温针灸联合玻璃酸钠关节腔注射治疗膝骨关节炎疗效及对MMPs的影响(1)
摘要 目的：探討温针灸联合玻璃酸钠关节腔注射治疗膝骨关节炎的疗效及对基质金属蛋白酶(MMPs)的影响。方法：选取2014年2月至2016年8月南京医科大学附属淮安第一医院收治的膝骨关节炎患者92例，随机分为观察组和对照组，每组46例。对照组采取关节腔内注射玻璃酸钠治疗，观察组在对照组基础上结合温针灸法治疗，2组均连续治疗4周。比较2组患者临床疗效；检测并比较2组患者治疗前后关节液中MMPs及其抑制剂水平、炎性因子水平；采用视觉模拟评分法(VAS)及Lysholm膝关节康复量表(LKSS)评估比较2组患者治疗前后疼痛状况及膝关节功能。结果：治疗后观察组总有效率(97.83%)显著高于对照组(80.43%)(P<0.01)；与治疗前比较，2组患者治疗后关节液中MMP-2、MMP-3、MMP-9及TIMP-1水平及IL-2、TNF-α水平均下降，且观察组低于对照组(P<0.01)；与治疗前比较，2组患者VAS评分降低，且观察组低于对照组，2组LKSS评分升高，且观察组高于对照组(P<0.01)。结论：温针灸联合玻璃酸钠关节腔注射治疗膝骨关节炎可显著降低关节液中MMPs及炎性因子水平，消除相关炎性疼痛症状，延缓关节退变，并促进其膝关节功能恢复，临床疗效显著优于玻璃酸钠关节腔内注射治疗。
关键词 膝骨关节炎；温针灸；玻璃酸钠；腔内注射；疗效；MMPs
Abstract Objective：To explore the efficacy of warming acupuncture combined with sodium hyaluronate intraarticular injection in the treatment of osteoarthritis and the influence on matrix metalloproteinase (MMPs). Methods：A total of 92 patients with osteoarthritis who were tread in our hospital from February 2014 to August 2016 were selected and randomly divided into observation group (n=46) and control group (n=46). Control group were treated with sodium hyaluronate intraarticular injection， and observation group were treated with warming acupuncture on the basis of control group. Both groups were treated for 4 weeks continuously. The clinical efficacy of 2 groups were compared， and the levels of MMPs and the tissue inhibitor of MMPs， the inflammatory factors of synovial fluid before and after treatment in 2 groups were detected and compared； Visual analogue scale (VAS) and Lysholm knee joint function score (LKSS) were used to evaluate and compare the pain condition and knee joint function in 2 groups before and after treatment. Results：The clinical efficacy of observation group (97.83%) was significantly higher than control group (80.43%) (P<0.01). Compared with that before treatment， the levels of MMP-2， MMP-3， MMP-9， TIMP-1 and IL-2， TNF-α of synovial fluid all decreased after treatment， and observation group was lower than control group (P<0.01). Compared with before treatment， the VAS scores of 2 groups decreased after treatment， and observation group was lower than control group. The LKSS score of 2 groups increased after treatment， and observation group was higher than control group (P<0.01). Conclusion：Warming acupuncture combined sodium hyaluronate in the treatment of osteoarthritis can significantly reduce the levels of MMPs and the tissue inhibitor of MMPs， inflammatory factors of synovial fluid， eliminate relevant inflammation and pain symptoms， delay the articular cartilage′s damage， and the clinical efficacy is significantly better than sodium hyaluronate intraarticular injection alone., http://www.100md.com(陈娟 沈娟 陈政 胡文浩)
关键词 膝骨关节炎；温针灸；玻璃酸钠；腔内注射；疗效；MMPs
Abstract Objective：To explore the efficacy of warming acupuncture combined with sodium hyaluronate intraarticular injection in the treatment of osteoarthritis and the influence on matrix metalloproteinase (MMPs). Methods：A total of 92 patients with osteoarthritis who were tread in our hospital from February 2014 to August 2016 were selected and randomly divided into observation group (n=46) and control group (n=46). Control group were treated with sodium hyaluronate intraarticular injection， and observation group were treated with warming acupuncture on the basis of control group. Both groups were treated for 4 weeks continuously. The clinical efficacy of 2 groups were compared， and the levels of MMPs and the tissue inhibitor of MMPs， the inflammatory factors of synovial fluid before and after treatment in 2 groups were detected and compared； Visual analogue scale (VAS) and Lysholm knee joint function score (LKSS) were used to evaluate and compare the pain condition and knee joint function in 2 groups before and after treatment. Results：The clinical efficacy of observation group (97.83%) was significantly higher than control group (80.43%) (P<0.01). Compared with that before treatment， the levels of MMP-2， MMP-3， MMP-9， TIMP-1 and IL-2， TNF-α of synovial fluid all decreased after treatment， and observation group was lower than control group (P<0.01). Compared with before treatment， the VAS scores of 2 groups decreased after treatment， and observation group was lower than control group. The LKSS score of 2 groups increased after treatment， and observation group was higher than control group (P<0.01). Conclusion：Warming acupuncture combined sodium hyaluronate in the treatment of osteoarthritis can significantly reduce the levels of MMPs and the tissue inhibitor of MMPs， inflammatory factors of synovial fluid， eliminate relevant inflammation and pain symptoms， delay the articular cartilage′s damage， and the clinical efficacy is significantly better than sodium hyaluronate intraarticular injection alone., http://www.100md.com(陈娟 沈娟 陈政 胡文浩)
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