| 引用本文:杨筱秋1，邓建敏1，曹正和2.不同温灸法对阳虚寒凝型膝骨关节炎的镇痛效果比较及其部分机制研究[J].世界中医药,2015,10(09):. |
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| 不同温灸法对阳虚寒凝型膝骨关节炎的镇痛效果比较及其部分机制研究 |
| Comparison of the Analgesic Effect of Different Needle Warming Moxibustion Methods on Syndrome of Yang-deficiency with Congealing Cold in KOA and their Mechanism |
| 投稿时间：2015-04-09 |
| DOI：10.3969/j.issn.1673-7202.2015.09.029 |
| 中文关键词: 膝骨性关节炎 阳虚寒凝型 温针灸 悬灸COX-2 |
| English Keywords:Knee osteoarthritis Syndrome of yang-deficiency with congealing cold Needle warming moxibustion Over skin moxibustion COX-2 |
| 基金项目:四川省卫生厅科研课题立项“社区脑梗死患者的康复和二级预防”(编号：110109) |
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| 中文摘要: |
| 目的：探讨不同温灸法对阳虚寒凝型膝骨性关节炎（Knee Osteoarthritis，KOA）的镇痛效果极其对炎症因子的影响。方法：将本院90例阳虚寒凝型KOA患者纳入研究，并根据治疗方法分为单纯针刺组（32例）、温针灸组（30例）以及悬灸组（28例），3组患者均接受针刺足三里、内外膝眼、梁丘、阴陵泉穴，单纯针刺组研究过程不予艾灸治疗，悬灸组在针刺结束后点然清艾条悬置于针刺穴位上，以受试者感觉局部温度舒适为度，每穴灸30 min，抖灰1次/3 min。艾灸1次/d，连续治疗1个月。温针灸组在进针后将清艾条套在针柄上，每穴灸30 min，艾灸1次/d，连续治疗1个月。比较3组治疗前、治疗后7 d以及1个月简易McGill疼痛评分、Oswestry功能障碍指数、汉密尔顿焦虑量表(Hamilton Anxiety Scale，HAMA)评分、汉密尔顿抑郁量表(Hamilton Anxiety Scale，HAMD)量表评分的变化，以及治疗前及治疗1个月后环氧酶2(Cyclo-oxygen-ase-2，COX-2)浓度变化。结果：1）治疗前3组各指标无统计学意义，经过治疗后接受艾灸治疗的患者在降低McGill疼痛评分、Oswestry功能障碍指、膝关节症状积分以及外周血COX-2浓度方面均优于单纯针刺组。2）温针灸较悬灸更能够改善患者的症状以及降低外周血COX-2浓度。结论：2种艾灸方法对KOA均有理想疗效，其中温针灸综合疗效更为明显，其其治疗机制可能与下调COX-2浓度有关。 |
| English Summary: |
| To observe the analgesic effect of different needle warming moxibustion methods on syndrome of Yang-deficiency with congealing cold in knee osteoarthritis(KOA)and their effects on inflammatory factors. Methods： Ninety cases of patients with syndrome of Yang-deficiency with congealing cold in KOA were covered in the study and were divided into simple acupuncture group(32 cases)， needle warming moxibustion group(30 cases)and the over skin moxibustion group(28 cases)according to different treating therapies. All three groups had acupuncture at Zusanli(ST36)， Neixiyan(EX-LE4)， Waixiyan(ST35)， Liangqiu(ST34)， and Yinlingquan(SP9). The simple acupuncture group did not have moxibustion therapy during the research process. The over skin moxibustion group was treated with a lighted folium artemisiae argyi suspended on the acupuncture points at the end of the acupuncture， and the distance is adjusted to the comfortable feeling of subjects. Every acupoint had moxibustion for 30 min， and practitioners shook the ash every 3 min. Continuous treatment for a month， and 1 time per day. For needle warming moxibustion group， practitioners put the folium artemisiae argyi on the needle handle after inserting needle， and every acupoint had moxibustion for 30 min. Continuous treatment for a month， and1 time per day. Compared the 3 group before the treatment and 7 days and 1 month after the treatment with simple McGill pain score， Oswestry disability index， Hamilton anxiety scale(HAMA)scores， Hamilton depression scale(HAMD)， as well as the cox-2 concentration changes before and 1 month after the treatment. Results： 1)There were no statistical differences on the indexes among the three groups before treatment and after treatment. The patients with moxibustion therapy performs better than simple acupuncture group in reducing McGill pain score， Oswestry disability index， knee joint symptoms integral and peripheral blood concentrations of COX-2. 2)Needle warming moxibustion was superior to over skin moxibustion in improving the patient’s symptoms and reducing the concentration of peripheral blood COX-2. Conclusion： Both of the methods of moxibustion have ideal curative effect on KOA， while the comprehensive curative effect of needle warming moxibustion is more apparent， and this may due to its reduction on COX-2 concentration. |
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