张增富　古婷博　董先惠

摘要 目的：探究電针对湿热瘀阻型痛风性膝关节炎NLRP3炎性体的影响。方法：选取2016年4月至2019年1月攀枝花市第四人民医院收治的湿热瘀阻型痛风性膝关节炎患者106例作为研究对象，按照就诊顺序编号随机分为对照组和观察组，每组53例。对照组采用西医治疗，观察组在对照组的基础上加用电针治疗，均治疗1周。观察2组治疗前、治疗后NLRP3炎性体及其蛋白、炎性反应递质、生命质量、血管内皮细胞变化并比较，总结疗效。结果：观察组患者在Caspase-1、凋亡相关斑点样蛋白（ASC）、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1β、C反应蛋白（CRP）、红细胞沉降率（ESR）、血清尿酸（UA）、IL-10、IL-4、内皮素-1（ET-1）、髓过氧化物酶（MPO）、可溶性细胞间黏附分子-1（sICAM-1）、一氧化氮（NO）改善效果均优于对照组，差异有统计学意义（P<0.05）。观察组患者治疗后生理功能、生理职能、躯体疼痛、总体健康、社会功能提升幅度较对照组高，差异有统计学意义（P<0.05），且治疗后临床治疗有效率明显高于对照组患者，差异有统计学意义（P<0.05）。结论：电针能抑制湿热瘀阻型痛风性膝关节炎NLRP3炎性体及其蛋白，抑制炎性反应，促进血管通透性，从而提高生命质量和疗效。

关键词 电针;湿热瘀阻型;痛风性膝关节炎;NLRP3炎性体;炎性反应递质;生命质量;血管内皮细胞;疗效

Effects of Electroacupuncture on NLRP3 Inflammatory Body in Gouty Knee Arthritis of Damp Heat and Stasis Type

ZHANG Zengfu，GU Tingbo，DONG Xianhui

（Department of Accupuncture，the Fourth People′s Hospital of Panzhihua City，Panzhihua 617061，China）

Abstract Objective：To explore the effects of electroacupuncture on the NLRP3 inflammatory body in gouty knee arthritis of damp heat stasis type.Methods：A total of 106 patients with gouty knee arthritis of damp heat stasis type in the Fourth People′s Hospital of Panzhihua City were divided into a control group and a study group，with 53 cases in each group.The control group was treated with Western medicine and the study group was treated with electroacupuncture based on the control group for 1 week.The changes of NLRP3 inflammatory body and its protein，inflammatory factors，quality of life，vascular endothelial cells were observed and compared before and after treatment in the 2 groups and the curative effects were summed up.Results：The improvement of Caspase-1，ASC，TNF-α，IL-1 β，CRP，ESR，UA，IL-10，IL-4，ET-1，MPO，sICAM-1 and NO in the observation group were better than those in the control group （P<0.05）.The improvement of physiological function，physiological action，body pain，general health and social function in the observation group was higher than that in the control group （P<0.05），and the total clinical effective rate was significantly higher than that in the control group （P<0.05）.Conclusion：Electroacupuncture could inhibit the inflammatory body and protein of NLRP3，inhibit the inflammatory reaction，promote the vascular permeability，and improve the quality of life and therapeutic effects.

Keywords Electroacupuncture; Damp-heat stagnation type; Gouty knee arthritis; NLRP3 inflammatory body; Inflammatory factors; Quality of life; Vascular endothelial cells; Therapeutic effects

中图分类号：R242;R249文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.15.025

痛风是因嘌呤代谢失衡或尿酸排出受阻引起的血尿酸异常升高的一种代谢性疾病，常见表现为高尿酸血症，反复发作急慢性宫颈炎性反应，病久形成尿酸盐结晶在关节组织脏器局部推积，影响肾脏，造成肾功能不全，晚期因痛风石沉积于关节，骨质和软骨结构破坏，关节侵蚀严重，造成功能障碍。流行病学调查显示，痛风发病率日渐升高，且趋向年轻化，男性显著高于女性，比率为20∶1，高收入人群患痛风概率显著高于一般普通人和体力劳动者[1-2]。目前西医治疗痛风以减轻疼痛症状，降低血尿酸水平，防止尿酸盐沉积在体内，避免关节遭受破坏为主。……