摘要
目的探讨经筋手法配合电针治疗膝骨关节炎(KOA)患者的临床疗效及作用机制。方法 80例KOA患者随机分为治疗组和对照组,每组各40例,观察并比较两组患者临床疗效和膝关节功能改善情况,检测炎性细胞因子,实时聚合酶链反应(Real-time PCR)法检测两组血清中p38丝裂原活化蛋白激酶(p38MAPK)和核转录因子-κB(NF-κB) mRNA的表达,蛋白免疫印迹法(Western blot)检测两组血清中p38MAPK和NF-κB蛋白表达,酶联免疫吸附法(ELISA)检测两组血清中白细胞(WBC)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)水平;治疗前后分别采用西大略和买马斯特大学KOA指数可视化量表(WOMAC)和形态学(Lequesne)指数进行评分。结果治疗后两组WOMAC、Lequesne指数评分较治疗前明显降低(P<0. 05),且治疗组低于对照组(P<0. 05);治疗后两组p38MAPK、NF-κB蛋白及mRNA水平比治疗前降低(P <0. 05),且治疗组p38MAPK、NF-κB mRNA及NF-κB蛋白水平低于对照组(P <0. 05);治疗后两组WBC、TNF-α和CRP水平较治疗前明显降低(P<0. 05),且治疗组WBC、TNF-α和CRP水平低于对照组(P <0. 05)。结论经筋手法配合电针治疗KOA患者疗效显著,可能通过抑制p38MAPK/NF-κB信号通路介导的炎症反应发挥作用。
Objective To explore the clinical effect and mechanism of tendon-soothing maneuver combined with acupuncture of knee osteoarthritis patients.Methods 80 cases of KOA patients were divided into treatment group receiving tendon-soothing maneuver combined with acupuncture( 40 cases) and control group receiving acupuncture( 40 cases).The clinical efficacy and the knee joint function of the two groups were observed and compared,and the level of inflammatory cytokines was detected.The expression of p38 MAK and NF-κBmRNA in serum were detected by Real-time PCR,the expression of p38 MAK and NF-κB proteins were detected by Western blot and the level of white blood cell,TNF-α and CRP were measured by ELISA in two groups. Results After treatment,the WOMAC and Lequesne index scores of the two groups were significantly lower than those before treatment( P < 0. 05),and the treatment group was lower than those of the control group( P <0.05).The levels of p38 MAPK,NF-kappa B protein and RNA of the two groups were lower than those before treatment( P<0.05) and the levels of p38 MAPK,NF-kappa B and NF-kappa B protein in the treatment group were lower than those in the control group( P<0.05).The levels of WBC,TNF-α and CRP in the two groups were significantly lower than those before treatment( P<0.05),and the levels of WBC,TNF-α and CRP in the treatment group were lower than those in the control group( P<0.05).Conclusion The tendon-soothing maneuver combined with acupuncture may play a role in the treatment of KOA by inhibiting the inflammatory response mediated by P38 mapk/NF-κB signaling pathway.
作者
刘菲
阳乐彬
Liu Fei;Yang Lebin(Department of TCM,The Second Affifiated Hospital,University of South China;Department of Gastrointestinal Surgery,The Second Affifiated Hospital,University of South China,Hengyang,Hunan 421001,China)
出处
《湖北民族学院学报（医学版）》
2019年第1期41-44,共4页
Journal of Hubei Minzu University(Medical Edition)
作者简介
刘菲,女,硕士,住院医师,研究方向:针刺镇痛的机理及临床研究;通信作者:阳乐彬,男,硕士,住院医师,主要从事胃肠道肿瘤方面的研究。
