电针辅助治疗膝骨关节炎疗效及对血清Wnt-3α、β-catenin和关节滑液中白介素水平的影响
|
摘要
目的观察电针辅助玻璃酸钠(SH)治疗膝骨关节炎患者的效果及对关节功能和血清分泌型糖蛋白(Wnt)-3α、β-链蛋白(β-catenin)及关节滑液中白介素水平的影响。方法选取164例膝骨关节炎患者,采用随机数字表法分为观察组和对照组,对照组82例患者给予SH治疗,观察组在对照组基础上采用电针治疗,对比两组中医症候疗效及患者治疗前后关节功能、血清Wnt-3α和β-catenin、关节滑液中白介素-1α(IL-1α)和白介素-1β(IL-1β)水平。结果观察组总有效率为93.9%,明显高于对照组的76.8%(P<0.05),两组患者治疗后关节功能各项评分明显高于治疗前(P<0.05),血清Wnt-3α和β-catenin水平及关节滑液中IL-1α和IL-1β含量明显低于治疗前(P<0.05),其中观察组关节功能评分明显高于对照组(P<0.05),血清Wnt-3α和β-catenin水平及关节滑液中IL-1α和IL-1β水平明显低于对照组(P<0.05)。结论电针辅助SH可有效改善膝骨关节炎患者关节功能,降低血清Wnt-3α和β-catenin水平及关节滑液中IL-1α和IL-1β水平,提高临床疗效。
Objective To investigate the therapeutic effect of electroacupuncture-assisted sodium hyaluronate(SH on knee osteoarthritis and its impact on articular function and serum secretory glycoproteinWnt-3α and β-catenin and synovial interleukin levels. Method One hundred and sixty-four patients with knee osteoarthritis were enrolled and allocated, using a random number table, to observation and control groups. The control group of 82 patients received SH and the observation group, electroacupuncture in addition. The therapeutic effects on CTM syndrome and pre-treatment and post-treatment articular functions, and serum Wnt-3α and β-catenin and synovial interleukin-1α(IL-1α) and interleukin-1β(IL-1β) levels were compared between the two groups. Result The total efficacy rate was 93.9% in the observation group, which was significantly higher than76.8% in the control group(P<0.05). After treatment, the articular function item scores were significantly higher, and serum Wnt-3α and β-catenin levels and synovial IL-1α and IL-1β contents were significantly lower in the two groups compared with before(P<0.05); the articular function scores were significantly higher, and serum Wnt-3α and β-catenin levels and synovial IL-1α and IL-1β contents were significantly lower in the observation group than in the control group(P<0.05). Conclusion Electroacupuncture-assisted SH can effectively improve knee joint function, decrease serum Wnt-3α and β-catenin and synovial IL-1α and IL-1β levels and enhance the clinical therapeutic effect in patients with knee osteoarthritis.
Objective To investigate the therapeutic effect of electroacupuncture-assisted sodium hyaluronate(SH on knee osteoarthritis and its impact on articular function and serum secretory glycoproteinWnt-3α and β-catenin and synovial interleukin levels. Method One hundred and sixty-four patients with knee osteoarthritis were enrolled and allocated, using a random number table, to observation and control groups. The control group of 82 patients received SH and the observation group, electroacupuncture in addition. The therapeutic effects on CTM syndrome and pre-treatment and post-treatment articular functions, and serum Wnt-3α and β-catenin and synovial interleukin-1α(IL-1α) and interleukin-1β(IL-1β) levels were compared between the two groups. Result The total efficacy rate was 93.9% in the observation group, which was significantly higher than76.8% in the control group(P<0.05). After treatment, the articular function item scores were significantly higher, and serum Wnt-3α and β-catenin levels and synovial IL-1α and IL-1β contents were significantly lower in the two groups compared with before(P<0.05); the articular function scores were significantly higher, and serum Wnt-3α and β-catenin levels and synovial IL-1α and IL-1β contents were significantly lower in the observation group than in the control group(P<0.05). Conclusion Electroacupuncture-assisted SH can effectively improve knee joint function, decrease serum Wnt-3α and β-catenin and synovial IL-1α and IL-1β levels and enhance the clinical therapeutic effect in patients with knee osteoarthritis.
引文
[1]韦国雨,陈清雄,唐永亮,等.当归四逆汤对类风湿性关节炎患者血清Wnt-3?、?-catenin及BMP-2表达的影响[J].中医药导报,2016,22(22):72-74.
[2]周殷,朱俊,李连波,等.电针对肝肾阴虚型类风湿关节炎患者关节功能的影响[J].针刺研究,2016,41(5):440-446.
[3]李洪涛,刘昊,杨方军,等.电针治疗膝关节骨性关节炎的临床疗效分析[J].中医药学报,2017,45(1):110-113.
[4]Arnett FC,Edworthy SM,Bloch DA,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J].Arthritis Rheum,1988,31(3):315-324.
[5]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:115-119.
[6]Lysholm J,Gillquist J,Liljedahl SO.Arthroscopy in the early diagnosis of injuries to the knee join[J].Acta Orthop Scand,1981,52(1):111-118.
[7]国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:46-47.
[8]唐林涛,许明辉,林波,等.近十年针灸治疗膝骨关节炎研究综述[J].亚太传统医药,2017,(4):54-56.
[9]徐方琼,石立鹏,冷文飞.中西医结合治疗膝骨关节炎研究进展[J].湖南中医杂志,2019,(1):147-149.
[10]谢旻成.中医外治法治疗膝骨关节炎的研究进展[J].中国民间疗法,2019,27(4):103-105.
[11]刘欢,杨晓凌.老年类风湿性关节炎的临床特征及血清炎症因子的改变[J].实用临床医药杂志,2017,21(3):188-190.
[12]Bouaziz W,Funck-Brentano T,Lin H,et al.Loss of sclerostin promotes osteoarthritis in mice via?-catenindependent and-independent Wnt pathways[J].Arthritis Res Ther,2015,17:24.
[13]Wang M,Wang B,Ma Z,et al.Detection of the novel IL-1 family cytokines by QAH-IL1F-1 assay in rheumatoid arthritis[J].Cell Mol Biol(Noisy-le-grand),2016,62(4):31-34.
[14]Alshevskaya AA,Lopatnikova JA,Shkaruba NS,et al.Differences of IL-1?receptors expression by immunecompetent cells subsets in rheumatoid arthritis[J].Mediators Inflamm,2015,2015:948393.
[15]赵懋宇.玻璃酸钠治疗膝关节骨性关节炎的疗效观察[J].医学信息,2019,32(1):112-114.
[16]张东阳,尚立林,李程锦,等.玻璃酸钠关节腔内注射治疗踝关节创伤性关节炎的临床疗效[J].北方药学,2019,16(1):121-122.
[17]白玉明,张海森,刘畅,等.玻璃酸钠关节腔注射对膝骨关节炎患者关节液及血浆中白介素-17的影响[J].中国医药导报,2017,14(19):118-121.
[18]张其亮,戴世友,刘红云.玻璃酸钠对骨关节炎关节液中IL-1?、TNF-?和PGE-2含量的影响[J].中国医师杂志,2013,15(11):1564-1566.
[19]王明华,湛梅圣.内热针联合玻璃酸钠治疗膝关节骨性关节炎临床观察[J].湖北中医药大学学报,2017,19(5):82-84.
[20]熊巍,吴忌,喻衫.祛风寒湿洗剂薰洗治疗膝骨关节炎风寒湿痹证[J].中医正骨,2019,31(2):74-76,79.
[21]刘映岐,杨松涛,陶程露.中医内治法治疗膝骨关节炎研究进展[J].现代临床医学,2017,43(2):158-160.
[22]潘明柱,荣兵,贾峻,等.温经通络汤联合针灸治疗风寒湿痹型关节炎的疗效及对患者血清Wnt-3?,?-catenin及BMP-2表达的影响[J].中国实验方剂学杂志,2017,23(24):175-179.
[23]陈朝蔚,魏贤振,丁超,等.电针联合魏氏手法治疗膝骨关节炎临床疗效观察[J].中国中医骨伤科杂志,2018,26(1):17-20.
[24]李洪涛,刘昊,杨方军,等.电针对膝关节骨性关节炎大鼠关节软骨中Wnt-3?、?-catenin蛋白表达的影响[J].针灸临床杂志,2017,33(3):65-68.
[25]王娟.电针与温针灸治疗瘀血阻滞型膝关节骨性关节炎的研究[J].检验医学与临床,2017,14(4):508-509.
[2]周殷,朱俊,李连波,等.电针对肝肾阴虚型类风湿关节炎患者关节功能的影响[J].针刺研究,2016,41(5):440-446.
[3]李洪涛,刘昊,杨方军,等.电针治疗膝关节骨性关节炎的临床疗效分析[J].中医药学报,2017,45(1):110-113.
[4]Arnett FC,Edworthy SM,Bloch DA,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J].Arthritis Rheum,1988,31(3):315-324.
[5]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:115-119.
[6]Lysholm J,Gillquist J,Liljedahl SO.Arthroscopy in the early diagnosis of injuries to the knee join[J].Acta Orthop Scand,1981,52(1):111-118.
[7]国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:46-47.
[8]唐林涛,许明辉,林波,等.近十年针灸治疗膝骨关节炎研究综述[J].亚太传统医药,2017,(4):54-56.
[9]徐方琼,石立鹏,冷文飞.中西医结合治疗膝骨关节炎研究进展[J].湖南中医杂志,2019,(1):147-149.
[10]谢旻成.中医外治法治疗膝骨关节炎的研究进展[J].中国民间疗法,2019,27(4):103-105.
[11]刘欢,杨晓凌.老年类风湿性关节炎的临床特征及血清炎症因子的改变[J].实用临床医药杂志,2017,21(3):188-190.
[12]Bouaziz W,Funck-Brentano T,Lin H,et al.Loss of sclerostin promotes osteoarthritis in mice via?-catenindependent and-independent Wnt pathways[J].Arthritis Res Ther,2015,17:24.
[13]Wang M,Wang B,Ma Z,et al.Detection of the novel IL-1 family cytokines by QAH-IL1F-1 assay in rheumatoid arthritis[J].Cell Mol Biol(Noisy-le-grand),2016,62(4):31-34.
[14]Alshevskaya AA,Lopatnikova JA,Shkaruba NS,et al.Differences of IL-1?receptors expression by immunecompetent cells subsets in rheumatoid arthritis[J].Mediators Inflamm,2015,2015:948393.
[15]赵懋宇.玻璃酸钠治疗膝关节骨性关节炎的疗效观察[J].医学信息,2019,32(1):112-114.
[16]张东阳,尚立林,李程锦,等.玻璃酸钠关节腔内注射治疗踝关节创伤性关节炎的临床疗效[J].北方药学,2019,16(1):121-122.
[17]白玉明,张海森,刘畅,等.玻璃酸钠关节腔注射对膝骨关节炎患者关节液及血浆中白介素-17的影响[J].中国医药导报,2017,14(19):118-121.
[18]张其亮,戴世友,刘红云.玻璃酸钠对骨关节炎关节液中IL-1?、TNF-?和PGE-2含量的影响[J].中国医师杂志,2013,15(11):1564-1566.
[19]王明华,湛梅圣.内热针联合玻璃酸钠治疗膝关节骨性关节炎临床观察[J].湖北中医药大学学报,2017,19(5):82-84.
[20]熊巍,吴忌,喻衫.祛风寒湿洗剂薰洗治疗膝骨关节炎风寒湿痹证[J].中医正骨,2019,31(2):74-76,79.
[21]刘映岐,杨松涛,陶程露.中医内治法治疗膝骨关节炎研究进展[J].现代临床医学,2017,43(2):158-160.
[22]潘明柱,荣兵,贾峻,等.温经通络汤联合针灸治疗风寒湿痹型关节炎的疗效及对患者血清Wnt-3?,?-catenin及BMP-2表达的影响[J].中国实验方剂学杂志,2017,23(24):175-179.
[23]陈朝蔚,魏贤振,丁超,等.电针联合魏氏手法治疗膝骨关节炎临床疗效观察[J].中国中医骨伤科杂志,2018,26(1):17-20.
[24]李洪涛,刘昊,杨方军,等.电针对膝关节骨性关节炎大鼠关节软骨中Wnt-3?、?-catenin蛋白表达的影响[J].针灸临床杂志,2017,33(3):65-68.
[25]王娟.电针与温针灸治疗瘀血阻滞型膝关节骨性关节炎的研究[J].检验医学与临床,2017,14(4):508-509.