针灸联合祖师麻治疗对膝骨关节炎患者血清VEGF、bFGF表达的影响
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摘要
目的观察针灸联合祖师麻治疗对膝骨关节炎患者血清血管内皮生长因子(vascular endothelialgrowth factor, VEGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor, bFGF)表达的影响。方法选取236例膝骨关节炎患者,采用随机数字表法分为两组,每组118例。对照组予以塞来昔布治疗,观察组给予针灸联合祖师麻治疗。比较两组患者疗效及治疗前后VAS评分、WOMAC评分和血清VEGF、b FGF水平;比较两组患者不良反应的发生率。结果对照组和观察组总有效率分别为87.3%、94.9%,观察组总有效率显著高于对照组(P<0.05);两组治疗前VAS评分、WOMAC评分比较差异无统计学意义(P>0.05),两组治疗后VAS评分、WOMAC评分均显著下降(P<0.05);两组治疗后VAS评分比较差异无统计学意义(P>0.05),而观察组WOMAC评分显著低于对照组(P<0.05);两组治疗前VEGF、bFGF比较差异无统计学意义(P>0.05),两组治疗后VEGF、bFGF均下降(P<0.05),且观察组显著低于对照组(P<0.05);对照组不良反应发生率为3.4%,观察组不良反应发生率为1.7%,两组比较差异无统计学意义(P>0.05)。结论针灸联合祖师麻治疗膝骨关节炎可以减轻炎症反应,抑制滑膜血管新生,有效改善疼痛和关节功能。
Objective To investigate the effect of acupuncture and moxibustion plus Zushima on serum vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(b FGF) in patients with knee osteoarthritis.Method Two hundred and thirty-six patients with knee osteoarthritis were allocated, using a random number table, to two groups, 118 cases each. The control group was treated with Celecoxib and the observation group, with acupuncture and moxibustion plus Zushima. The therapeutic effects, and pre-treatment and post-treatment VAS scores and WOMAC scores and serum VEGF and bFGF levels were compared between the two groups of patients. The adverse reaction incidences were compared between the two groups of patients. Result The total efficacy rate was 87.3% in the control group and 94.9% in the observation group and was significantly higher in the observation group than in the control group(P<0.05). There were no statistically significant pre-treatment differences in the VAS score and WOMAC score between the two groups(P>0.05). The VAS score and WOMAC score decreased significantly in both groups after treatment(P<0.05). After treatment, there was no statistically significant difference in the VAS score between the two groups(P>0.05) but the WOMAC score was significantly lower in the observation group than in the control group(P<0.05). There were no statistically significant pre-treatment differences in VEGF and bFGF between the two groups(P>0.05). After treatment, VEGF and bFGF decreased significantly in both groups(P<0.05) and were significantly lower in the observation group than in the control group(P<0.05). The adverse reaction incidence was3.4% in the control group and 1.7% in the observation group with no statistically significant difference between the two groups(P > 0.05). Conclusion Acupuncture and moxibustion plus Zushima can reduce inflammatory reactions, inhibit synovial angiogenesis, and effectively relive the pain, and improve articular functions in the treatment of knee osteoarthritis.
Objective To investigate the effect of acupuncture and moxibustion plus Zushima on serum vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(b FGF) in patients with knee osteoarthritis.Method Two hundred and thirty-six patients with knee osteoarthritis were allocated, using a random number table, to two groups, 118 cases each. The control group was treated with Celecoxib and the observation group, with acupuncture and moxibustion plus Zushima. The therapeutic effects, and pre-treatment and post-treatment VAS scores and WOMAC scores and serum VEGF and bFGF levels were compared between the two groups of patients. The adverse reaction incidences were compared between the two groups of patients. Result The total efficacy rate was 87.3% in the control group and 94.9% in the observation group and was significantly higher in the observation group than in the control group(P<0.05). There were no statistically significant pre-treatment differences in the VAS score and WOMAC score between the two groups(P>0.05). The VAS score and WOMAC score decreased significantly in both groups after treatment(P<0.05). After treatment, there was no statistically significant difference in the VAS score between the two groups(P>0.05) but the WOMAC score was significantly lower in the observation group than in the control group(P<0.05). There were no statistically significant pre-treatment differences in VEGF and bFGF between the two groups(P>0.05). After treatment, VEGF and bFGF decreased significantly in both groups(P<0.05) and were significantly lower in the observation group than in the control group(P<0.05). The adverse reaction incidence was3.4% in the control group and 1.7% in the observation group with no statistically significant difference between the two groups(P > 0.05). Conclusion Acupuncture and moxibustion plus Zushima can reduce inflammatory reactions, inhibit synovial angiogenesis, and effectively relive the pain, and improve articular functions in the treatment of knee osteoarthritis.
引文
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[11]庞青民,赵欲晓,王承惠,等.针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效观察及对炎症因子和血液流变学影响[J].辽宁中医杂志,2017,44(4):782-785.
[12]Qiu J.Acupuncture as a complementary treatment in a patient with a wide range of diseases involving inflammation and underlying immune-system dysregulation syndrome[J].Med Acupunct,2015,27(1):46-49.
[13]Liu M,Yang S,Zhang D,et al.Fructopyrano-(1→4)-glucopyranose inhibits the proliferation of liver cancer cells and angiogenesis in a VEGF/VEGFR dependent manner[J].Internat J Clin Experiment Med,2014,7(11):3859-3869.
[14]Minchenko OH,Garmash IA,Kovalevska OV,et al.Expression of phosphoribosyl pyrophosphate synthetase genes in U87 glioma cells with ERN1 knockdown:effect of hypoxia and endoplasmic reticulum stress[J].Ukr Biochem J,2014,86(6):74-83.
[15]Ozawa A,Kadowaki E,Haga Y,et al.Acetylcholine esterase is a regulator of GFAP expression and a target of dichlorvos in astrocytic differentiation of rat glioma C6cells[J].Brain Res,2013,1537(16):37-45.
[16]Sun XP,Dong X,Lin L,et al.Up-regulation of survivin by AKT and hypoxia-inducible factor 1?contributes to cisplatin resistance in gastric cancer[J].FEBS J,2014,281(1):115-128.
[2]Bar-Or D,Rael LT,Thomas GW,et al.Inflammatory pathways in knee osteoarthritis:potential targets for treatment[J].Curr Rheumatol Rev,2015,11(1):50-58.
[3]Bai J,Li G,Shen M,et al.Primary central nervous system histiocytic sarcoma mimicking glioma[J].Neurol India,2014,62(6):684-685.
[4]Cojocaru IM,?tef?nescu V,Tra?c?D,et al.Multiple intracerebral hemorrhages in an old patient with rheumatoid arthritis[J].Rom J Intern Med,2015,53(4):365-373.
[5]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:87.
[6]American Thoracic Society;American College of Chest Physicians.ATS/ACCP Statement on cardiopulmonary exercise testing[J].Am J Respir Crit Care Med,2003,167(2):211-277.
[7]Altman R,Asch E,Bloch D,et al.Development of criteria for the classification and reporting of osteoarthritis.Classification of osteoarthritis of the knee.Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association[J].Arthritis Rheum,1986,29(8):1039-1049.
[8]林丽娇,许金森,朱小香,等.针灸影响微循环的研究进展[J].中国针灸,2015,35(2):203-208.
[9]胡伊力格其,张玲玲,林龙飞,等.祖师麻主要成分抗炎活性的体外研究[J].国际中医中药杂志,2017,39(4):343-346.
[10]夏循礼.中医艾灸功效的药物基础及其作用机制探讨[J].中医学报,2015,30(2):297-299.
[11]庞青民,赵欲晓,王承惠,等.针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效观察及对炎症因子和血液流变学影响[J].辽宁中医杂志,2017,44(4):782-785.
[12]Qiu J.Acupuncture as a complementary treatment in a patient with a wide range of diseases involving inflammation and underlying immune-system dysregulation syndrome[J].Med Acupunct,2015,27(1):46-49.
[13]Liu M,Yang S,Zhang D,et al.Fructopyrano-(1→4)-glucopyranose inhibits the proliferation of liver cancer cells and angiogenesis in a VEGF/VEGFR dependent manner[J].Internat J Clin Experiment Med,2014,7(11):3859-3869.
[14]Minchenko OH,Garmash IA,Kovalevska OV,et al.Expression of phosphoribosyl pyrophosphate synthetase genes in U87 glioma cells with ERN1 knockdown:effect of hypoxia and endoplasmic reticulum stress[J].Ukr Biochem J,2014,86(6):74-83.
[15]Ozawa A,Kadowaki E,Haga Y,et al.Acetylcholine esterase is a regulator of GFAP expression and a target of dichlorvos in astrocytic differentiation of rat glioma C6cells[J].Brain Res,2013,1537(16):37-45.
[16]Sun XP,Dong X,Lin L,et al.Up-regulation of survivin by AKT and hypoxia-inducible factor 1?contributes to cisplatin resistance in gastric cancer[J].FEBS J,2014,281(1):115-128.