Wang Chao, Zhu Jun-Chen, Zheng Zhi-Wen, Xiong Ying-Zong, Ma Xing-Fu, Gong Yue-Cheng, He Ye-Lin
The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230061, Anhui, China.
Zhongguo Gu Shang. 2022 Sep 25;35(9):848-52. doi: 10.12200/j.issn.1003-0034.2022.09.009.
To explore effects of acupotomy on pain, function, gait and serum inflammatory factors in patients with knee osteoarthritis(KOA).
From December 2017 to June 2019, 110 patients with KOA were collected and divided into acupotomy group(56 cases) and western medicine group(54 cases) by using random number table method. In acupotomy group, there were 16 males and 40 females, aged from 46 to 74 years old with an average of (62.98±6.68) years old, the course of disease ranged from 1 to 240 months with an average of 24.5(15.25, 33.00) months;were treated with acupotomy on the pain points around knee joint once a week for 3 weeks. In western medicine group, there were 18 males and 36 females, aged from 47 to 73 years old with an average of (64.19±5.98 ) years old;the course of disease ranged from 1 to 220 months with an average of 25.00(13.75, 33.00) months;were took celecoxib capsule orally, 200 mg once a day for 3 weeks. Oxford Knee Score(OKS) was performed before treatment, 3 weeks and 3 months after treatment. Gait kinematics analysis and serum levels of tumor necrosis factor-α(TNF-α) and interleukin-1β (IL-1β) were measured before and after treatment for 3 weeks.
All patients were followed up from 6 to 24 months with an average of(15.03±4.55) months. OKS between two groups decreased significantly at 3 weeks and 3 months after treatment(<0.001). Functional scores and overall scores in acupotomology group were significantly decreased at 3 months compared with 3 weeks after treatment(<0.001). OKS of acupotomy group were significantly lower than those of western medicine group at 3 weeks and 3 months after treatment(<0.05). Gait speed, frequency and length between two groups were significantly improved at 3 weeks after treatment(<0.05). At 3 weeks after treatment, gait freguency of acupotomy group was significantly improved compared with western medicine group(<0.05). TNF-α and IL-1β were significantly lower in both groups at 3 weeks after treatment than before treatment(<0.05). At 3 weeks after treatment, level of IL-1 β was lower in western medicine group than in acupotomy group(<0.05), and difference in TNF-α level was not statistically significant(>0.05).
Acupotomology of pain points could significantly improve pain, function, gait, and decreased serum inflammatory factors at early to mid stage of KOA patients, in particular, it is superior to non-steroidal anti-inflammatory drugs in terms of knee function recovery and cadence improvement.
探讨针刀对膝关节骨性关节炎（KOA）患者疼痛、功能、步态及血清炎症因子的影响。
收集2017年12月至2019年6月110例KOA患者，采用随机数字表法分为针刀组（56例）和西药组（54例）。针刀组男16例，女40例，年龄46～74岁，平均（62.98±6.68）岁，病程1～240个月，平均24.5（15.25，33.00）个月；每周1次对膝关节周围痛点行针刀治疗，共3周。西药组男18例，女36例，年龄47～73岁，平均（64.19±5.98）岁；病程1～220个月，平均25.00（13.75，33.00）个月；口服塞来昔布胶囊，200mg/d，共3周。于治疗前、治疗3周及3个月后进行牛津膝关节评分（OKS）。治疗3周前后进行步态运动学分析及检测血清肿瘤坏死因子-α（TNF-α）和白细胞介素-1β（IL-1β）水平。
所有患者随访6～24个月，平均（15.03±4.55）个月。两组治疗3周及3个月后OKS均显著降低（<0.001）。针刀组治疗3个月时功能评分及总分较治疗3周时显著降低（<0.001）。治疗3周及3个月后针刀组OKS显著低于西药组（<0.05）。治疗3周后两组步态速度、频率及步长均显著改善（<0.05）。治疗3周时针刀组步态频率较西药组显著改善（<0.05）。两组治疗3周后TNF-α和IL-1β均较治疗前显著降低（<0.05）。治疗3周后西药组IL-1β水平低于针刀组（<0.05），TNF-α水平差异无统计学意义（>0.05）。
针刀治疗KOA患者早中期可显著改善疼痛、功能及步态，降低血清炎症因子水平，尤其在膝关节功能恢复及步频改善方面优于非甾体类抗炎药。
