李俐，吴明霞(等)

摘要：目的评价电针治疗膝骨性关节炎不同证型的疗效。方法每个证型选取60例膝骨性关节炎患者随机分为治疗组与对照组，肾虚髓亏及瘀血阻滞型患者对照组以单纯针刺，治疗组加以电针，治疗60d；阳虚寒凝及风寒湿阻型患者对照组以温针、治疗组加以电针，治疗60d，在治疗前后抽取患者关节液及血液进行检查，同时进行量表评估。结果对于肾虚髓亏型患者，电针疗法与针刺疗法疗效无明显差异，亦未对各项指标造成明显差异性改变。而对于阳虚寒凝型患者，电针疗法更显著地降低TNF-α含量，缓解症状。而电针疗法对瘀血阻滞型患者则更大程度上缓解了疼痛、降低了关节液TNF-α、MMP-3含量降低了ESR，增加HA的含量。对于风寒湿阻型患者，电针同样能更大程度提高疗效，降低关节液TNF-α、MMP-3含量，增加HA含量。结论电针对瘀血阻滞型患者的疗效影响最大、风寒湿阻型次之、阳虚寒凝型最弱，而对于肾虚髓亏型患者未能显著提高疗效。

关键词：膝骨性关节炎；电针；证型

中图分类号：R684.3文献标志码：B文章编号：1007-2349（2014）04-0044-04

ClinicalEffectofAcupunctureTreatmentonKneeOsteoarthritisPatientswithDifferentSyndromes

LILi，WUMing-xia，ChenSongPing-Cheng，etal.

（TheSecondAffiliatedHospitalofFujianUniversityofTraditionalChineseMedicine，Fuzhou350003，Fujian）

【Abstract】Objective：Toevaluatetheclinicaleffectofacupuncturetreatmentonkneeosteoarthritispatientswithdifferentsyndromes.Methods：60patientswereselectedfromeachsyndromeandrandomlydividedintoatreatmentgroupandacontrolgroup.Thepatientswithkidneydeficiencyandbloodstasisinthecontrolgroupweretreatedwithsimpleacupuncturewhilethepatientsinthetreatmentgroupweretreatedwithelectro-acupuncture，for60days.Thepatientswithyangdeficiencyandcongealingcoldandwindcoldanddampretentioninthecontrolgroupweretreatedwithwarmacupuncturewhilethepatientsinthetreatmentgrouptreatedwithwarmacupuncturepluselectro-acupuncture，for60days.Theirsynovialfluidandbloodwereextractedandexaminedbeforeandafterthetreatmentandtheirscaleassessmentwasmadesimultaneously.Results：Forthepatientswithkidneymarrowdeficiency，electro-acupunctureandacupuncturetherapyshowedneithersignificantdifferenceintheeffectivenessnorsignificantdifferencesinchangesofindicators.Forthepatientswithyangdeficiencyandcongealingcold，theelectro-acupuncturesignificantlyreducedTNF-αlevelandrelievedtheirsymptoms.Forthepatientswithbloodstasis，theelectro-acupunctureevengreatlyrelievedthepainandreducedtheTNF-α，MMP-3levelandESR，andincreasedHAlevel.Forthepatientswithwindcoldanddampretention，EAevengreatlyimprovedtheireffectivenessandreducedTNF-α，MMP-3levelandincreasedHAlevel.Conclusion：EAhasthegreatesteffectonthepatientswithbloodstasis，abettereffectonthepatientswithwindcoldanddampretention，andtheweakesteffectonthepatientswithyangdeficiencyandcongealingcoldandforthepatientswithkidneymarrowdeficiency，therewasnosignificantimprovement.

【Keywords】kneeosteoarthritis，acupuncture，syndrome

膝骨性关节炎（kneeosteoarthritis）是中老年人易患的一种慢性骨关节病，以膝关节软骨进行性损害（变性、破坏及骨质增生）为特征的慢性关节病，临床以疼痛、肿胀和关节活动障碍等为主要表现。本研究选取本院门诊2009—2012年膝骨性关节炎240例，随机分为治疗组与对照组，根据中医辨证分为4种证型，进行电针干预治疗，现将临床观察报道如下。endprint

1资料与方法

1.1一般资料本研究……