摘要
目的探讨基于toll-4受体(TLR4)/NF-κB炎性轴探讨三通针法治疗对膝骨关节炎患者的临床研究。方法选取2020年8月—2021年8月期间南京鼓楼医院集团安庆市石化医院康复医学科收治治疗的102例膝骨关节炎患者为研究对象,按随机数字表法分为对照组和研究组,每组各51例。对照组给予常规治疗,研究组在对照组基础上给予三通针法治疗。均治疗4周。观察比较两组患者治疗前后中医证候积分、疼痛程度、炎症因子水平、TLR4/NF-κ及关节炎症指数,观察比较两组患者临床疗效。结果治疗后研究组总有效率98.04%(50/51)高于对照组84.31%(43/51),差异有统计学意义(P<0.05)。治疗后,两组患者膝关节酸痛、重着不移、遇热痛减、恶风、失眠多梦、关节屈伸不利积分均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者疼痛程度评分较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-6、IL-1β、TNF-α水平均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者TLR4mRNA、NF-κBmRNA较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者日常活动功能、僵硬、疼痛评分均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。结论三通针法可有效缓解膝骨关节炎患者临床症状,减轻疼痛程度,降低炎症因子水平,抑制TLR4/NF-κB炎性轴,降低关节炎症指数,疗效显著,可在临床推广应用。
Objective To explore the clinical effect of three-unblocking acupuncture on knee osteoarthritis based on Toll-like receptor 4(TLR4)/nuclear factor(NF)-κB axis.Method A total of 102 patients with knee osteoarthritis treated in the Anqing Shihua Hospital of Nanjing Drum Tower Hospital Group from August 2020 to August 2021 were selected and assigned into a control group(51 patients,receiving conventional treatment)and a research group(51 patients,receiving three-unblocking acupuncture on the basis of the therapy in the control group)according to the random number table method.Both groups were treated for 4 weeks.The TCM symptom scores,degree of pain,levels of inflammatory cytokines,mRNA levels of TLR4 and NF-κB,and joint inflammation index were compared between the two groups and between before and after intervention.The efficacy was compared between the two groups.Results The total response rate in the research group was 98.04%(50/51),which was higher than that(84.31%,43/51)in the control group(P<0.05).After treatment,the scores of knee joint pain,pain of fixed location,pain reduction because of warming,aversion to wind,insomnia and dreaminess,and inhibited flexion and extension of joints in both groups declined compared with those before treatment,and the research group had lower scores than the control group(P<0.05).After treatment,the degree of pain in the two groups was lower than that before treatment,and the study group had lower degree of pain than the control group(P<0.05).The treatment in both groups lowered the levels of IL-6,IL-1β,and TNF-α,and the study group had lower levels of IL-6,IL-1β,and TNF-αthan the control group after treatment(P<0.05).The treatment down-regulated the mRNA levels of TLR4 and NF-κB,and the study group had lower mRNA levels of TLR4 and NF-κB than the control group after treatment(P<0.05).After treatment,the scores of daily activity,stiffness,and pain in the two groups become lower,and the study group had lower scores than the control group(P<0.05).Conclusion Three-unblocking acupuncture can alleviate the symptoms,relieve the pain,lower the levels of inflammatory cytokines,inhibit TLR4/NF-κB axis,and reduce the joint inflammation index in the patients with knee osteoarthritis,which demonstrates definite efficacy and can be promoted in clinical practice.
作者
王燕
陈炬烽
WANG Yan;CHEN Ju-feng(Department of Rehabilitation Medicine,Anqing Shihua Hospital of Nanjing Drum Tower Hospital Group,Anqing Anhui 246000;Department of Acupuncture and Massage,Fujian Academy of Chinese Medical Sciences,Fuzhou Fujian 350003)
出处
《世界中西医结合杂志》
2023年第11期2254-2258,2263,共6页
World Journal of Integrated Traditional and Western Medicine
基金
安徽省卫生健康科研项目(AHWJ2022b082)。
作者简介
通信作者:陈炬烽,Email:pgj0@qq.com。
