温针灸结合经筋手法治疗膝关节骨性关节炎临床疗效观察
Clinical observation of warming acupuncture and moxibustion combined with tendon manipulation in the treatment of knee osteoarthritis
  
DOI:10.3969/j.issn.1006-7108.2026.01.010
中文关键词:  膝关节骨性关节炎  温针灸  经筋手法  疼痛  炎症反应  膝关节功能
英文关键词:knee osteoarthritis  meridian theory  warming acupuncture and moxibustion  meridian technique  pain  inflammatory response  knee joint function
基金项目:河南省创新发展行动计划项目(202191-XM-17)
作者单位
李明哲1* 潘华2 陶江涛3 梁振新1 1.南阳医学高等专科学校张仲景国医研究院针灸骨伤系河南 南阳 473000 2.南阳医学高等专科学校附属中医院针灸推拿科河南 南阳 473000 3.南阳市南石医院中医科河南 南阳 473000 
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中文摘要:
      目的 探究温针灸与经筋手法相结合,对膝关节骨性关节炎(knee osteoarthritis,KOA)患者的治疗效果。方法 选择2023年6月至2024年6月我院接诊KOA患者80例,以随机抽签法分组,对照组予温针灸治疗,观察组在温针灸治疗基础上联合经筋手法治疗4周。观察比较两组中医证候总积分、疼痛评分(VAS)、骨关节炎指数(WOMAC)评分、炎症指标[白细胞介素-1β(interleukin-1 β,IL-1β)、C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、膝关节活动度、治疗总有效率及治疗安全性。结果 治疗4周后,两组中医证候总积分、VAS评分、关节疼痛、僵硬、躯体功能评分及WOMAC总分、CRP、IL-1β、IL-6、TNF-α水平均降低(P<0.05),且观察组与对照组比较更低(P<0.05);两组最大关节屈伸活动度均升高(P<0.05),且观察组与对照组比较更高(P<0.05);观察组关节伸直角度、胫骨角、胫骨平台后倾角较对照组更低(P<0.05);观察组总有效率(92.5%)与对照组(72.5%)比较更高(P<0.05);治疗期间两组均未发生与本次治疗相关的不良反应事件。结论 温针灸结合经筋手法治疗KOA疗效显著,能够缓解患者膝关节疼痛等不适症状,抑制局部炎症反应,有助于促进关节功能康复。
英文摘要:
      Objective To investigate the therapeutic effect of combining warm needle acupuncture with meridian tendon manipulation on patients with knee osteoarthritis (KOA). Methods Eighty KOA patients admitted to our hospital between June 2023 and June 2024 were randomly allocated into two groups. Patients in the control group received warm acupuncture and moxibustion, and those in the observation group received warm acupuncture and moxibustion plus meridian manipulation for for four weeks. The total score of TCM syndromes, pain score (VAS), osteoarthritis index (WOMAC), inflammatory indexes [C-reactive protein (CRP), interleukin-1β (IL-1β), interleukin -6(IL-6), and tumor necrosis factor -α (TNF-α)], knee joint mobility, and total effective rate and safety of treatment were observed and compared between the two groups. Results After the 4-week treatment period, statistically significant improvements (P<0.05) were observed across all measured parameters in both groups. These included declines in TCM syndrome scores, VAS scores, WOMAC dimensions (pain, stiffness and physical function) and total score, and inflammatory biomarkers (CRP, IL-1β, IL-6, TNF-α). The magnitude of these reductions was significantly greater in the observation group than in controls (P<0.05). Furthermore, while active and passive joint range of motion increased in both groups (P<0.05), the observation group achieved superior gains (P<0.05). Radiographic measurements also favored the observation group, showing significantly smaller joint extension, tibial, and posterior tibial plateau tilt angles (P<0.05). The overall clinical effectiveness rate was 92.5% for the observation group, significantly outperforming that of 72.5% in the control group (P<0.05). During the treatment, no adverse events related to this treatment occurred in both groups. Conclusion Warm acupuncture and moxibustion combined with tendon manipulation has a significant effect on KOA, which alleviates the pain and other discomfort symptoms of knee joints, inhibits local inflammatory reaction, and helps to promote joint function recovery.
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