目的:观察温针齐刺法联合中药对风寒湿痹型膝骨关节炎(KOA)患者炎症反应及日常活动能力的影响.方法:按照随机数字表法将101例风寒湿痹型KOA患者分为针药结合组与中药组.中药组50例采用口服防风膝痹汤治疗,针药结合组51例在中药组干预基础上加用温针齐刺法治疗.治疗前后比较两组患者的中医证候评分、炎症因子水平和膝关节活动功能,治疗后比较两组临床疗效.结果:研究过程中针药结合组脱落3例,中药组脱落2例,最终两组各48例纳入统计.针药结合组总有效率为95.8%,明显高于中药组的79.2%,组间差异有统计学意义(P<0.05).治疗后,两组患者的中医证候评分与治疗前相比明显下降(P<0.05),针药结合组患者的中医证候评分低于中药组(P<0.05).两组患者治疗后白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α及IL-1β水平与治疗前相比较均降低(P<0.05),针药结合组的三项炎症因子水平均低于中药组(P<0.05).与治疗前相比,治疗后两组膝部疼痛程度、膝关节僵硬程度及日间活动程度分值均下降(P<0.05),针药结合组三项指标评分均低于中药组(P<0.05).结论:温针齐刺法联合防风膝痹汤能有效降低风寒湿痹型KOA患者的炎症反应,增加患者日常活动能力,提高患者的生活质量.
Objective:To observe the effects of warming triple needling plus Chinese medication on inflammatory responses and daily functioning ability in patients with knee osteoarthritis(KOA)due to wind-cold-dampness Bi-impediment. Methods:A total of 101 patients with KOA due to wind-cold-dampness Bi-impediment were divided into an acupuncture-medication group and a Chinese medication group using the random number table method.Fifty cases in the Chinese medication group took oral Fang Feng Xi Bi Tang for treatment,and 51 cases in the acupuncture-medication group received additional warming triple needling therapy.The symptom score of traditional Chinese medicine(TCM),inflammatory factor levels,and motor function of the knee joint were compared before and after treatment.The clinical efficacy was also compared between the two groups after treatment. Results:Three cases in the acupuncture-medication group and 2 cases in the Chinese medication group dropped out during the study,and the two groups each had 48 cases being included in statistical analysis ultimately.The total effective rate was 95.8%in the acupuncture-medication group,higher than 79.2%in the Chinese medication group,and the between-group difference was statistically significant(P<0.05).After treatment,the TCM symptom score dropped in both groups(P<0.05)and was lower in the acupuncture-medication group than in the Chinese medication group(P<0.05).The levels of interleukin(IL)-6,tumor necrosis factor(TNF)-α,and IL-1β dropped after the intervention in both groups(P<0.05)and were lower in the acupuncture-medication group than in the Chinese medication group(P<0.05).The scores of knee pain intensity,knee joint stiffness,and diurnal functioning decreased after treatment in the two groups(P<0.05)and were lower in the acupuncture-medication group than in the Chinese medication group(P<0.05). Conclusion:Warming triple needling plus Fang Feng Xi Bi Tang can reduce inflammatory responses,improve daily functioning ability,and enhance the quality of life in patients with KOA due to wind-cold-dampness Bi-impediment.