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温针灸疗法治疗绝经后骨质疏松症疼痛的临床研究

[Clinical research on warm acupuncture therapy for pain in postmenopausal osteoporosis].

作者信息

Cai Guo-Wei, Li Jing, Xu Xiao-Juan, Xue Yuan-Zhi, Li Gang, Wu Man, Li Peng-Fei

出版信息

Zhongguo Zhen Jiu. 2014 Jan;34(1):25-7.

Abstract

OBJECTIVE

To observe the clinical efficacy on pain in postmenopausal osteoporosis treated with the warm acupuncture therapy and discuss its effect mechanism.

METHODS

Ninety cases of postmenopausal osteoporosis were randomized into a warm acupuncture group, an electroacupuncture group and a medication group, 30 cases in each group. In the warm acupuncture group and the electroacupuncture group, Dazhu (BL 11), Shenshu (BL 23) and Xuanzhong (GB 39) were selected bilaterally and stimulated with the warm acupuncture and electroacupuncture therapies respectively, once a day for 30 days totally. In the medication group, caltrate-D tablets were prescribed, 600 mg, once a day for 30 days totally. The changes in the bone density T value, visual analogue scale (VAS) score, serum insulin like growth factor 1 (IGF-1), interleukin 6 (IL-6) and tumor necrosis factor (TNF-alpha) were observed before and after treatment in the three groups.

RESULTS

(1) The bone density T value in the patients of postmenopausal osteoporosis did not change obviously after 30 days treatment with the three therapies; (2) VAS score was all reduced after treatment, in which, the result in the warm acupuncture group was the most obvious (6.73 +/- 0.24 before treatment vs 4.43 +/- 0.26 after treatment). The value after treatment in the warm acupuncture group was different significantly as compared with the electroacupuncture group (5.13 +/- 0.31) and the medication group (5.17 +/- 0.33, both P < 0.05). (3) The level of serum IGF-1 was improved after treatment in the warm acupuncture therapy [(119.5 +/- 20.1) ng/mL before treatment vs (156.5 +/- 23.9) ng/mL after treatment], which was more apparent as compared with the electroacupuncture group [(136.3 +/- 24.5) ng/mL] and the medication group [(127.7 +/- 22.1) ng/mL, all P < 0.05]. Concerning to reducing the levels of IL-6 and TNF-alpha in serum, the results in the warm acupuncture group were superior to the other two groups (all P < 0.05).

CONCLUSION

The warm acupuncture therapy achieves the significant efficacy on pain in postmenopausal osteoporosis, which could be related to increasing the level of IGF-1, decreasing the levels of IL-6 and TNF-alpha, promoting bone formation and inhibting bone absorption.

摘要

目的

观察温针灸疗法治疗绝经后骨质疏松症疼痛的临床疗效并探讨其作用机制。

方法

将90例绝经后骨质疏松症患者随机分为温针灸组、电针组和药物组,每组30例。温针灸组和电针组双侧选取大杼(BL 11)、肾俞(BL 23)、悬钟(GB 39),分别采用温针灸疗法和电针疗法刺激,每日1次,共治疗30天。药物组给予钙尔奇-D片,600mg,每日1次,共治疗30天。观察三组治疗前后骨密度T值、视觉模拟评分(VAS)、血清胰岛素样生长因子1(IGF-1)、白细胞介素6(IL-6)及肿瘤坏死因子(TNF-α)的变化。

结果

(1)三种疗法治疗30天后绝经后骨质疏松症患者的骨密度T值均无明显变化;(2)治疗后VAS评分均降低,其中温针灸组最明显(治疗前6.73±0.24,治疗后4.43±0.26)。温针灸组治疗后的VAS评分与电针组(5.13±0.31)和药物组(5.17±0.33)相比差异均有统计学意义(均P<0.05)。(3)温针灸治疗后血清IGF-1水平升高[治疗前(119.5±20.1)ng/mL,治疗后(156.5±23.9)ng/mL],与电针组[(136.3±24.5)ng/mL]和药物组[(127.7±22.1)ng/mL]相比更明显(均P<0.05)。在降低血清IL-6和TNF-α水平方面,温针灸组效果优于其他两组(均P<0.05)。

结论

温针灸疗法治疗绝经后骨质疏松症疼痛疗效显著,其机制可能与提高IGF-1水平、降低IL-6和TNF-α水平、促进骨形成及抑制骨吸收有关。

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