王光辉

【摘 要】 目的：观察针刺联合麝香乌龙丸和双醋瑞因胶囊治疗膝骨关节炎53例臨床观察。方法：选取105例KOA患者为研究对象，采取随机数字表法分为对照组和观察组。对照组52例行双醋瑞因胶囊治疗，观察组53例在对照组基础上行毫针针刺联合麝香乌龙丸治疗，观察两组的疼痛情况，血清生物标志物，膝关节功能。结果：两组治疗前至治疗3月末膝关节压痛、20 m步行痛视觉模拟评分（VAS）水平呈降低趋势，观察组治疗1、3月末膝关节压痛、20 m步行痛VAS评分水平低于对照组（P<0.05）。两组治疗3月末血清白介素-6（IL-6）、基质金属蛋白酶1（MMP-1）、基质金属蛋白酶3（MMP-3）水平较治疗前降低，观察组低于对照组;血清金属蛋白酶组织抑制剂1（TIMP-1）水平较治疗前升高，观察组高于对照组（P<0.05）。两组治疗3月末西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分水平较干预前降低，观察组低于对照组（P<0.05）;两组治疗3月末膝关节屈曲活动度（ROM）水平较治疗前经比较差异有统计学意义（P<0.05）。结论：针刺联合麝香乌龙丸和双醋瑞因胶囊治疗膝骨关节炎患者通过促进关节组织营养及代谢废物的吸收及排泄以改善膝关节功能，调节血清生物标志物水平，缓解膝关节胀痛，改善膝关节活动度，提高临床疗效。

【关键词】 毫针针刺; 麝香乌龙丸; 膝骨关节炎; 疼痛程度; 膝关节功能

【中图分类号】R684.3 【文献标志码】 A 【文章编号】1007-8517（2021）15-0087-04

Abstract：Objective To investigate the clinical observation of acupuncture combined with Shexiang Wulong pill and Shuang acetaren capsule in the treatment of knee osteoarthritis （KOA）.Methods 105 patients with koa in our hospital were randomly divided into control group and observation group. 52 cases in the control group were treated with diacerein capsule， and 53 cases in the observation group were treated with filiform needle acupuncture combined with Shexiang Wulong Pill on the basis of the control group. The pain， serum biomarkers and knee joint function of the two groups were observed. Results the vas levels of knee tenderness and 20 m walking pain in the two groups decreased from before treatment to the end of March， and the VAS scores of knee tenderness and 20 m walking pain in the observation group were lower than those in the control group （P<0.05）. At the end of 3 months， the levels of IL-6， MMP-1 and MMP-3 in the two groups were lower than those before treatment， and those in the observation group were lower than those in the control group; the level of tissue inhibitor of metalloproteinase-1 （TIMP-1） in the observation group was higher than that in the control group （P<0.05）. At the end of 3 months， the WOMAC score of Western Ontario University and McMaster University was lower than that before intervention， and the observation group was lower than that of the control group （P<0.05）; the knee flexion activity （ROM） level of the two groups at the end of 3 months was significantly different from that before treatment （P<0.05）.Conclusion acupuncture combined with Shexiang Wulong pill can improve knee joint function， regulate serum biomarker level， relieve knee joint swelling pain， improve knee joint range of motion and improve clinical efficacy by promoting joint tissue nutrition and metabolism waste absorption and excretion.

Keywords：Filiform Needle Acupuncture; Shexiang Wulong Pill; Knee Osteoarthritis; Pain Degree; Knee Joint Function

膝骨关节炎（Knee osteoarthritis，KOA）是由于人口老龄化、关节软骨超负荷应力等因素引起的膝关节骨质增生、软骨退变的骨关节疾病。KOA患者多见于老年群体，男女均可发病。临床上目前针对KOA患者多采用双醋瑞因胶囊治疗，可改善膝关节肿胀疼痛，但可能引起胃肠道反应。毫针针刺可改善KOA患者的膝关节活动受限。麝香乌龙丸对于KOA患者可调控其膝关节功能，利于患者早日进行康复锻炼[1]。本研究旨在观察针刺联合麝香乌龙丸和双醋瑞因胶囊治疗KOA53例临床观察，现报道如下。

1 资料与方法

1.1 一般资料 选取我院2017年10月至2019年10月105例KOA患者为研究对象，采取随机数字表法分为对照组和观察组。对照组52例，男14例，女38例;年龄50～71岁，平均（60.54±8.23）岁;病程1～5年，平均（3.26±1.14）年;病变部位为单侧36例，双侧16例。观察组53例，男12例，女41例;年龄51～72（61.57±7.32）岁;病程1～5年，平均（3.35±1.12）年;病变部位为单侧38例，双侧15例。……