浮针激光联合自制金黄膏外敷治疗膝骨性关节炎的疗效观察
|
摘要
目的观察浮针激光联合外敷自制金黄膏治疗膝骨性关节炎(KOA)的疗效,探讨治疗机制。方法将186例KOA住院患者采用随机数字表法分为浮针激光组和综合治疗组,各93例。浮针激光组采用浮针激光及口服美洛昔康片治疗,综合治疗组在浮针激光后局部外敷自制金黄膏并加服奥泰灵,两组均治疗3周。采用视觉模拟量表(VAS)和西安大略与麦克马斯特大学骨关节炎指数(WOMAC)进行评估,并测定关节腔积液中KOA相关介质白细胞介素-1β(IL-1β)和透明质酸(HA),检查患者膝关节软骨细胞基质金属蛋白酶-1(MMP-1)阳性表达率及膝关节X线影像学检查等对临床疗效进行综合评价。结果治疗3周后,与浮针激光组比较,综合治疗组患者VAS、WOMAC评分降低(P<0.05),HA明显升高,IL-1β含量及MMP-1阳性表达率明显降低(P<0.05),X线示膝关节较治疗前和浮针激光组明显好转(P<0.05)。结论浮针激光联合自制金黄膏外敷治疗KOA疗效优于浮针激光组。
Objective: To observe the therapeutic effect of floating needle laser combined with self-made golden ointment for treatment of knee osteoarthritis(KOA) and its mechanism. Methods: 186 cases of KOA were randomly divided into floating needle laser group and observation group,93 cases in each group. Floating needle laser group was treated with floating needle laser and oral treatment of meloxicam tablets;while in the observation group,after floating needle laser treatment,local application of self-made Jinhuanggao plus oral treatment of Glucosamine Hydrochloride Capsules were applied. Both groups were treated for 3 weeks. The clinical curative effect was evaluated using visual analogue scale(VAS) and Xi′an Ontario and Mc Master University Osteoarthritis Index(WOMAC),and arthritis effusion KOA medium interleukin-1 beta(interleukin-1 beta),IL-1 and hyaluronic acid(beta) hyaluronic acid,HA),examination of patients with knee articular cartilage matrix metalloproteinase-1(MMP-1) the positive expression rate of knee joint X-ray imaging were determined to evaluate the clinical curative effect. Results: After 3 weeks of treatment,compared with floating needle laser group,VAS and WOMAC scores in the observation group were lower(P < 0.05),HA increased significantly,IL-1 beta content and the positive expression rate of MMP-1 was significantly lower(P < 0.05),the X-ray showed the knee joint situation significantly improved after treatment and the result was superior to that in the floating needle laser group with total efficiency(P < 0.05). Conclusion: The curative effect of floating needle laser combined with self-made golden ointment in the treatment of KOA is better than the floating needle laser group.
Objective: To observe the therapeutic effect of floating needle laser combined with self-made golden ointment for treatment of knee osteoarthritis(KOA) and its mechanism. Methods: 186 cases of KOA were randomly divided into floating needle laser group and observation group,93 cases in each group. Floating needle laser group was treated with floating needle laser and oral treatment of meloxicam tablets;while in the observation group,after floating needle laser treatment,local application of self-made Jinhuanggao plus oral treatment of Glucosamine Hydrochloride Capsules were applied. Both groups were treated for 3 weeks. The clinical curative effect was evaluated using visual analogue scale(VAS) and Xi′an Ontario and Mc Master University Osteoarthritis Index(WOMAC),and arthritis effusion KOA medium interleukin-1 beta(interleukin-1 beta),IL-1 and hyaluronic acid(beta) hyaluronic acid,HA),examination of patients with knee articular cartilage matrix metalloproteinase-1(MMP-1) the positive expression rate of knee joint X-ray imaging were determined to evaluate the clinical curative effect. Results: After 3 weeks of treatment,compared with floating needle laser group,VAS and WOMAC scores in the observation group were lower(P < 0.05),HA increased significantly,IL-1 beta content and the positive expression rate of MMP-1 was significantly lower(P < 0.05),the X-ray showed the knee joint situation significantly improved after treatment and the result was superior to that in the floating needle laser group with total efficiency(P < 0.05). Conclusion: The curative effect of floating needle laser combined with self-made golden ointment in the treatment of KOA is better than the floating needle laser group.
引文
[1]杨利,魏蓉,魏云,等.中药外敷治疗膝关节骨关节炎临床观察[J].中国中医急症,2016,25(1):12-121.
[2]Zhou XS,Zhou K.Studied on analgesic and anti-inflammatory effects of clematis Chinensis osbeck[J].Zhongguo Yiyao Daobao,2009,6(11):39-40
[3]屈玉疆,玄志金.推拿股四头肌为主治疗膝骨性关节炎近期疗效的临床研究[J].针灸推拿医学:英文版,2016,12(3):216-219.
[4]Qu HY,Wang RH,Liu J.Clinical observation on warm needling in canicular days for knee osteoarthritis[J].J Acupunct Tuina Sci,2015,13(1):63-65.
[5]刘献祥,林燕萍.中西医结合治疗骨性关节炎[M].北京:人民卫生出版社,2009:100-101.
[6]施桂英,栗占国.关节炎诊断与治疗[M].北京:人民卫生出版社,2009:189.
[7]解纪惠,刘梅珍,崔丽芹,等.清痹汤治疗膝骨关节炎的VAS评分WOMAC骨关节炎指数的变化[J].河北中医药学报,2011,26(1):16-19.
[8]Yang RC,Yang JH.Therapeutic observation of acupuncturemoxibustion plus Chinese medicinal fumigation for knee effusion[J].Shanghai Zhenjiu Zazhi,2014,33(5):459-460.
[9]Zhou YL,Li J,Hou WG,et al.Clinical observation of moxibustion in treatment of knee osteoarthritis[J].Shanhai Zhenjiu Zazhi,2014,33(12):1086-1088.
[10]陈琼,赵明才,陈悦,等.姜黄素对骨关节炎软骨细胞增殖及分泌MMP-13,IL-6的影响[J].现代中西医结合杂志,2013,22(5):459-461.
[11]孙建琴,陈红英,姚忠红,等.电针配合威灵仙关节腔内注射对大鼠膝骨关节炎MMPs及HA的影响术[J].中国中医急症,2016,25(5):791-794.
[12]周效思,周凯,谭安雄,等.威灵仙对兔膝骨关节炎结构和功能的影响[J].时珍国医国药,2011,22(10):2454-2457.
[13]符中华.浮针疗法[M].北京:人民军医出版社,2000:9-12.
[14]颜梅,郭俐宏.激光针刀配合穴位注射威灵仙总皂苷对膝骨关节炎模型大鼠RF及PGE_2的影响[J].针灸临床杂志,2015,12(11):71-74.
[15]王俊华,徐远红,万超,等.温针疗法灸阳陵泉结合关节松动术治疗创伤性膝关节僵直的疗效研究[J].中国中医急症,2014,23(12):2189-2191.
[16]李敏,方伟,穆敬平,等.电针联合中药外敷治疗膝骨性关节炎[J].针灸推拿医学:英文版,2016,12(1):41-45.
[2]Zhou XS,Zhou K.Studied on analgesic and anti-inflammatory effects of clematis Chinensis osbeck[J].Zhongguo Yiyao Daobao,2009,6(11):39-40
[3]屈玉疆,玄志金.推拿股四头肌为主治疗膝骨性关节炎近期疗效的临床研究[J].针灸推拿医学:英文版,2016,12(3):216-219.
[4]Qu HY,Wang RH,Liu J.Clinical observation on warm needling in canicular days for knee osteoarthritis[J].J Acupunct Tuina Sci,2015,13(1):63-65.
[5]刘献祥,林燕萍.中西医结合治疗骨性关节炎[M].北京:人民卫生出版社,2009:100-101.
[6]施桂英,栗占国.关节炎诊断与治疗[M].北京:人民卫生出版社,2009:189.
[7]解纪惠,刘梅珍,崔丽芹,等.清痹汤治疗膝骨关节炎的VAS评分WOMAC骨关节炎指数的变化[J].河北中医药学报,2011,26(1):16-19.
[8]Yang RC,Yang JH.Therapeutic observation of acupuncturemoxibustion plus Chinese medicinal fumigation for knee effusion[J].Shanghai Zhenjiu Zazhi,2014,33(5):459-460.
[9]Zhou YL,Li J,Hou WG,et al.Clinical observation of moxibustion in treatment of knee osteoarthritis[J].Shanhai Zhenjiu Zazhi,2014,33(12):1086-1088.
[10]陈琼,赵明才,陈悦,等.姜黄素对骨关节炎软骨细胞增殖及分泌MMP-13,IL-6的影响[J].现代中西医结合杂志,2013,22(5):459-461.
[11]孙建琴,陈红英,姚忠红,等.电针配合威灵仙关节腔内注射对大鼠膝骨关节炎MMPs及HA的影响术[J].中国中医急症,2016,25(5):791-794.
[12]周效思,周凯,谭安雄,等.威灵仙对兔膝骨关节炎结构和功能的影响[J].时珍国医国药,2011,22(10):2454-2457.
[13]符中华.浮针疗法[M].北京:人民军医出版社,2000:9-12.
[14]颜梅,郭俐宏.激光针刀配合穴位注射威灵仙总皂苷对膝骨关节炎模型大鼠RF及PGE_2的影响[J].针灸临床杂志,2015,12(11):71-74.
[15]王俊华,徐远红,万超,等.温针疗法灸阳陵泉结合关节松动术治疗创伤性膝关节僵直的疗效研究[J].中国中医急症,2014,23(12):2189-2191.
[16]李敏,方伟,穆敬平,等.电针联合中药外敷治疗膝骨性关节炎[J].针灸推拿医学:英文版,2016,12(1):41-45.