管垒,田向东,朱光宇,谭冶彤,王剑,杜东风,李述文
GUAN Lei,TIAN Xiangdong,ZHU Guangyu,TAN Yetong,WANG Jian,DU Dongfeng,LI Shuwen

• 1:北京中医药大学第三附属医院微创关节科

摘要(Abstract)：

目的:探讨关节镜联合揿针对膝骨性关节炎(KOA)患者血清及关节液中肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-3(MMP-3)和基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法:87例膝骨性关节炎患者分为观察组(n=44)和对照组(n=43),对照组采用关节镜治疗,观察组在对照组治疗的基础上增加揿针治疗20 d;分别于治疗前、治疗第20天时测定两组患者血清及关节液中TNF-α、IL-1β、MMP-3和TIMP-1水平,并于治疗第20天时观察2组患者的治疗效果。结果:治疗前,两组患者血清及关节液IL-1β、TNF-α、MMP-3及TIMP-1水平比较,差异无统计学意义(P> 0. 05);与治疗前比较,治疗第20天时两组患者血清及关节液IL-1β、TNF-α及MMP-3水平显著降低、观察组关节液TIMP-1水平显著升高(P <0. 05);治疗第20天时观察组关节液IL-1β、TNF-α及MMP-3水平显著低于对照组、TIMP-1水平显著高于对照组(P <0. 05);治疗第20天时,观察组KOA患者的症状控制率、总有效率显著高于对照组(P <0. 05)。结论:关节镜联合揿针治疗KOA的临床疗效优于单一的关节镜治疗,其治疗机制可能与揿针治疗改变血清和关节液中炎性因子水平有关。
Objective: To investigate the effects of arthroscopy combined with acupuncture on serum and synovial fluid levels of tumor necrosis factor-α( TNF-α),interleukin-1β( IL-1β),matrix metalloproteinase-3( MMP-3) and matrix metalloproteinase inhibitor-1( TIMP-1) in patients with knee osteoarthritis( KOA). Methods: A total of 87 cases of knee osteoarthritis were divided into observation group( 44 cases) and control group( 43 cases). The control group was treated with arthroscopy,and the observation group increased the press needle therapy on the basis of treatment in the control group.The levels of TNF-α,IL-1β,MMP-3 and TIMP-1 in serum and synovial fluid of the two groups were measured before treatment and at the 20 thday of treatment respectively. The therapeutic effects of the two groups were observed at the 20 thday of treatment. Results: The levels of TNF-α,IL-1β,MMP-3 and TIMP-1 in serum and synovial fluid of the two groups had no significant difference before treatment( P > 0. 05). At the 20 thday of treatment,the levels of IL-1β,TNF-α and MMP-3 in serum and joint fluid were decreased in observation group and control group( P < 0. 05),and TIMP-1 level in joint fluid were increased in observation group( P < 0. 05). The levels of IL-1β,TNF-α and MMP-3 in joint fluid of observation group were lower than those in control group,and TIMP-1 level in joint fluid was higher than that in control group( P < 0. 05). At the 20 thday of treatment,the symptom control rate and total effective rate of observation group were significantly higher than those of the control group( P < 0. 05). Conclusion: The clinical effect of arthroscopy combined with Acupuncturing in the treatment of KOA is better than that of arthroscopy alone. The therapeutic mechanism may be related to the change of inflammatory factors in serum and joint fluid by acupuncturing.

关键词(KeyWords)： 膝骨性关节炎;关节镜;揿针;炎性因子;临床疗效
knee osteoarthritis;arthroscopy;acupuncture;inflammatory factors;clinical efficacy

Abstract:

Keywords:

基金项目(Foundation): 北京中医药大学中青年教师项目(2016-JYB-JSMS-073)

作者(Author): 管垒,田向东,朱光宇,谭冶彤,王剑,杜东风,李述文
GUAN Lei,TIAN Xiangdong,ZHU Guangyu,TAN Yetong,WANG Jian,DU Dongfeng,LI Shuwen

DOI: 10.19367/j.cnki.1000-2707.2019.02.024

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