调神止痛针法治疗膝关节骨性关节炎患者的疗效及对IL-1、hs-CRP的影响
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摘要
目的探讨调神止痛针法治疗膝关节骨性关节炎患者的疗效及对血清白细胞介素-1(IL-1)和高敏C反应蛋白(hs-CRP)的影响。方法将60例膝关节骨性关节炎患者随机分为观察组和对照组各30例,对照组采用常规针法进行治疗,观察组采用调神止痛针法治疗,均连续治疗1周。对比2组临床疗效,观察2组治疗前后疼痛VAS评分、西安大略麦克马斯特大学骨性关节炎指数(WOMAC)评分和血清IL-1、hs-CRP水平变化情况。结果观察组的总有效率为76. 67%,显著高于对照组的50. 00%(P <0. 05); 2组治疗后VAS评分、WOMAC各项评分及血清IL-1、hs-CRP水平均显著低于治疗前(P均<0. 05),且观察组治疗后VAS评分、WOMAC评分中疼痛评分和日常功能活动评分及血清IL-1、hs-CRP水平均显著低于对照组(P均<0. 05)。结论调神止痛针法治疗膝关节骨性关节炎患者的临床疗效明显优于常规针法,且可显著减轻患者的疼痛,明显下调IL-1、hs-CRP水平可能是其机制之一。
Objective It is to investigate the curative effect of acupuncture for regulating spirit and relieving pain in patients with knee osteoarthritis and its effects on the levels of serum interleukin-1( IL-1) and high-sensitivity C-reactive protein( hs-CRP) in these patients. Methods Sixty patients with knee osteoarthritis were randomly divided into observation group and control group,30 cases in each group. The patients in the control group were treated with conventional acupuncture method. The ones in the observation group were treated with acupuncture for regulating spirit and relieving pain. All patients were treated for 1 week. The clinical efficacy of the two groups was compared. The changes of pain VAS scores and Western Ontario McMaster University Osteoarthritis Index( WOMAC) scores,and serum IL-1 and hs-CRP levels of the two groups before and after treatment were observed. Results The total effective rate of the observation group was 76. 67%,which was significantly higher than that of the control group( 50. 00%)( P < 0. 05). The VAS score,WOMAC scores and serum IL-1 and hs-CRP levels after treatment were significantly lower than those before treatment in the two groups( P <0. 05),the VAS score,the pain score and daily functional activity score in WOMAC scores and the serum IL-1 and hsCRP levels in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion The clinical efficacy of acupuncture for regulating spirit and relieving pain which can significantly reduce the pain of patients is significantly better than conventional acupuncture in the treatment of knee osteoarthritis. Down-regulation of IL-1 and hsCRP levels may be one of the mechanisms.
Objective It is to investigate the curative effect of acupuncture for regulating spirit and relieving pain in patients with knee osteoarthritis and its effects on the levels of serum interleukin-1( IL-1) and high-sensitivity C-reactive protein( hs-CRP) in these patients. Methods Sixty patients with knee osteoarthritis were randomly divided into observation group and control group,30 cases in each group. The patients in the control group were treated with conventional acupuncture method. The ones in the observation group were treated with acupuncture for regulating spirit and relieving pain. All patients were treated for 1 week. The clinical efficacy of the two groups was compared. The changes of pain VAS scores and Western Ontario McMaster University Osteoarthritis Index( WOMAC) scores,and serum IL-1 and hs-CRP levels of the two groups before and after treatment were observed. Results The total effective rate of the observation group was 76. 67%,which was significantly higher than that of the control group( 50. 00%)( P < 0. 05). The VAS score,WOMAC scores and serum IL-1 and hs-CRP levels after treatment were significantly lower than those before treatment in the two groups( P <0. 05),the VAS score,the pain score and daily functional activity score in WOMAC scores and the serum IL-1 and hsCRP levels in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion The clinical efficacy of acupuncture for regulating spirit and relieving pain which can significantly reduce the pain of patients is significantly better than conventional acupuncture in the treatment of knee osteoarthritis. Down-regulation of IL-1 and hsCRP levels may be one of the mechanisms.
引文
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[9]张建宾,张智龙.张智龙运用调神止痛针法治疗带状疱疹后遗痛经验[J].世界中西医结合杂志,2016,11(11):1514-1515;1519
[10]闫静伟,赵帅.调神活血止痛针刺法治疗癌痛[J].长春中医药大学学报,2014,30(1):86-87
[11]Mankan AK,Dau T,Jenne D,et al.The NLRP3/ASC/Caspase-1 axis regulates IL-1βprocessing in neutrophils[J].Eur J Immunol,2012,42(3):710-715
[12]杨建辉,吕建国,王辉,等.氨基葡萄糖对IL-1β诱导人骨关节炎软骨细胞蛋白聚糖分解代谢的影响[J].中国老年学杂志,2013,33(15):3673-3676
[13]贾宁,马云,谷雪莲,等.老年下肢骨科手术患者认知功能及炎症因子水平的变化[J].中国老年学杂志,2017,37(2):431-433
[14]韩润霞,杨晶,张天生,等.火针对类风湿性关节炎大鼠血清白介素-1和肿瘤坏死因子-α的影响[J].针刺研究,2012,37(2):114-118
[15]李敏,梁翼,吴晓惠,等.伴骨髓水肿的膝骨关节炎患者白细胞介素-1β白细胞介素-6肿瘤坏死因子-α的相关性研究[J].中华风湿病学杂志,2012,16(2):107-110
[16]任景,李涛,于苗,等.针灸联合独活寄生汤治疗膝关节骨性关节炎疗效观察及对微炎性反应指标的影响[J].世界中医药,2016,11(10):2113-2115;2119
[2]陈亮,唐乐微,杜怀斌,等.调神止痛法理论探析及临床应用[J].中国针灸,2015,35(4):393-396
[3]卢昌均,刘国成,黄永军,等.调神止痛针法治疗丘脑痛临床研究[J].吉林中医药,2013,33(2):184-185
[4]Altman R,Asch E,Bloch D,et al.Development of criteria for the classification and reporting of osteoarthritis.Classification of osteoarthritis of the knee.Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association[J].Arthritis Rheum,1986,29(8):1039-1049
[5]国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科学技术出版社,2002:349-353
[6]Stratford PW,Kennedy DM.Does parallel item content on WOMAC’s pain and function subscales limit its ability to detect change in functional status[J].BMC Musculoskeletal Disorders,2004,5:17
[7]周洪保,张曦,吕正祥,等.膝关节骨性关节炎治疗进展[J].中医药导报,2012,18(2):87-89
[8]黄木全,王勇.膝关节骨性关节炎中医证素的聚类分析研究[J].中医学报,2012,27(9):1134-1135
[9]张建宾,张智龙.张智龙运用调神止痛针法治疗带状疱疹后遗痛经验[J].世界中西医结合杂志,2016,11(11):1514-1515;1519
[10]闫静伟,赵帅.调神活血止痛针刺法治疗癌痛[J].长春中医药大学学报,2014,30(1):86-87
[11]Mankan AK,Dau T,Jenne D,et al.The NLRP3/ASC/Caspase-1 axis regulates IL-1βprocessing in neutrophils[J].Eur J Immunol,2012,42(3):710-715
[12]杨建辉,吕建国,王辉,等.氨基葡萄糖对IL-1β诱导人骨关节炎软骨细胞蛋白聚糖分解代谢的影响[J].中国老年学杂志,2013,33(15):3673-3676
[13]贾宁,马云,谷雪莲,等.老年下肢骨科手术患者认知功能及炎症因子水平的变化[J].中国老年学杂志,2017,37(2):431-433
[14]韩润霞,杨晶,张天生,等.火针对类风湿性关节炎大鼠血清白介素-1和肿瘤坏死因子-α的影响[J].针刺研究,2012,37(2):114-118
[15]李敏,梁翼,吴晓惠,等.伴骨髓水肿的膝骨关节炎患者白细胞介素-1β白细胞介素-6肿瘤坏死因子-α的相关性研究[J].中华风湿病学杂志,2012,16(2):107-110
[16]任景,李涛,于苗,等.针灸联合独活寄生汤治疗膝关节骨性关节炎疗效观察及对微炎性反应指标的影响[J].世界中医药,2016,11(10):2113-2115;2119