正骨推拿联合温针灸对膝骨性关节炎（寒湿痹阻型）患者的步态及炎性相关因子水平的影响

Effects of bone-setting massage combined with warm acupuncture and moxibustion on gait and levels of inflammatory factors in patients with（cold-damp obstructing blockage syndrome） knee osteoarthritis

关键词:  膝骨性关节炎  正骨推拿  温针灸  随机对照研究

Key words:  knee osteoarthritis  bone-setting massage  warm acupuncture  randomized controlled study

摘要:

[目的] 探讨正骨推拿联合温针灸对寒湿痹阻型膝骨性关节炎（KOA）患者的步态及炎性相关因子水平的影响。[方法] 选取2023年1月—2023年9月在天津市天津医院接受治疗的膝骨性关节炎患者136例，按1∶1比例随机分为治疗组（正骨推拿联合温针灸）和对照组（口服塞来昔布胶囊），并完成4周的治疗。在治疗结束时，比较两组患者的步态运动学分析（步速、步频、步长），肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、基质金属蛋白酶-3（MMP-3）等炎性相关因子水平和临床有效率。[结果] 两组患者在治疗后步速、步频和步长均优于治疗前（P＜0.01），治疗组在治疗后的步速和步频优于对照组（P＜0.05或P＜0.01），而步长与对照组比较差异没有统计学意义（P＞0.05）；两组患者治疗后的TNF-α、IL-1β、IL-6、MMP-3均优于治疗前（P＜0.01），且治疗组优于对照组（P＜0.01）；治疗组的有效率优于对照组（P＜0.05）。[结论] 正骨推拿联合温针灸可以有效改善寒湿痹阻型KOA患者的步态，降低IL-6、IL-1β、TNF-α和MMP-3的水平，且有效率高于非甾体抗炎药。

Abstract:

[Objective] To investigate the effects of bone-setting massage combined with warm acupuncture and moxibustion on the level of gait and inflammatory factors in patients with（cold-damp obstructing blockage syndrome） knee osteoarthritis（KOA）. [Methods] The 136 patients with knee osteoarthritis who received treatment in our hospital from January 2023 to September 2023 were selected and randomly divided into treatment group and control group according to 1∶1 ratio. The treatment group was treated with bone-setting massage combined with warm acupuncture and moxibustion，and the control group was treated with oral cecoxib capsule. Both groups received treatment for 4 weeks. Gait kinematics analysis（stride speed，stride frequency，stride length），levels of inflammatory factors [tumor necrosis factor-α （TNF-α），interleukin-1β （IL-1β），interleukin-6 （IL-6），matrix metalloproteinase-3 （MMP-3）] and response rate were compared between the two groups. [Results] After treatment，the step speed，step frequency and step length of the two groups were better than before treatment（P<0.01），and the step speed and step frequency of the treatment group were better than that of the control group（P<0.05 or P<0.01），but there was no statistical difference between the two groups（P>0.05）. The levels of TNF-α，IL-1β，IL-6 and MMP-3 after treatment were higher than those before treatment（P<0.01），and the treatment group was better than the control group（P<0.01）. The effective rate of treatment group was better than that of control group（P<0.05）. [Conclusion] Bone-setting massage combined with warm acupuncture and moxibustion can effectively improve the gait of（cold-damp obstructing blockage syndrome） KOA patients，reduce the levels of IL-6，IL-1β，TNF-α and MMP-3，and the effective rate is better than non-steroidal anti-inflammatory drugs.