摘要
目的:观察齐刺配合短波治疗膝关节骨性关节炎(KOA)的临床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)和基质金属蛋白酶-3(MMP-3)的影响。方法:136例KOA患者被随机分为综合治疗组和对照组,每组各68例,对照组采用美洛昔康片和盐酸氨基葡萄糖胶囊治疗,综合治疗组采用齐刺配合短波治疗。采用视觉模拟量表(VAS)和骨性关节炎指数可视化量表(WOMAC)从疼痛和关节功能两个方面评价KOA患者症状改善情况,观察两组患者的临床疗效,并比较两组患者治疗前后关节液中IL-1β、TNF-α和MMP-3的变化。结果:两组患者治疗后VAS评分和WOMAC评分均较治疗前明显降低(P<0.01),且综合治疗组低于对照组(P<0.01)。综合治疗组总有效率为92.65%,明显高于对照组的83.82%,两组比较差异有统计学意义(P<0.05)。两组治疗后关节液中IL-1β、TNF-α及MMP-3含量均较治疗前明显下降(P<0.01),且综合治疗组较对照组下降更显著(P<0.01)。结论:齐刺配合短波可减轻KOA患者疼痛,改善膝关节功能,临床疗效显著,其作用机制可能与降低关节液中炎症因子IL-1β、TNF-α和MMP-3水平有关。
Objective: To observe the clinical effect of triple needling combined with short wave therapy in treatment of knee osteoarthritis( KOA) and its intervention on the levels of interleukin-1β( IL-1β),tumor necrosis factor-α( TNF-α) and matrix metalloproteinase-3( MMP-3) in synovial fluid. Methods: A total of136 patients with KOA were randomly divided into the comprehensive treatment group( n = 68) and the control group( n = 68). The control group was treated with Meloxicam and Glucosamine Hydrochloride,and the comprehensive treatment group was treated by triple needling combined with short wave therapy. The scores of visual analogue scale( VAS) and osteoarthritis index visual scale( WOMAC) were used to evaluate the improvement of symptoms in KOA patients from two aspects,i. e. pain relief and joint function. The clinical efficacy of the two groups was observed,and the changes of IL-1β,TNF-α and MMP-3 in synovial fluid were compared between the two groups before and after the treatment. Results: The VAS score and WOMAC score were both significantly lowered after the treatment in the two groups( P < 0. 01),of which the comprehensive treatment group was superior to the control group( P < 0. 01). The total effective rate was 92. 65% in the comprehensive treatment group,which was significantly higher than 83. 82% in the control group( P < 0. 05). The levels of IL-1β,TNF-α and MMP-3 in synovial fluid were significantly reduced after the treatment in the two groups( P < 0. 01); of which the reduction of the comprehensive treatment group was more significant than that of the control group( P < 0. 01). Conclusion: Triple needling combined with short wave therapy can alleviate pain and improve knee function in the patients with KOA,and the clinical efficacy was remarkable. The mechanism of this action may be related to the decrease of IL-1β,TNF-α and MMP-3 in synovial fluid.
引文
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