關(guān)韶勇 張立波 王建濤

【摘要】 目的：探討針刺結(jié)合足三里溫針灸治療膝骨關(guān)節(jié)炎的臨床效果及預(yù)后。方法：將筆者所在醫(yī)院2016年6月-2018年10月的40例膝骨關(guān)節(jié)炎患者，隨機分為兩組，每組20例。常規(guī)西醫(yī)治療組對膝骨關(guān)節(jié)炎患者予以常規(guī)西醫(yī)治療，針刺+溫針灸組對膝骨關(guān)節(jié)炎患者以西醫(yī)+針刺結(jié)合足三里溫針灸。比較兩組療效、疼痛減輕及膝關(guān)節(jié)活動改善時間、治療前后視覺模擬疼痛程度評分、TNF-α、IL-6及hs-CRP、并發(fā)癥發(fā)生率。結(jié)果：針刺+溫針灸組的總有效率為100%，高于常規(guī)西醫(yī)治療組的80%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療前兩組視覺模擬疼痛程度評分、TNF-α、IL-6、hs-CRP比較差異均無統(tǒng)計學(xué)意義（P>0.05）;治療后針刺+溫針灸組視覺模擬疼痛程度評分、TNF-α、IL-6、hs-CRP優(yōu)于常規(guī)西醫(yī)治療組，差異有統(tǒng)計學(xué)意義（P<0.05）。針刺+溫針灸組疼痛減輕、膝關(guān)節(jié)活動改善時間優(yōu)于常規(guī)西醫(yī)治療組，差異有統(tǒng)計學(xué)意義（P<0.05），且其并發(fā)癥發(fā)生率低于常規(guī)西醫(yī)治療組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：膝骨關(guān)節(jié)炎患者實施西醫(yī)+針刺結(jié)合足三里溫針灸可獲得較好的效果，可更好地緩解疼痛，控制炎癥，減少并發(fā)癥。

【關(guān)鍵詞】 針刺 足三里溫針灸治療 膝骨關(guān)節(jié)炎 臨床效果 疼痛 炎癥

doi：10.14033/j.cnki.cfmr.2020.10.007 文獻標識碼 B 文章編號 1674-6805（2020）10-00-03

Clinical Effect and Prognosis of Acupuncture Combined with Zusanli Warm Acupuncture and Moxibustion in the Treatment of Knee Osteoarthritis/GUAN Shaoyong， ZHANG Libo， WANG Jiantao. //Chinese and Foreign Medical Research， 2020， 18（10）： -18

[Abstract] Objective： To explore the clinical effect and prognosis of acupuncture combined with Zusanli warm acupuncture and moxibustion in the treatment of knee osteoarthritis. Method： A total of 40 patients with knee osteoarthritis in our hospital from June 2016 to October 2018 were randomly divided into two groups， 20 cases in each group. Routine western medicine treatment group treated knee osteoarthritis patients with routine western medicine treatment， acupuncture+warming moxibustion group treated with western medicine+acupuncture combined with Zusanli warm acupuncture and moxibustion. The curative effect， pain relief and knee joint activity improvement time， visual analogue pain score， TNF-alpha， IL-6 and hs-CRP before and after treatment， and the incidence of complications were compared between the two groups. Result： The total curative effect of acupuncture+warming moxibustion group was 100%， which was higher than 80% of the conventional western medicine treatment group， the difference was statistically significant （P<0.05）. Before treatment， the scores of visual analogue pain， TNF-a， IL-6 and hs-CRP in the two groups were not statistically significant （P>0.05）. After treatment， the scores of visual analogue pain， TNF-a， IL-6 and hs-CRP in the acupuncture+warming moxibustion group were better than those in the conventional western medicine treatment group， the differences were statistically significant （P<0.05）. Acupuncture+warming moxibustion group had better pain relief and knee joint activity improvement time than that of conventional western medicine treatment group， the differences were statistically significant （P<0.05）， and the incidence of complications was lower than that of the conventional western medicine treatment group （P<0.05）. Conclusion： Western medicine plus acupuncture combined with Zusanli warm acupuncture and moxibustion can achieve better results in relieving pain， controlling inflammation and reducing complications in patients with knee osteoarthritis.