来源：风湿病与关节炎,2018,7（5）:22-24,47.

温针灸联合关节腔注射玻璃酸钠治疗轻、中度膝骨关节炎

临床观察（临床研究）

张慧铭¹，陈燕超¹，何剑全²

　　【摘　要】目的：观察温针灸联合关节腔内注射玻璃酸钠治疗轻、中度膝骨关节炎的临床疗效。方法：将62例轻、中度膝骨关节炎患者分为治疗组和对照组，每组31例。治疗组以温针灸联合膝关节腔内注射玻璃酸钠治疗，入组后第1天注射玻璃酸钠注射液，每周1次，次日起温针灸，每日1次，每周5次，连续治疗5周为1个疗程。对照组仅给予玻璃酸钠膝关节腔内注射，每周1次，连续注射5周。观察2组临床疗效，以及治疗前后WOMAC症状、体征评分和膝关节液相关炎症因子肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1、IL-6变化。结果：治疗组临床控制6例，显效18例，有效6例，无效1例，总有效率为96.77%；对照组临床控制2例，显效12例，有效14例，无效3例，总有效率为90.32%。2组比较，差异有统计学意义（P < 0.01）。治疗后，2组疼痛、关节僵硬、功能评价、总积分、TNF-α、IL-1、IL-6较治疗前均有改善（P < 0.01），且治疗组疼痛、功能评价、总积分优于对照组（P < 0.01）。结论：2种治疗方法均能不同程度改善轻、中度膝骨关节炎患者的临床症状，同时降低炎症因子水平；温针灸联合关节腔注射玻璃酸钠治疗效果优于单纯关节腔注射玻璃酸钠治疗，其优势体现于缓解疼痛和改善功能活动方面。

　　【关键词】　骨关节炎，膝；温针灸；玻璃酸钠；炎症；临床疗效

Clinical Observation on Treating Mild to Moderate Knee Osteoarthritis with Warm Needling Combined with Intra-articular Injection of Sodium Hyaluronate

ZHANG Hui-ming,CHEN Yan-chao,HE Jian-quan

　　【ABSTRACT】Objective:To observe the clinical effect of warm needling combined with intra-articular injection of sodium hyaluronate on mild to moderate knee osteoarthritis.Methods:Sixty-two patients with mild to moderate knee osteoarthritis were divided into a treatment group and a control group,thirty-one cases in each group.The treatment group was treated with warm needling combined with intra-articular injection of sodium hyaluronate.They were treated for five weeks as a course.The control group was only given intra-articular injection of sodium hyaluronate for five weeks.The clinical effects of the two groups were observed,as well as the symptoms and signs of WOMAC before and after treatment and the changes of TNF-α,IL-1 and IL-6.Results:In the treatment group,the illness of 6 cases were controlled,18 cases were markedly effective,6 cases were effective and a case was ineffective,with a total effective rate of 96.77%.while in the control group,the condition of 2 cases were controlled,12 cases showed marked effectiveness,14 cases were effective,3 cases were ineffective,and the total effective rate was 90.32%.The difference between the two groups was statistically significant（P < 0.01）.After treatment,pain,joint stiffness,function evaluation,total score,TNF-α,IL-1,IL-6 were improved compared with those before treatment（P < 0.01）,and the pain,function evaluation and total score of the treatment group were better than those of the control group（P < 0.01）.Conclusion:Both therapeutic methods can improve the clinical symptoms of the patients with knee osteoarthritis and reduce the level of inflammatory factors.The combined way is better than that of sodium hyaluronate injection alone,whose advantage is to relieve pain and improve functional activity.

　　【Keywords】 osteoarthritis,knee;warm needling;sodium hyaluronate;inflammation;clinical efficacy