMP-9水平的影响及其疗效差异,明确改良青龙摆尾针法治疗骨性关节炎的优势。方法:将95例膝骨性关节炎患者随机分为两组,其中改良青龙摆尾组48例,采用改良青龙摆尾针法进行治疗;普通针刺组47例,采用普通针刺法进行治疗。采用尼莫地平法评定临床疗效。结果:①两组患者治疗后MMP-3、MMP-9水平均有所下降,与治疗前比较差异均具有统计学意义(P<0.05),且改良青龙摆尾组优于普通针刺组(P<0.01);②改良青龙摆尾组临床治愈率为52.08%,总有效率为97.92%;普通针刺组临床治愈率为25.53%,总有效率为85.11%。两组临床总有效率比较,差异有统计学意义(P<0.01)。结论:改良青龙摆尾针法和普通针刺均能改善患者MMP-3、MMP-9水平,但改良青龙摆尾组明显优于普通针刺组,临床疗效确切,值得推广应用。
Objective: To compare and observe the effects of modified Qinglong Baiwei acupuncture method on matrix metalloproteinase(MMP)-3 and MMP-9 levels in patients with knee osteoarthritis and the difference in curative effect, and to clear the advantages of Qinglong Baiwei acupuncture method for osteoarthritis. Methods: Ninety-five patients with knee osteoarthritis were randomly divided into two groups. Forby-eight patients in the modified Qinglong Baiwei group were treated with modified Qinglong Baiwei acupuncture method, and 47 patients in the ordinary acupuncture group were treated with ordinary acupuncture.The clinical efficacy was assessed using the knee osteoarthritis severity index(ISOA). Results: ①The levels of MMP-3 and MMP-9 decreased after treatment in both groups, and there was a statistically significant difference comparing with before treatment(P<0.05). The improvement of the modified Qinglong Baiwei group was better than that of ordinary acupuncture(P<0.01). ②The clinical cure rate of modified Qinglong Baiwei group was 52.08%, and the total effective rate was 97.92%, while the clinical cure rate in the ordinary acupuncture group was 25.53%, and the total effective rate was 85.11%. The clinical cure rates of the two groups were compared and significant difference was found(P<0.01). Conclusion: Both modified Qinglong Baiwei acupuncture method and ordinary acupuncture can improve the level of MMP-3 and MMP-9 in patients, but the modified Qinglong Baiwei acupuncture method is significantly better than ordinary acupuncture with definite clinical curative effect and is worthy of popularization and application.
Objective: To compare and observe the effects of modified Qinglong Baiwei acupuncture method on matrix metalloproteinase(MMP)-3 and MMP-9 levels in patients with knee osteoarthritis and the difference in curative effect, and to clear the advantages of Qinglong Baiwei acupuncture method for osteoarthritis. Methods: Ninety-five patients with knee osteoarthritis were randomly divided into two groups. Forby-eight patients in the modified Qinglong Baiwei group were treated with modified Qinglong Baiwei acupuncture method, and 47 patients in the ordinary acupuncture group were treated with ordinary acupuncture.The clinical efficacy was assessed using the knee osteoarthritis severity index(ISOA). Results: ①The levels of MMP-3 and MMP-9 decreased after treatment in both groups, and there was a statistically significant difference comparing with before treatment(P<0.05). The improvement of the modified Qinglong Baiwei group was better than that of ordinary acupuncture(P<0.01). ②The clinical cure rate of modified Qinglong Baiwei group was 52.08%, and the total effective rate was 97.92%, while the clinical cure rate in the ordinary acupuncture group was 25.53%, and the total effective rate was 85.11%. The clinical cure rates of the two groups were compared and significant difference was found(P<0.01). Conclusion: Both modified Qinglong Baiwei acupuncture method and ordinary acupuncture can improve the level of MMP-3 and MMP-9 in patients, but the modified Qinglong Baiwei acupuncture method is significantly better than ordinary acupuncture with definite clinical curative effect and is worthy of popularization and application.
引文
[1]陈震,吴志明,郑传飞,等.膝骨性关节炎的现代针灸治疗研究进展分析.云南中医中药杂志,2018,39(5):85-88
[2]帖小佳,郑如庚,赵梦,等.中国中老年人膝关节骨关节炎患病率的Meta分析.中国组织工程研究, 2018,22(4):650-656
[3]李其友,郭瑾,田华张,等.腹针结合温针灸治疗膝关节骨性关节炎临床研究.针刺研究,2017,42(4):350-353
[4]赵培青,关雪峰.针灸治疗膝骨性关节炎的临床研究进展.针灸临床杂志,2015,31(3):79-82
[5]Haseeb A,Haqqi T M.Immunopathogenesis of osteoarthritis.ClinImmunol,2013,146(3):185-196
[6]雷文淼,张鸿.独活寄生汤治疗膝骨性关节炎患者的疗效及对患者关节液MMP-3、MMP-9水平的影响.陕西中医,2017,38(10):1432-1433
[7]中华医学会骨科学分会.骨关节炎诊治指南(2007年版).中国矫形外科杂志,2014,27(3):28-30
[8]付大清,李继恩.电针加揿针治疗高龄老年人膝关节骨性关节炎疗效观察.中国针灸,2013,33(S1):20-23
[9]贺占坤,沈杰威.MMP-2、MMP-3、MMP-9和TIMP-1评价膝关节骨性关节炎的临床研究.重庆医学,2013,42(32):3872-3874
[10]黄怡然,金英利,李娜,等.针刀、电针和圆利针对兔膝骨关节炎软骨MMP-1、MMP-3、MMP-13和TIMP-1表达的影响.中华中医药杂志,2014,29(8):2600-2604
[11]Jeong J H,Moon S J,Jhun J Y,et al.Eupatilin exerts antinociceptiveand chondroprotective properties in a rat model of osteoarthritisby downregulating oxidative damage and catabolic activity inchondrocytes.Plos One,2015,10(6):e0130882
[12]Stone A V,Vanderman K S,Willey J S,et al.Osteoarthritic changesin vervet monkey knees correlate with meniscus degradationand increased matrix metalloproteinase and cytokine secretion.Osteoarthritis&Cartilage,2015,23(10):1780
[13]Ding Q H,Ji X W,Cheng Y,et al.Inhibition of matrix metalloproteinases and inducible nitric oxide synthase by andrographolidein human osteoarthritic chondrocytes.Mod Rheumatol,2012,15(1):57-64
[14]王维山,董金波,何斌,等.OA患者血液及关节液中MMP-3、u PA水平检测及临床意义.山东医药,2011,51(3):63-64
[15]祁同宁,常韬.膝关节骨性关节炎中医药治疗研究进展.中国医院药学杂志学术年会,2016:36
[16]杨帅,徐峰,秦丽娜.近年针灸治疗膝关节骨性关节炎的文献综述.世界中西医结合杂志,2016,11(2):278-284
[17]岳萍,高亮,陈默,等.温针灸对膝骨性关节炎兔行为学及关节软骨肿瘤坏死因子-α、基质金属蛋白酶-3含量的影响.针刺研究,2016,41(3):235-239
[18]卢智,陈华,胡方梅,等.毫针齐刺阿是穴结合青龙摆尾法治疗腰3横突综合征临床研究.中国中医急症,2013,22(10):1778-1779
[19]刘磊,王富春.古今医家青龙摆尾针法技术对比分析.辽宁中医药大学学报,2007,9(6):19-20
[20]焦杨,辜锐鑫.改良青龙摆尾针法治疗腰椎间盘突出症的临床观察.湖北中医杂志,2011,33(1):15-17
[21]费兰波,李家康.青龙摆尾针法治疗腰椎间盘突出症疗效观察.中国中医骨伤科杂志,2005,13(1):47-48
[2]帖小佳,郑如庚,赵梦,等.中国中老年人膝关节骨关节炎患病率的Meta分析.中国组织工程研究, 2018,22(4):650-656
[3]李其友,郭瑾,田华张,等.腹针结合温针灸治疗膝关节骨性关节炎临床研究.针刺研究,2017,42(4):350-353
[4]赵培青,关雪峰.针灸治疗膝骨性关节炎的临床研究进展.针灸临床杂志,2015,31(3):79-82
[5]Haseeb A,Haqqi T M.Immunopathogenesis of osteoarthritis.ClinImmunol,2013,146(3):185-196
[6]雷文淼,张鸿.独活寄生汤治疗膝骨性关节炎患者的疗效及对患者关节液MMP-3、MMP-9水平的影响.陕西中医,2017,38(10):1432-1433
[7]中华医学会骨科学分会.骨关节炎诊治指南(2007年版).中国矫形外科杂志,2014,27(3):28-30
[8]付大清,李继恩.电针加揿针治疗高龄老年人膝关节骨性关节炎疗效观察.中国针灸,2013,33(S1):20-23
[9]贺占坤,沈杰威.MMP-2、MMP-3、MMP-9和TIMP-1评价膝关节骨性关节炎的临床研究.重庆医学,2013,42(32):3872-3874
[10]黄怡然,金英利,李娜,等.针刀、电针和圆利针对兔膝骨关节炎软骨MMP-1、MMP-3、MMP-13和TIMP-1表达的影响.中华中医药杂志,2014,29(8):2600-2604
[11]Jeong J H,Moon S J,Jhun J Y,et al.Eupatilin exerts antinociceptiveand chondroprotective properties in a rat model of osteoarthritisby downregulating oxidative damage and catabolic activity inchondrocytes.Plos One,2015,10(6):e0130882
[12]Stone A V,Vanderman K S,Willey J S,et al.Osteoarthritic changesin vervet monkey knees correlate with meniscus degradationand increased matrix metalloproteinase and cytokine secretion.Osteoarthritis&Cartilage,2015,23(10):1780
[13]Ding Q H,Ji X W,Cheng Y,et al.Inhibition of matrix metalloproteinases and inducible nitric oxide synthase by andrographolidein human osteoarthritic chondrocytes.Mod Rheumatol,2012,15(1):57-64
[14]王维山,董金波,何斌,等.OA患者血液及关节液中MMP-3、u PA水平检测及临床意义.山东医药,2011,51(3):63-64
[15]祁同宁,常韬.膝关节骨性关节炎中医药治疗研究进展.中国医院药学杂志学术年会,2016:36
[16]杨帅,徐峰,秦丽娜.近年针灸治疗膝关节骨性关节炎的文献综述.世界中西医结合杂志,2016,11(2):278-284
[17]岳萍,高亮,陈默,等.温针灸对膝骨性关节炎兔行为学及关节软骨肿瘤坏死因子-α、基质金属蛋白酶-3含量的影响.针刺研究,2016,41(3):235-239
[18]卢智,陈华,胡方梅,等.毫针齐刺阿是穴结合青龙摆尾法治疗腰3横突综合征临床研究.中国中医急症,2013,22(10):1778-1779
[19]刘磊,王富春.古今医家青龙摆尾针法技术对比分析.辽宁中医药大学学报,2007,9(6):19-20
[20]焦杨,辜锐鑫.改良青龙摆尾针法治疗腰椎间盘突出症的临床观察.湖北中医杂志,2011,33(1):15-17
[21]费兰波,李家康.青龙摆尾针法治疗腰椎间盘突出症疗效观察.中国中医骨伤科杂志,2005,13(1):47-48