温针灸治疗阳虚寒凝型膝骨关节炎的临床研究
|
摘要
目的：通过随机对照研究,观察治疗前后患者膝关节疼痛、僵硬症状及膝关节功能,步行距离,生活质量等评分改变情况,从而研究温针灸治疗阳虚寒凝型膝骨关节炎的临床疗效。
方法：收集60例合格之膝骨性关节炎患者,按1：1随机分配至温针灸治疗组及单纯针灸组两组,两组皆取穴：阴陵泉、阳陵泉、内、外膝眼、血海及梁丘等共6个穴位治疗。观察指标运用患者自评量表WOMAC、中文版简明健康状况调查表(SF-36)和6分钟持续步行距离等三个量表来评估膝骨关节炎症状、肢体功能及生活质量等,在治疗前、治疗4周时进行评估。临床疗效评定分析采用尼莫地平法,分为临床痊愈、显效、有效无效四级,同时,对不良反应进行观测。
结果：分析60例患者的研究结果显示,在治疗组和对照组两组患者中性别、年龄、患病时间、膝患部等构成,其差异性无统计学意义(P>0.05),组间具有可比性。治疗后患者膝关节疼痛症状、僵硬状况及膝关节功能显着改善,步行距离增加,生活质量提高。治疗组、对照组在试验4周后比较WOMAC、SF-36评分和6分钟步行距离等三个量表,除4周之6分钟步行距离外,均分别与治疗前有统计学差异(P<0.05)。治疗组与对照组在试验4周后比较WOMAC、SF-36评分和6分钟步行距离,除SF-36精神健康分数外,差异均有统计学意义(P<0.05)。
4周后,治疗组临床基本痊愈者9例,显效者12例,有效者7例,无效者2例,总有效率93.3%。对照组临床基本痊愈者2例,显效者10例,有效者14例,无效者4例,总有效率86.6%。经统计学分析,差异无统计学意义(P>0.05)。温针灸与单纯针刺在总体疗效上无明显差异,二者均具有较好的临床疗效。
此外,温针灸组与单纯针灸组无一例出现不良反应。说明温针灸与单纯针刺均具有较高的安全性。
综合分析,温针灸与普通针刺均具有较好的临床疗效。温针灸的总体疗效与单纯针刺组无异,但在改善关节的疼痛、僵硬症状及关节或活动度方面,则明显优于单纯针刺组。结论：温针灸能改善阳虚寒凝型膝骨关节炎患者的临床症状和功能,达到止痛,提高生活质量的效果,且未发现明显临床副作用,是一值得推广的临床治疗方法。
Objection:To investigate the clinical effect of Warm Needle Moxibustion in treating Knee Osteoarthritis by randomized control study.
Methods:This research was undertaken in Taipei Medical University Hospital (TMUH) in Taiwan,60 patients with knee osteoarthritis were randomly assigned (1:1 ratio) to receive Warm Needle Moxibustion plus acupuncture (treatment group) or acupuncture (control group) in 2 courses (5 times a week,2 weeks as a course). The clinical effect was evaluated by three different observation forms, WOMAC Index Of Osteoarthritis (WOMAC), SF-36 in Chinese and 6-minute walk on week 0,2 and 4. The therapeutic effect was evaluated with Nimodipine calculating method. The safety parameters were well monitored and analyzed.
Results:All randomly assigned participants were analyzed. There is no statistic difference between treatment and control group in age, gender, and the disease average course (P>0.05). Warm needle moxibustion plus acupuncture significantly improved clinical symptoms, stiffness, function, walking distance and quality of life (P<0.05).
The scores in WOMAC, SF-36 in Chinese version are significantly improved in treatment and placebo group after 2 and 4 weeks of treatment. (P<0.05) The score in 6-minute walk is significantly improved in treatment and placebo group after 4 weeks of treatment. Treatment group significantly improved scores in WOMAC and 6-minute walk compared with placebo. (P<0.05)
After two courses of treatment, the response rate of treatment group is 93.3%. Among the 30 patients,9 were clinically and basically recovered, 12 had obvious effect,7 had fair effect and 2 had no response. The response rate of controlled group is 86.6%. Among the 30 patients,2 were clinically and basically recovered,10 had obvious effect,14 had fair effect and 4 had no response. Warm needle moxibustion plus acupuncture is a more beneficial for knee OA treatment with acupuncture alone.
No adverse effects happened in both groups during the research. Conclusion The clinical research shows that warm needle moxibustion plus acupuncture is more helpful for knee OA. The treatment is well tolerated and offers improved clinical symptoms, stiffness, function, walking distance and quality of life.
方法：收集60例合格之膝骨性关节炎患者,按1：1随机分配至温针灸治疗组及单纯针灸组两组,两组皆取穴：阴陵泉、阳陵泉、内、外膝眼、血海及梁丘等共6个穴位治疗。观察指标运用患者自评量表WOMAC、中文版简明健康状况调查表(SF-36)和6分钟持续步行距离等三个量表来评估膝骨关节炎症状、肢体功能及生活质量等,在治疗前、治疗4周时进行评估。临床疗效评定分析采用尼莫地平法,分为临床痊愈、显效、有效无效四级,同时,对不良反应进行观测。
结果：分析60例患者的研究结果显示,在治疗组和对照组两组患者中性别、年龄、患病时间、膝患部等构成,其差异性无统计学意义(P>0.05),组间具有可比性。治疗后患者膝关节疼痛症状、僵硬状况及膝关节功能显着改善,步行距离增加,生活质量提高。治疗组、对照组在试验4周后比较WOMAC、SF-36评分和6分钟步行距离等三个量表,除4周之6分钟步行距离外,均分别与治疗前有统计学差异(P<0.05)。治疗组与对照组在试验4周后比较WOMAC、SF-36评分和6分钟步行距离,除SF-36精神健康分数外,差异均有统计学意义(P<0.05)。
4周后,治疗组临床基本痊愈者9例,显效者12例,有效者7例,无效者2例,总有效率93.3%。对照组临床基本痊愈者2例,显效者10例,有效者14例,无效者4例,总有效率86.6%。经统计学分析,差异无统计学意义(P>0.05)。温针灸与单纯针刺在总体疗效上无明显差异,二者均具有较好的临床疗效。
此外,温针灸组与单纯针灸组无一例出现不良反应。说明温针灸与单纯针刺均具有较高的安全性。
综合分析,温针灸与普通针刺均具有较好的临床疗效。温针灸的总体疗效与单纯针刺组无异,但在改善关节的疼痛、僵硬症状及关节或活动度方面,则明显优于单纯针刺组。结论：温针灸能改善阳虚寒凝型膝骨关节炎患者的临床症状和功能,达到止痛,提高生活质量的效果,且未发现明显临床副作用,是一值得推广的临床治疗方法。
Objection:To investigate the clinical effect of Warm Needle Moxibustion in treating Knee Osteoarthritis by randomized control study.
Methods:This research was undertaken in Taipei Medical University Hospital (TMUH) in Taiwan,60 patients with knee osteoarthritis were randomly assigned (1:1 ratio) to receive Warm Needle Moxibustion plus acupuncture (treatment group) or acupuncture (control group) in 2 courses (5 times a week,2 weeks as a course). The clinical effect was evaluated by three different observation forms, WOMAC Index Of Osteoarthritis (WOMAC), SF-36 in Chinese and 6-minute walk on week 0,2 and 4. The therapeutic effect was evaluated with Nimodipine calculating method. The safety parameters were well monitored and analyzed.
Results:All randomly assigned participants were analyzed. There is no statistic difference between treatment and control group in age, gender, and the disease average course (P>0.05). Warm needle moxibustion plus acupuncture significantly improved clinical symptoms, stiffness, function, walking distance and quality of life (P<0.05).
The scores in WOMAC, SF-36 in Chinese version are significantly improved in treatment and placebo group after 2 and 4 weeks of treatment. (P<0.05) The score in 6-minute walk is significantly improved in treatment and placebo group after 4 weeks of treatment. Treatment group significantly improved scores in WOMAC and 6-minute walk compared with placebo. (P<0.05)
After two courses of treatment, the response rate of treatment group is 93.3%. Among the 30 patients,9 were clinically and basically recovered, 12 had obvious effect,7 had fair effect and 2 had no response. The response rate of controlled group is 86.6%. Among the 30 patients,2 were clinically and basically recovered,10 had obvious effect,14 had fair effect and 4 had no response. Warm needle moxibustion plus acupuncture is a more beneficial for knee OA treatment with acupuncture alone.
No adverse effects happened in both groups during the research. Conclusion The clinical research shows that warm needle moxibustion plus acupuncture is more helpful for knee OA. The treatment is well tolerated and offers improved clinical symptoms, stiffness, function, walking distance and quality of life.
引文
[1]许建荣,柴维敏.膝类风湿性关节炎和骨关节炎的MRI表现特点和比较骨锵肌肉放射学[J].临床放射学杂志,2001：20(11)：862-864.
[2]Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, Lui LY, FelsonDT. Comparison of the Prevalence of Knee Osteoarthritis Between the Elderly Chinese Population in Beijing and Whites in the United States:The Beijing Osteoarthritis Study. ArthritisRheum 2001,44:2065 2071.
[3]Alon T, HEMO I, ITIN A, et al. Vascular endothelial growth factoacts as a survival factor for newly formed retinal vessels and implica-tions for retinophathy of prematurity[J]. Nat Med,1995,1(10):1024.
[4]Felson DT, Zhang Y, Anthony JM, et al. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham study [J]. Ann Intern Med,1992,116 (7):535-539.
[5]王晶,肖德明.性激素与骨关节炎[J].中华骨科杂志,2001,1(1)：50.
[6]蓝旭,刘雪梅,葛宝丰等.豚鼠原发性骨性关节炎生化研究[J].中国骨伤,2001,14(4)：212.
[7]胥少汀,葛宝丰,徐印坎主编.实用骨科学[M].第2版.北京：人民军医出版社,1999：1192.
[8]黄丽红.胶原基因变异与骨性关节炎[J].国外医学.内科学分册,2002,29(10)：447.
[9]吴昊,查振刚.维持生活素D受体和骨关节炎[J].中华风湿病学杂志,2003,7(8)：494
[10]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[11]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[12]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[13]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[14]陈启明主编.骨科基础学[M].第2版.北京：人民机生出社,2002：416.
[15]孟和,愿志华主编.骨伤科生物力学[M].第2版.北京：人民机生出社,1999：187,189.
[16]褚立希,王锋.膝骨关节炎X片生物力学及形态学测量分析[J].中西医结合学报,2004,11(2)：433.
[17]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[18]王学谦主译.股关节炎一诊断与治疗[M].第一版.天津：天津科技翻译出版公司,2004,11(2)：433.
[19]Haynes MK, Hume EL, Smith JB. Phenotypic characterization of inflammatory cells from osteoarthritic synovium and synovial fluids [J]. Clin Irnmunol, 2002,105(3):5213-5220.
[20]周士枋,丁伯坦.运动学[M].北京：第二版.华夏出版社,2005：235.
[21]王学谦,类思权,侯彼魁,等译.骨关节炎诊断与治疗.天津：天津科技翻译出版公司,2005：87.
[22]吴海山主编.膝关节镜外科[M].上海：上海科学技术文献出版社,1992：58.)(中
华医学会风湿病学分会,骨性关节炎诊治指南.中华风湿病学杂志,2003,7(11),702——.,704.
[23]Ehrlich MG, Armstrong AL, Treadwe BV, et al. The effects of degneradative enzyme systems in cartilage [J].Chin Orthop,2002,76:57-61.
[24]Ohta S, Imai K, Yamashita K, et al. Expression of matrix metallo-proteinase 7 in human osteoarthritic cartilage[J]. Lab Invest, 1998,78(1):79-87.
[25]Singer I, Kawka DW, Scott S, et al. The relation of matrix metalloproteinase and human osteoarthritic [J]. Arthritis Rheum,2003, 46(9):2642-2648.
[26]高仰贤.骨性关节炎国内研究的发病进展.中医正骨,2005,17(4)：55.
[27]Tain A, Nanchahal J, Troeberg L, et al. Production of cytokines, vascular endothelial growth factor, matrix metallo proteinases, and tissue inhibitor of metalloproteinase 1 by tenosynovium demonstrates its proteial for tendon destruction in rheumatoid arthritis[J]. Arthritis Rheum,2001,44(8):1754-1760.
[28]黄涛.骨性关节炎病因与发病机制研究进展.福建中医药.2005,36(4)：57.[11]黄启福主编.病理学.北京：科学出版社.2004：29.
[29]李德达,张凯,王毅等.OA患者关节液与血清中金属蛋白酶及抑制剂的检测及临床意义[J].中国骨伤,2002,15(10)：580-585.
[30]Stremme S, Duerr S, Bau B, et al. MMP-8 is only a minor gene product of human adult articular chondrocytes of the knee[J]. Clin Exp Rheumatol, 2003,21 (2):205.
[31]Largo R, Alvarez-Soria MA, Diez-Ortego I, et al. Glucosamine inhibits IL-1 beta-induced NF-kappaB activation in human osteoarthritic chondrocytes [J]. Osteoarthritis Cartilage,2003,11 (4):290-298.
[32]Homandberg GA, Umadi V, Kang H, et al. High molecular weight hyaluronan promotes repair of IL-1 beta-damaged cartilag explants from both young and old bovines [J]. Osteoarthritis Cartilage,2003,11(3):177-186.
[33]Vuolteenaho K, Moilanen T, Hamalainen M, et al. Regulation of nitric oxide production in osteoarthritis and rheumatoid cartilage[J]. Scand J Rheumatol,2003,32 (1):19-24.
[34]Deschner J, Hofman CR, Piesco NP, et al. Signal transduction by mechanical strain in chondrocytes [J]. Curr Opin Nutr Metab Care,2003, 6 (3):289-293.
[35]Apparailly F, Verwaerde C, Jacquet C, et al. Adenovirus-mediated transfer of viral IL-10 gene inhibits murine collagen-induced arthritis [J]. J Immunol, 1998,160(11):5213-5220
[36]Haynes MK, Hume EL, Smith JB. Phenotypic characterization of inflammatory cells from osteoarthritis synovium and synovial fluids [J]. Clin Immunol,2002, 105(3):5213-5220.
[37]Raimund Kinne, Thomas Liehr, Volkmar Beensen, et al. Mosaic chromosomal aberrations in synovial fibroblasts of patients with rheumatoid arthritis, osteoarthritis and other inflammatory joint diease[J]. Arthritis Res,2001, 3(5):315-330.
[38]袁国华.骨关节炎患者血清抗软骨细胞抗体测定及意义[J].中华风湿学杂志,1997,(1)：15.
[39]J Arnoldi CC, Lemperg RK, Linderholm H. Intraosseous hypertension and pain in the knee [J]. J Bone Joint Surg Br.,1975,57(3):360.
[40]许学猛,王羽丰,邓晋丰等.补肾活血胶囊影响兔膝关节退变性疾病骨内压变化的实验研究[J].中初中医骨伤科杂志,2001,91(4)：24.
[41]张洁浩,许善锦.自由基在大骨节病病理过程中的作用[J].北京医科大学学报,1990,22(1)：50.
[42]Wei X, Wright GC Jr, Sokoloff L. The effects of sodium selenite on chondrocytes in monolayer culture [J].Arthritis Rheum,1986,29 (5):660.
[43]许鹏,姚建锋,蔡乾坤等.骨关节病人者病情程度与体内自由基含量变化分析[J].中国矫形外科杂志,2001,8(5)：469
[44]张洁浩,许善锦.自由基在大骨节病病理过程中的作用[J].北京医科大学学报,1990,22(1)：50.
[45]孟和,愿志华主编.骨伤科生物力学[M].第2版.北京：人民生出版社,1999：187,189.
[46]张亮刘红光膝关节组成结构细微损伤的影像学研究实用医学影像杂志,2007(3)：159-160
[47]张长青.COX-2抑制剂与心血管疾病[J].国外医学·骨科学分册,2002,23：57259.
[48]Linclow TE. Osteoarthritis:new insights[J]. Ann InternMed,2002, 136:86-88.
[49]Pelletier JP, Yaron M, Haraoui B, et al. Efficacy and safety of diacerein in osteoarthritis of the knee:a double-blind, placebo-controlled trial [J]. Arthritis Rheum,2000,43:2339-2348.
[50]今翠英,芮耀城主编.现代药物学[M].北京：人民军医出版社,1999.438-468.
[51]Takahashi K, Hashimoto S, et al. Effect of hyalurinan on chondrocyte apoptosis and nitric oxide production in experimentally induced osteoarthritis[J]. J Rheumatol,2000,27:1713-1720.
[52]蒋明,DAV ID YU,林孝义等主编.中华风湿病学[M].北京：华夏出版社,2004.1296-1297.
[53]昊琼华,陈正形.基质金属蛋白酶与腰椎间盘病变[J].国外医学·骨科学分册,2002,23:93-95.
[54]DD Frisbie, SC Ghivizzani, PD robbins, et al. Treatment of esp-rimental eqione osteoarthritis by in vivo delivery of the equine interleukin-1 receptor antagonist gene[J]. Gene Ther,2002,9:12-20.
[55]Chemajovsky Y, Adams G, Podhajcer C, et al. Inhibition of transfer of collagen-induced arthritis into SCID mice by ex vivo infection of spleen cells with retroviruses expressing soluble tumor necrosis factor receptor [J]. Gene Trer,1995,2:731-732.
[56]Ikeda T,Kubo T, et al. Adenovirus mediated gene delivery to the joints of guinea pigs[J]. J Rheumatol,1998,25:1666-1673.
[57]Kang R, Marui T, Ghivizzani SC,et al. Ex vivo gene transfer to chondrocytes in full-thickness articular cartilage defects:A feasibility study[J]. Osteoarthritis Cartilage,1995,2:731-732.
[58]Doherty PJ, Zhang H, Manolopoulos V, et al. Adhesion of transplanted chondrocytes onto cartilage in vitro and in vivo[J]. J Rheumatol,2000, 27:1725-1731.
[59]马明明,余姚。中医辨证治疗中老年膝关节骨性关节炎98例[J].河北中医.2002：24(2).107-108.
[60]邓晋丰,刘会文.中西医结合骨伤科学[M].北京：科学出版社,2003：271-274.
[61]邓晋丰,钟广玲,刘金文,等。骨伤科专病中医临床诊治[M].北京：人民卫生出版社,2005：282-289.
[62]石印玉,徐荣善,陈友红.养血软坚方治疗膝关节炎的临床报告[J].中国中医骨伤杂志.1994；2(4)：33.
[63]尚天裕,董福慧.实用中西医结合骨伤科学[M].北京：北京医科大学中国协和医科大学联合出版社,1998：418-420.
[64]韦贵康,施杞.实用中医骨伤科学[M].上海：上海科学技术出版社,2006：624-627.
[65]王肯堂.证治准绳[M].北京：人民卫生出版社,1991：362.
[66]徐传毅,樊粤光,宁显明.肾虚血瘀与骨性关节炎关系初探闭.新中医.2002；34(3)：8.
[67]孟庆云.痰病原道解说[J].中医杂志.1996：37(4)：200
[68]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,1999：33.
[69]郑莜萸.中药新药临床研究指导原则[M].北京：中国医药科技出版社,2002：349-353.
[70]袁浩,娄多峰.中医骨病学[M].上海：上海科学技术出版社,1998：38-62.
[71]路志正,焦树德.实用中医风湿病学[M].北京：人民卫生出版社,1996：610-611.
[72]刘洪旺,刘志刚,孙宝金.退行性膝关节骨性关节病的中医辨证施治[J].中国骨伤.1997；10(4)：27.
[73]张建福.骨质增生病的中西医诊疗[M].北京：中国中医药出版社,1995：59.
[74]吴林生,金嫣莉.中药及手法治疗膝关节骨性关节炎,121例疗效分析[J].中医杂志.1993；34(12)：742
[75]郭建刚,冯坤,赵移珍,等.中药内服治疗骨性关节炎新进展[J].中医正骨.2002；14(4)：54
[76]谭燕珍,杨业清.中西医结合治疗骨关节炎临床研究田.世界临床药物.2006；27(4)：203-206.
[77]宏树臣.中医指针综合治疗膝关节骨性关节炎[J].中国骨伤.1998：11(5)：23.
[78]王少山,张世华,邱红明,等.骨病中西医结合诊疗学[M].北京：中医药出版社,2001：338-360.
[79]朱卫星,韩玉范,李成军,等.五联疗法治疗膝关节骨性关节炎538例[J].中医外治杂志.2006：15(3)：14-15.
[80]刘向前,姚共和,卢敏,等.膝关节骨关节炎期刊文献病机因子与证候类型分析[J].江苏中医药.2005：26(10)：63-64.
[81]刘向前,姚共和,李建斌,等.膝关节骨关节炎中医住院病历的中医证候诊断回顾性分析[J].湖南中医学院学报.2004：(5)：34.
[82]姚共和,刘向前.膝关节骨关节炎基本证候及其分布特点的研究[J].中医药学 刊。2005：23(9)：1553-1554.
[83]李念虎.补肾活血中药治疗早中期膝骨性关节炎临床观察[J].中医正骨.2006：18(10)：11.
[84]惠华,孟祥奇,姜宏。从痰湿瘀论治膝骨性关节炎的临床观察[J].中医正骨,2007：19(2)：12.
[85]姜洪洋,薛剑冰,程云峰.中药熏洗治疗膝关节骨性关节炎120例报告[J].中医正骨.2004：16(7)：50.
[86]刘惠敏.复方温通散外敷对膝关节骨性关节炎止痛疗效的观察[J].湖南中医学院学报.2006：26(1)：42.
[87]钱来军.中药醋拌热敷治疗膝关节骨性关节炎68例[J].河南中医学院学报.2007；22(2)：63.
[88]樊成虎,张玉昌.陇中中药洗剂治疗膝关节骨性关节炎60例临床观察[J].甘肃中医.2008：21(12)：17.
[89]陈海鹏,刘志坤,程火生,吴竹涵,方成.膝痛消熏洗方治疗绝经后膝关节骨性关节炎53例[J].中国中医骨伤杂志.2008：16(9)：56.
[90]王进军.针刺治疗类风湿性关节炎急性期之消炎镇痛作用机理探讨[J].时珍国医国药,2006；17(3)：437-438.
[91]金立昆,针灸治疗膝关节骨性关节炎研究现状及机理探讨.中国中医药信息杂志,2008；15(5)：79-81.
[92]周楣生.灸绳[M].青岛：青岛出版社,1998,104—105.
[93]刘旭光,等.艾灸对实验性类风湿性关节炎家兔关二13.滑膜液MMP-3、TIMP—1含量的影响[J].成都中医药人学学报,2005,4(28)：1-2.
[94]陈游,孙材江,方建珍.不同科度膝关节炎患者滑液中几种细胞冈子水平变化[J].中国临床康复,2002,6(10)：1426—1427.
[95]杜引平.齐刺治疗老年性膝骨性关节炎50例[J].湖北中医杂志.2002：24(7)：49.
[96]王铁刚,公维志.温针灸治疗退行性膝关节炎48例.针灸临床杂志.2004,20(7)：41
[97]周伟能,王体敏.温针灸治疗退行性膝关节炎54例.针灸临床杂志2006,22(1)：31
[98]张宏荣,李晓棠.温针灸治疗退行性膝关节炎60例.实用中医药杂志.2001,17(10)：33.
[99]艾鹏飞,潘月财.温针灸配合火罐治疗退行性膝关节炎60例.吉林中医药.2006,26(8)：51-52
[100]汤群珍.温针灸加推拿治疗退行性膝关节炎50例.江西中医药.2003,8：41
[101]张金贵.针灸治疗膝关节骨性关节炎60例疗效观察[J].针灸临床杂志.2003；19(11)：21-22
[102]姚志芳,黄晓卿,张炜.温针灸与单纯针刺治疗膝关节骨性关节炎疗效观察比较[J].针灸临床杂志,2003：19(7)：32-33
[103]谷建林。温针灸加中药治疗膝关节骨性关节炎的体会[J]..中医临床医学研究杂志。2003；70(7)：1 1663-1664.
[104]李宁,吴滨,张永铃.艾灸配合运动疗法治疗膝关节骨性关节炎疗效观察叨.中国针灸,2002：22(11)：729-730.
[105]刘书鹏,刘华小针刀治疗膝关节骨性关节炎85例疗效观察叨.山西中医.2006：22(1)：38.
[106]罗仁瀚,黄云声.针刀治疗膝关节骨性关节炎临床观察阴.甘肃中医学院学报.2007：24(1)：30.
[107]汪利合.点穴加旋转屈伸手法治疗膝关节骨性关节炎[J].中国民间疗法.2002：10(11)：29
[108]许旺,陈玉辰,朱立国.捉拿髌骨手法治疗膝关节骨性关节炎疗效观察[J].中国骨伤.2005；18(4)：245
[109]滕蔚然,杜宁.’史炜镔.手法治疗膝骨关节病对膝关节功能改善的研究[J].中国中医骨伤科杂志.2000：8(5)：46-48
[110]黄明伟.三步推拿手法治疗退行性膝关节病36例[J].广西中医学院学报.2000；3(2)：23,45
[111]张勇,黄筑华.膝关节骨性关节炎手法治疗及康复训练[J].中国现代医学杂志.20041 13(24)：13
[112]王文东.手法为主治疗膝关节骨性关节炎的临床观察[J].中国现代医生.2008；46(22)：136.137
[113]曹国富,马素慧,蒙家纺,吕文英。手法治疗膝关节骨性关节炎疗效分析[J]. 中国康复医学杂志.2007：22(4)：365
[114]陈文治,葛鸿庆,王君鏊,等.关节腔注射参麦液治疗膝关节骨性关节炎的临床疗效观察[J].天津中医药.2005；22(6)：518
[115]陈利新,莫卫海,卜晗.红花注射液关节腔内注射治疗膝骨性关节炎56例[J].新中医.2006：38(6)：75
[116]苟凌云,郑红波,冯穗,等.关节腔内注射正清风痛宁治疗膝关节骨性关节炎158例[J].广西中医学院学报.2007；10(1)：37
[117]李金虎.推拿加中药熏蒸治疗膝关节骨性关节炎疗效分析明[J].中医药临床杂志,2008：20(3)：290-291
[118]陈国胜.温针、中药及医疗体操综合疗原发性膝关节骨关节炎的观察[J].中西医,2007：116：67-68
[119]邓泽前,张荣龙,俞宙.中药配合理疗手法治疗膝关节骨性关节炎106例分析[J].中国误诊学诊治,2008：8(34)：8466—8467
[120]顾晓美,徐小梅,孙志脱针刺配合肌力训练治疗老年性膝关节骨性关节炎的疗效研究阴[J].实用老年医学,2008；22(6)：467-468
[121]刘基柱,钟兆健.豆鼓姜超临界C02萃取物的GC分析,2006,29(2)：142-144.
[122]邱贵兴,王树寰,卢世璧等.骨关节炎诊治指南(2007年版)[J].中华骨科志,2007；27(10)：793-796.
[123]许建荣,柴维敏.膝类风湿性关节炎和骨关节炎的MRI表现特点和比较骨骼肌肉放射学[J].临床放射学杂志,2001：20(11)：862-864.
[124]王进军.针刺治疗类风湿性关节炎急性期之消炎镇痛作用机理探讨.[J].时珍国医国药2006：17(3)：437-438.
[125]金立昆,针灸治疗膝关节骨性关节炎研究现状及机理探讨.中国中医药信息杂志[J].2008：15(5)：79—81.
[126]户田静男.艾高气相色讲法分析.国外医学中医中药分册,1992；4(5)：54-54.
[127]杨华元.艾灸疗法的生物物理机制初探[J].中国针灸1996；3(10)：17-17.
[128]白耀辉.艾灸与温热刺激关系的探讨[J].针灸学报,1991；2(4)：10-10.
[129]国家中医药管理局.中医病证诊断疗效标准[M].南京：南京人学出版社,1999,33.
[130]郑莜萸主编.中药新药临床研究指导原则[M].第1版.北京：中国医药科技出版社,2002,349-353.
[131]石学敏主编,针灸学[M].北京：中国中医药出版社,2006
[132]王建国,何丽娟.温针灸治疗膝骨关节炎疗效观察[J].中图针灸,200727(3)：191-192.
[133]中华人民共和国卫生部医政司主编.中国康复医学诊疗规范[S].北京：华夏出版社,1999：3.
[134]Cecehi F, Molino-Lova R, DilorioA et al. Measures of physical performance capture the excess disability associated with hip pain or knee pain in older persons[J].Med Sei,2009.64(12):1316-1324.
[135]Pavol MJ, Owings TM, Foley KT. et al. Influence of lower extremity strength of healthy older adults on the outcome of an induced trip [J]. J Am Geriatr Soc,2002,50(2):256-262.
[136]Peat G, Thomas E, Wilkie R, et al. Multiple joint pain and lower extremity disability in middle and old age[J]. Disabil Rehabil,2006,28(24):1543-1549.
[137]Cecchi F, Mannoni A, Benvenuti E. et al. Epidemiology of hip and knee pain in a representative cohort of Italian persons aged 65 and older: the InCHIANTI Study [J].Osteoarth Cartilage,2008,16(9):1039-1046.
[138]Salaffi F, Carotti M, Grassi W. Health-related quality of life in patients with hip or knee osteoarthritis:comparison of generic and disease specific instruments[J].Clin Rheumatol,2005,24:29-37.
[2]Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, Lui LY, FelsonDT. Comparison of the Prevalence of Knee Osteoarthritis Between the Elderly Chinese Population in Beijing and Whites in the United States:The Beijing Osteoarthritis Study. ArthritisRheum 2001,44:2065 2071.
[3]Alon T, HEMO I, ITIN A, et al. Vascular endothelial growth factoacts as a survival factor for newly formed retinal vessels and implica-tions for retinophathy of prematurity[J]. Nat Med,1995,1(10):1024.
[4]Felson DT, Zhang Y, Anthony JM, et al. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham study [J]. Ann Intern Med,1992,116 (7):535-539.
[5]王晶,肖德明.性激素与骨关节炎[J].中华骨科杂志,2001,1(1)：50.
[6]蓝旭,刘雪梅,葛宝丰等.豚鼠原发性骨性关节炎生化研究[J].中国骨伤,2001,14(4)：212.
[7]胥少汀,葛宝丰,徐印坎主编.实用骨科学[M].第2版.北京：人民军医出版社,1999：1192.
[8]黄丽红.胶原基因变异与骨性关节炎[J].国外医学.内科学分册,2002,29(10)：447.
[9]吴昊,查振刚.维持生活素D受体和骨关节炎[J].中华风湿病学杂志,2003,7(8)：494
[10]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[11]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[12]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[13]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[14]陈启明主编.骨科基础学[M].第2版.北京：人民机生出社,2002：416.
[15]孟和,愿志华主编.骨伤科生物力学[M].第2版.北京：人民机生出社,1999：187,189.
[16]褚立希,王锋.膝骨关节炎X片生物力学及形态学测量分析[J].中西医结合学报,2004,11(2)：433.
[17]徐机东,吴岳嵩,张春才主编.骨关节炎的诊断与治疗[M].第2版.上海：第二军医大学出版社,2004：8,10,20.
[18]王学谦主译.股关节炎一诊断与治疗[M].第一版.天津：天津科技翻译出版公司,2004,11(2)：433.
[19]Haynes MK, Hume EL, Smith JB. Phenotypic characterization of inflammatory cells from osteoarthritic synovium and synovial fluids [J]. Clin Irnmunol, 2002,105(3):5213-5220.
[20]周士枋,丁伯坦.运动学[M].北京：第二版.华夏出版社,2005：235.
[21]王学谦,类思权,侯彼魁,等译.骨关节炎诊断与治疗.天津：天津科技翻译出版公司,2005：87.
[22]吴海山主编.膝关节镜外科[M].上海：上海科学技术文献出版社,1992：58.)(中
华医学会风湿病学分会,骨性关节炎诊治指南.中华风湿病学杂志,2003,7(11),702——.,704.
[23]Ehrlich MG, Armstrong AL, Treadwe BV, et al. The effects of degneradative enzyme systems in cartilage [J].Chin Orthop,2002,76:57-61.
[24]Ohta S, Imai K, Yamashita K, et al. Expression of matrix metallo-proteinase 7 in human osteoarthritic cartilage[J]. Lab Invest, 1998,78(1):79-87.
[25]Singer I, Kawka DW, Scott S, et al. The relation of matrix metalloproteinase and human osteoarthritic [J]. Arthritis Rheum,2003, 46(9):2642-2648.
[26]高仰贤.骨性关节炎国内研究的发病进展.中医正骨,2005,17(4)：55.
[27]Tain A, Nanchahal J, Troeberg L, et al. Production of cytokines, vascular endothelial growth factor, matrix metallo proteinases, and tissue inhibitor of metalloproteinase 1 by tenosynovium demonstrates its proteial for tendon destruction in rheumatoid arthritis[J]. Arthritis Rheum,2001,44(8):1754-1760.
[28]黄涛.骨性关节炎病因与发病机制研究进展.福建中医药.2005,36(4)：57.[11]黄启福主编.病理学.北京：科学出版社.2004：29.
[29]李德达,张凯,王毅等.OA患者关节液与血清中金属蛋白酶及抑制剂的检测及临床意义[J].中国骨伤,2002,15(10)：580-585.
[30]Stremme S, Duerr S, Bau B, et al. MMP-8 is only a minor gene product of human adult articular chondrocytes of the knee[J]. Clin Exp Rheumatol, 2003,21 (2):205.
[31]Largo R, Alvarez-Soria MA, Diez-Ortego I, et al. Glucosamine inhibits IL-1 beta-induced NF-kappaB activation in human osteoarthritic chondrocytes [J]. Osteoarthritis Cartilage,2003,11 (4):290-298.
[32]Homandberg GA, Umadi V, Kang H, et al. High molecular weight hyaluronan promotes repair of IL-1 beta-damaged cartilag explants from both young and old bovines [J]. Osteoarthritis Cartilage,2003,11(3):177-186.
[33]Vuolteenaho K, Moilanen T, Hamalainen M, et al. Regulation of nitric oxide production in osteoarthritis and rheumatoid cartilage[J]. Scand J Rheumatol,2003,32 (1):19-24.
[34]Deschner J, Hofman CR, Piesco NP, et al. Signal transduction by mechanical strain in chondrocytes [J]. Curr Opin Nutr Metab Care,2003, 6 (3):289-293.
[35]Apparailly F, Verwaerde C, Jacquet C, et al. Adenovirus-mediated transfer of viral IL-10 gene inhibits murine collagen-induced arthritis [J]. J Immunol, 1998,160(11):5213-5220
[36]Haynes MK, Hume EL, Smith JB. Phenotypic characterization of inflammatory cells from osteoarthritis synovium and synovial fluids [J]. Clin Immunol,2002, 105(3):5213-5220.
[37]Raimund Kinne, Thomas Liehr, Volkmar Beensen, et al. Mosaic chromosomal aberrations in synovial fibroblasts of patients with rheumatoid arthritis, osteoarthritis and other inflammatory joint diease[J]. Arthritis Res,2001, 3(5):315-330.
[38]袁国华.骨关节炎患者血清抗软骨细胞抗体测定及意义[J].中华风湿学杂志,1997,(1)：15.
[39]J Arnoldi CC, Lemperg RK, Linderholm H. Intraosseous hypertension and pain in the knee [J]. J Bone Joint Surg Br.,1975,57(3):360.
[40]许学猛,王羽丰,邓晋丰等.补肾活血胶囊影响兔膝关节退变性疾病骨内压变化的实验研究[J].中初中医骨伤科杂志,2001,91(4)：24.
[41]张洁浩,许善锦.自由基在大骨节病病理过程中的作用[J].北京医科大学学报,1990,22(1)：50.
[42]Wei X, Wright GC Jr, Sokoloff L. The effects of sodium selenite on chondrocytes in monolayer culture [J].Arthritis Rheum,1986,29 (5):660.
[43]许鹏,姚建锋,蔡乾坤等.骨关节病人者病情程度与体内自由基含量变化分析[J].中国矫形外科杂志,2001,8(5)：469
[44]张洁浩,许善锦.自由基在大骨节病病理过程中的作用[J].北京医科大学学报,1990,22(1)：50.
[45]孟和,愿志华主编.骨伤科生物力学[M].第2版.北京：人民生出版社,1999：187,189.
[46]张亮刘红光膝关节组成结构细微损伤的影像学研究实用医学影像杂志,2007(3)：159-160
[47]张长青.COX-2抑制剂与心血管疾病[J].国外医学·骨科学分册,2002,23：57259.
[48]Linclow TE. Osteoarthritis:new insights[J]. Ann InternMed,2002, 136:86-88.
[49]Pelletier JP, Yaron M, Haraoui B, et al. Efficacy and safety of diacerein in osteoarthritis of the knee:a double-blind, placebo-controlled trial [J]. Arthritis Rheum,2000,43:2339-2348.
[50]今翠英,芮耀城主编.现代药物学[M].北京：人民军医出版社,1999.438-468.
[51]Takahashi K, Hashimoto S, et al. Effect of hyalurinan on chondrocyte apoptosis and nitric oxide production in experimentally induced osteoarthritis[J]. J Rheumatol,2000,27:1713-1720.
[52]蒋明,DAV ID YU,林孝义等主编.中华风湿病学[M].北京：华夏出版社,2004.1296-1297.
[53]昊琼华,陈正形.基质金属蛋白酶与腰椎间盘病变[J].国外医学·骨科学分册,2002,23:93-95.
[54]DD Frisbie, SC Ghivizzani, PD robbins, et al. Treatment of esp-rimental eqione osteoarthritis by in vivo delivery of the equine interleukin-1 receptor antagonist gene[J]. Gene Ther,2002,9:12-20.
[55]Chemajovsky Y, Adams G, Podhajcer C, et al. Inhibition of transfer of collagen-induced arthritis into SCID mice by ex vivo infection of spleen cells with retroviruses expressing soluble tumor necrosis factor receptor [J]. Gene Trer,1995,2:731-732.
[56]Ikeda T,Kubo T, et al. Adenovirus mediated gene delivery to the joints of guinea pigs[J]. J Rheumatol,1998,25:1666-1673.
[57]Kang R, Marui T, Ghivizzani SC,et al. Ex vivo gene transfer to chondrocytes in full-thickness articular cartilage defects:A feasibility study[J]. Osteoarthritis Cartilage,1995,2:731-732.
[58]Doherty PJ, Zhang H, Manolopoulos V, et al. Adhesion of transplanted chondrocytes onto cartilage in vitro and in vivo[J]. J Rheumatol,2000, 27:1725-1731.
[59]马明明,余姚。中医辨证治疗中老年膝关节骨性关节炎98例[J].河北中医.2002：24(2).107-108.
[60]邓晋丰,刘会文.中西医结合骨伤科学[M].北京：科学出版社,2003：271-274.
[61]邓晋丰,钟广玲,刘金文,等。骨伤科专病中医临床诊治[M].北京：人民卫生出版社,2005：282-289.
[62]石印玉,徐荣善,陈友红.养血软坚方治疗膝关节炎的临床报告[J].中国中医骨伤杂志.1994；2(4)：33.
[63]尚天裕,董福慧.实用中西医结合骨伤科学[M].北京：北京医科大学中国协和医科大学联合出版社,1998：418-420.
[64]韦贵康,施杞.实用中医骨伤科学[M].上海：上海科学技术出版社,2006：624-627.
[65]王肯堂.证治准绳[M].北京：人民卫生出版社,1991：362.
[66]徐传毅,樊粤光,宁显明.肾虚血瘀与骨性关节炎关系初探闭.新中医.2002；34(3)：8.
[67]孟庆云.痰病原道解说[J].中医杂志.1996：37(4)：200
[68]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,1999：33.
[69]郑莜萸.中药新药临床研究指导原则[M].北京：中国医药科技出版社,2002：349-353.
[70]袁浩,娄多峰.中医骨病学[M].上海：上海科学技术出版社,1998：38-62.
[71]路志正,焦树德.实用中医风湿病学[M].北京：人民卫生出版社,1996：610-611.
[72]刘洪旺,刘志刚,孙宝金.退行性膝关节骨性关节病的中医辨证施治[J].中国骨伤.1997；10(4)：27.
[73]张建福.骨质增生病的中西医诊疗[M].北京：中国中医药出版社,1995：59.
[74]吴林生,金嫣莉.中药及手法治疗膝关节骨性关节炎,121例疗效分析[J].中医杂志.1993；34(12)：742
[75]郭建刚,冯坤,赵移珍,等.中药内服治疗骨性关节炎新进展[J].中医正骨.2002；14(4)：54
[76]谭燕珍,杨业清.中西医结合治疗骨关节炎临床研究田.世界临床药物.2006；27(4)：203-206.
[77]宏树臣.中医指针综合治疗膝关节骨性关节炎[J].中国骨伤.1998：11(5)：23.
[78]王少山,张世华,邱红明,等.骨病中西医结合诊疗学[M].北京：中医药出版社,2001：338-360.
[79]朱卫星,韩玉范,李成军,等.五联疗法治疗膝关节骨性关节炎538例[J].中医外治杂志.2006：15(3)：14-15.
[80]刘向前,姚共和,卢敏,等.膝关节骨关节炎期刊文献病机因子与证候类型分析[J].江苏中医药.2005：26(10)：63-64.
[81]刘向前,姚共和,李建斌,等.膝关节骨关节炎中医住院病历的中医证候诊断回顾性分析[J].湖南中医学院学报.2004：(5)：34.
[82]姚共和,刘向前.膝关节骨关节炎基本证候及其分布特点的研究[J].中医药学 刊。2005：23(9)：1553-1554.
[83]李念虎.补肾活血中药治疗早中期膝骨性关节炎临床观察[J].中医正骨.2006：18(10)：11.
[84]惠华,孟祥奇,姜宏。从痰湿瘀论治膝骨性关节炎的临床观察[J].中医正骨,2007：19(2)：12.
[85]姜洪洋,薛剑冰,程云峰.中药熏洗治疗膝关节骨性关节炎120例报告[J].中医正骨.2004：16(7)：50.
[86]刘惠敏.复方温通散外敷对膝关节骨性关节炎止痛疗效的观察[J].湖南中医学院学报.2006：26(1)：42.
[87]钱来军.中药醋拌热敷治疗膝关节骨性关节炎68例[J].河南中医学院学报.2007；22(2)：63.
[88]樊成虎,张玉昌.陇中中药洗剂治疗膝关节骨性关节炎60例临床观察[J].甘肃中医.2008：21(12)：17.
[89]陈海鹏,刘志坤,程火生,吴竹涵,方成.膝痛消熏洗方治疗绝经后膝关节骨性关节炎53例[J].中国中医骨伤杂志.2008：16(9)：56.
[90]王进军.针刺治疗类风湿性关节炎急性期之消炎镇痛作用机理探讨[J].时珍国医国药,2006；17(3)：437-438.
[91]金立昆,针灸治疗膝关节骨性关节炎研究现状及机理探讨.中国中医药信息杂志,2008；15(5)：79-81.
[92]周楣生.灸绳[M].青岛：青岛出版社,1998,104—105.
[93]刘旭光,等.艾灸对实验性类风湿性关节炎家兔关二13.滑膜液MMP-3、TIMP—1含量的影响[J].成都中医药人学学报,2005,4(28)：1-2.
[94]陈游,孙材江,方建珍.不同科度膝关节炎患者滑液中几种细胞冈子水平变化[J].中国临床康复,2002,6(10)：1426—1427.
[95]杜引平.齐刺治疗老年性膝骨性关节炎50例[J].湖北中医杂志.2002：24(7)：49.
[96]王铁刚,公维志.温针灸治疗退行性膝关节炎48例.针灸临床杂志.2004,20(7)：41
[97]周伟能,王体敏.温针灸治疗退行性膝关节炎54例.针灸临床杂志2006,22(1)：31
[98]张宏荣,李晓棠.温针灸治疗退行性膝关节炎60例.实用中医药杂志.2001,17(10)：33.
[99]艾鹏飞,潘月财.温针灸配合火罐治疗退行性膝关节炎60例.吉林中医药.2006,26(8)：51-52
[100]汤群珍.温针灸加推拿治疗退行性膝关节炎50例.江西中医药.2003,8：41
[101]张金贵.针灸治疗膝关节骨性关节炎60例疗效观察[J].针灸临床杂志.2003；19(11)：21-22
[102]姚志芳,黄晓卿,张炜.温针灸与单纯针刺治疗膝关节骨性关节炎疗效观察比较[J].针灸临床杂志,2003：19(7)：32-33
[103]谷建林。温针灸加中药治疗膝关节骨性关节炎的体会[J]..中医临床医学研究杂志。2003；70(7)：1 1663-1664.
[104]李宁,吴滨,张永铃.艾灸配合运动疗法治疗膝关节骨性关节炎疗效观察叨.中国针灸,2002：22(11)：729-730.
[105]刘书鹏,刘华小针刀治疗膝关节骨性关节炎85例疗效观察叨.山西中医.2006：22(1)：38.
[106]罗仁瀚,黄云声.针刀治疗膝关节骨性关节炎临床观察阴.甘肃中医学院学报.2007：24(1)：30.
[107]汪利合.点穴加旋转屈伸手法治疗膝关节骨性关节炎[J].中国民间疗法.2002：10(11)：29
[108]许旺,陈玉辰,朱立国.捉拿髌骨手法治疗膝关节骨性关节炎疗效观察[J].中国骨伤.2005；18(4)：245
[109]滕蔚然,杜宁.’史炜镔.手法治疗膝骨关节病对膝关节功能改善的研究[J].中国中医骨伤科杂志.2000：8(5)：46-48
[110]黄明伟.三步推拿手法治疗退行性膝关节病36例[J].广西中医学院学报.2000；3(2)：23,45
[111]张勇,黄筑华.膝关节骨性关节炎手法治疗及康复训练[J].中国现代医学杂志.20041 13(24)：13
[112]王文东.手法为主治疗膝关节骨性关节炎的临床观察[J].中国现代医生.2008；46(22)：136.137
[113]曹国富,马素慧,蒙家纺,吕文英。手法治疗膝关节骨性关节炎疗效分析[J]. 中国康复医学杂志.2007：22(4)：365
[114]陈文治,葛鸿庆,王君鏊,等.关节腔注射参麦液治疗膝关节骨性关节炎的临床疗效观察[J].天津中医药.2005；22(6)：518
[115]陈利新,莫卫海,卜晗.红花注射液关节腔内注射治疗膝骨性关节炎56例[J].新中医.2006：38(6)：75
[116]苟凌云,郑红波,冯穗,等.关节腔内注射正清风痛宁治疗膝关节骨性关节炎158例[J].广西中医学院学报.2007；10(1)：37
[117]李金虎.推拿加中药熏蒸治疗膝关节骨性关节炎疗效分析明[J].中医药临床杂志,2008：20(3)：290-291
[118]陈国胜.温针、中药及医疗体操综合疗原发性膝关节骨关节炎的观察[J].中西医,2007：116：67-68
[119]邓泽前,张荣龙,俞宙.中药配合理疗手法治疗膝关节骨性关节炎106例分析[J].中国误诊学诊治,2008：8(34)：8466—8467
[120]顾晓美,徐小梅,孙志脱针刺配合肌力训练治疗老年性膝关节骨性关节炎的疗效研究阴[J].实用老年医学,2008；22(6)：467-468
[121]刘基柱,钟兆健.豆鼓姜超临界C02萃取物的GC分析,2006,29(2)：142-144.
[122]邱贵兴,王树寰,卢世璧等.骨关节炎诊治指南(2007年版)[J].中华骨科志,2007；27(10)：793-796.
[123]许建荣,柴维敏.膝类风湿性关节炎和骨关节炎的MRI表现特点和比较骨骼肌肉放射学[J].临床放射学杂志,2001：20(11)：862-864.
[124]王进军.针刺治疗类风湿性关节炎急性期之消炎镇痛作用机理探讨.[J].时珍国医国药2006：17(3)：437-438.
[125]金立昆,针灸治疗膝关节骨性关节炎研究现状及机理探讨.中国中医药信息杂志[J].2008：15(5)：79—81.
[126]户田静男.艾高气相色讲法分析.国外医学中医中药分册,1992；4(5)：54-54.
[127]杨华元.艾灸疗法的生物物理机制初探[J].中国针灸1996；3(10)：17-17.
[128]白耀辉.艾灸与温热刺激关系的探讨[J].针灸学报,1991；2(4)：10-10.
[129]国家中医药管理局.中医病证诊断疗效标准[M].南京：南京人学出版社,1999,33.
[130]郑莜萸主编.中药新药临床研究指导原则[M].第1版.北京：中国医药科技出版社,2002,349-353.
[131]石学敏主编,针灸学[M].北京：中国中医药出版社,2006
[132]王建国,何丽娟.温针灸治疗膝骨关节炎疗效观察[J].中图针灸,200727(3)：191-192.
[133]中华人民共和国卫生部医政司主编.中国康复医学诊疗规范[S].北京：华夏出版社,1999：3.
[134]Cecehi F, Molino-Lova R, DilorioA et al. Measures of physical performance capture the excess disability associated with hip pain or knee pain in older persons[J].Med Sei,2009.64(12):1316-1324.
[135]Pavol MJ, Owings TM, Foley KT. et al. Influence of lower extremity strength of healthy older adults on the outcome of an induced trip [J]. J Am Geriatr Soc,2002,50(2):256-262.
[136]Peat G, Thomas E, Wilkie R, et al. Multiple joint pain and lower extremity disability in middle and old age[J]. Disabil Rehabil,2006,28(24):1543-1549.
[137]Cecchi F, Mannoni A, Benvenuti E. et al. Epidemiology of hip and knee pain in a representative cohort of Italian persons aged 65 and older: the InCHIANTI Study [J].Osteoarth Cartilage,2008,16(9):1039-1046.
[138]Salaffi F, Carotti M, Grassi W. Health-related quality of life in patients with hip or knee osteoarthritis:comparison of generic and disease specific instruments[J].Clin Rheumatol,2005,24:29-37.