针刺对老年膝骨关节炎患者炎症因子表达的影响

Effect of Acupuncture on Inflammatory Factor Expression in the Elderly with KOA

中文关键词: 针刺  骨关节炎  膝  白细胞介素-6  肿瘤坏死因子-α  基质金属蛋白酶13

英文关键词: acupuncture  osteoarthritis  knee  IL-6 (interleukin-6)  TNF-α (tumor necrosis factor-alpha)  MMP-13 (matrix metalloproteinase 13)

中文摘要:

      目的 研究针刺对老年膝骨关节炎(knee osteoarthritis,KOA)患者的疗效.方法 选取2013年6月-2016年6月KOA患者130例,随机分为观察组67例和对照组63例.其中男性45例,女性85例,年龄65 ～ 80岁,平均(67.3±13.0)岁.观察组针刺血海、内膝眼、外膝眼和阳陵泉4穴,低频脉冲治疗仪疏密波连接20 min,每周治疗2次.对照组口服盐酸氨基葡萄糖480 mg,每日3次.2组疗程均为4周,治疗前后采用骨性关节炎指数WOMAC评分、视觉模拟评分法(visual analogue scale,VAS)评估KOA的疗效.同时检测炎症因子白细胞介素-1β(interleukin-1 beta,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、前列腺素E2(prostaglandins E2,PGE2)和基质金属蛋白酶13(matrix metalloproteinase 13,MMP-13)在膝关节液中的表达水平.结果 治疗后与对照组相比,治疗组WOMAC评分更低[(48.25±10.52) vs(33.36 ±6.26),P＜0.05],VAS评分更低[(2.86±1.10) vs (5.23±1.66),P＜0.05].IL-1β含量更低[42.59±6.72) pg/mL vs (89.68±12.86) pg/mL,P＜0.05],IL-6含量更低[(126.38±37.25) pg/mL vs (199.26±35.58) pg/mL,P＜0.05],TNF-α含量更低[(6.50±1.02) pg/mL vs (14.22±3.00) pg/mL,P＜0.05],PGE2含量更低[(102.50±25.58) pg/mLvs (306.69±49.5) pg/mL,P＜0.05],MMP13含量更低[(324.65±45.20) pg/mL vs (462.79±56.68) pg/mL,P＜0.05].结论 针刺能改善老年KOA患者的相关症状,减少炎症因子含量,适合临床推广.

英文摘要:

      Objective To explore the effect of acupuncture on the elderly with knee osteoarthritis (KOA).Methods 130 elderly with KOA were selected and randomly divided into 2 groups:observation group (n =67) and control group (n =63);acupuncture at the acupoints of Xue-hai,inner Xi-yan,outer Xi-yan and Yangling-quan plus low frequency pulse with dilatational wave for 20 minutes was performed on the elderly in observation group,once every other day;oral administration of glucosamine hydrochloride was made to the elderly in control group,480 mg once,3 times a day;the courses for both groups lasted for 4 weeks;WOMAC and visual analogue scale (VAS) were applied to the elderly in both groups before and after treatment and the curative effect was assessed with the scores;the expression levels of IL-1β (interleukin-1 beta),IL-6 (interleukin-6),TNF-α (tumor necrosis factor-alpha),PGE2 (prostaglandinsE2) and MMP-13 (matrix metalloproteinase 13) in knee joint fluid were detected.Results After treatment,the score of WOMAC in observation group (48.25 ± 10.52) was lower than that in control group (33.36±6.26),as well as the score of VAS [(2.86 ± 1.10) vs (5.23 ± 1.66) (P＜ 0.05);the contents of IL-1β,IL-6,TNF-α,PGE2 and MMP13 in observation group were all lower than those in control group:[42.59±6.72) pg/mL vs (89.68±12.86) pg/mL,P＜0.05],[(126.38 ±37.25)pg/mL vs (199.26±35.58)pg/mL,P＜0.05],[(6.50±1.02) pg/mLvs (14.22±3.00) pg/mL,P＜0.05],[(102.50±25.58) pg/mL vs (306.69±49.5) pg/mL,P＜0.05] and [(324.65±45.20) pg/mL vs (462.79±56.68)pg/mL,P＜ 0.05].Conclusion Acupuncture can improve the related inflammatory symptoms of the elderly with KOA and reduce the contents of inflammatory factors,it is worthy of wide clinical application.