针刀松解术对类风湿关节炎肘关节僵硬患者炎性反应递质和氧自由基的影响
|
摘要
目的:探讨针刀松解术对类风湿关节炎(RA)肘关节僵硬患者炎性反应递质和氧自由基的影响。方法:选取2016年2月至2018年3月龙岗中心医院收治的RA肘关节僵硬患者72例作为研究对象,按照抽签法随机分为对照组和观察组,每组36例。对照组采用西医常规治疗联合针刺,观察组采用西医常规治疗联合针刀松解术。比较2组患者的炎性反应递质、氧自由基代谢水平、红细胞沉降率、类风湿因子及肘关节活动范围等指标。结果:治疗后,2组患者的血清白细胞介素-6(IL-6)、肿瘤坏死因子-ɑ(TNF-α)、丙二醛(MDA)、红细胞沉降率(ESR)和类风湿因子(RF)水平均降低,超氧化物歧化酶(SOD)水平均升高,且观察组较对照组显著,差异有统计学意义(P <0. 05); 2组患者的肘关节延伸最大角度降低,屈曲最大角度和活动范围增加,且观察组患者的肘关节活动功能的改善较对照组明显,差异有统计学意义(P <0. 05)。结论:针刀松解术联合常规西医治疗能有效抑制RA肘关节僵硬患者体内的炎性反应和氧自由基反应,下调RF水平,促进患者关节功能恢复,临床效果更优。
Objective: To explore the effects of acupotomy loosing treatment on inflammatory factors and oxygen free radicals in rheumatoid arthritis( RA) patients with elbow joint stiffness. Methods: A total of 72 RA patients with elbow join stiffness treated in Longgang Central Hospital from February 2016 to March 2018 were randomly divided into an observation group and a control group according to envelope method,with 36 patients in each group. The control group received conventional western medicine combined with acupuncture,and the observation group received conventional western medicine combined with acupotomy loosing treatment.The inflammatory factors,oxygen free radicals,blood sedimentation,rheumatoid factors and range of elbow joint were compared between the 2 groups. Results: After treatment,the serum levels of IL-6,TNF-α,MDA,ESR and RF all declined,while the levels of SOD rose in the 2 groups,and the changes in the observation group were more significant than those in the control group,with statistical significance( P < 0. 05). The maximum angle of elbow extension decreased,the maximum angle of flexion and the range of motion increased in the 2 groups,and the improvement of elbow function in the observation group was more significant than that in the control group( P < 0. 05). Conclusion: Compared with acupuncture,acupotomy loosing treatment combined with conventional western medicine can effectively suppress inflammation and oxygen free radical reaction,reduce the level of RF,and promote the recovery of joint function in RA patients with elbow join stiffness,with better clinical efficacy.
Objective: To explore the effects of acupotomy loosing treatment on inflammatory factors and oxygen free radicals in rheumatoid arthritis( RA) patients with elbow joint stiffness. Methods: A total of 72 RA patients with elbow join stiffness treated in Longgang Central Hospital from February 2016 to March 2018 were randomly divided into an observation group and a control group according to envelope method,with 36 patients in each group. The control group received conventional western medicine combined with acupuncture,and the observation group received conventional western medicine combined with acupotomy loosing treatment.The inflammatory factors,oxygen free radicals,blood sedimentation,rheumatoid factors and range of elbow joint were compared between the 2 groups. Results: After treatment,the serum levels of IL-6,TNF-α,MDA,ESR and RF all declined,while the levels of SOD rose in the 2 groups,and the changes in the observation group were more significant than those in the control group,with statistical significance( P < 0. 05). The maximum angle of elbow extension decreased,the maximum angle of flexion and the range of motion increased in the 2 groups,and the improvement of elbow function in the observation group was more significant than that in the control group( P < 0. 05). Conclusion: Compared with acupuncture,acupotomy loosing treatment combined with conventional western medicine can effectively suppress inflammation and oxygen free radical reaction,reduce the level of RF,and promote the recovery of joint function in RA patients with elbow join stiffness,with better clinical efficacy.
引文
[1]Nishida K,Hashizume K,Nasu Y,et al.Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis[J].Bone Joint J,2018,100-B(8):1066-1073.
[2]马欣蕾,照日格图.中西医关于类风湿关节炎发病机制研究新进展[J].新疆中医药,2019,37(1):117-120.
[3]Lagerstr9m MC.Sinomenine is a promising analgesic and antihyperalgesic for pain and hypersensitivity in rheumatoid arthritis[J].Scand JPain,2015,7(1):15-16.
[4]白玉,武平,熊燕,等.针灸治疗类风湿关节炎临床选穴规律探讨[J].亚太传统医药,2018,14(4):95-97.
[5]杨才德,鱼灵会,于灵芝,等.针刀枢椎棘突松解术对椎动脉型颈椎病疗效评价[J].世界中医药,2014,9(1):89-91.
[6]赵璐,何东仪.类风湿关节炎病因病机及辨证论治[J].风湿病与关节炎,2016,5(7):71-74.
[7]邢洁,姜萍,姜月华,等.和痹方对类风湿关节炎大鼠α7nAChR、STAT3蛋白表达及TNF-α、IL-6、IL-17表达的影响[J].中华中医药杂志,2018,33(2):730-733.
[8]汤荣华,黄建军.类风湿性关节炎患者血清GM-CSF、IL-6、IL-17和TNF-α的水平测定及临床意义[J].检验医学,2013,28(3):173-177.
[9]马过龙.小针刀联合手法复位治疗颈源性头痛50例[J].西部中医药,2018,31(4):96-98.
[10]高丙南.针刀激痛法治疗神经根型颈椎病临床研究[J].新中医,2017,49(7):85-87.
[11]Bala A,Mondal C,Haldar PK,et al.Oxidative stress in inflammatory cells of patient with rheumatoid arthritis:clinical efficacy of dietary antioxidants[J].Inflammopharmacology,2017,25(6):595-607.
[12]Mateen S,Moin S,Shahzad S,et al.Level of inflammatory cytokines in rheumatoid arthritis patients:Correlation with 25-hydroxy vitamin D and reactive oxygen species[J].PLo S One,2017,12(6):e0178879.
[13]龚新宇,饶贞权,张教明,等.针刀松解术结合穴位埋线治疗对慢性胃炎患者血清超氧化物歧化酶及丙二醛的影响[J].湖北中医药大学学报,2016,18(2):22-24.
[14]张昶,王瑞红,徐耀,等.针刀联合痛点阻滞改善冈上肌腱炎肩关节痛和肩关节活动度的临床研究[J].中国医药导报,2017,14(9):158-162.
[15]李少芳,林卓鹏,卢蓬,等.小针刀治疗膝关节骨关节炎临床研究[J].中医临床研究,2015,7(34):39-40.
[2]马欣蕾,照日格图.中西医关于类风湿关节炎发病机制研究新进展[J].新疆中医药,2019,37(1):117-120.
[3]Lagerstr9m MC.Sinomenine is a promising analgesic and antihyperalgesic for pain and hypersensitivity in rheumatoid arthritis[J].Scand JPain,2015,7(1):15-16.
[4]白玉,武平,熊燕,等.针灸治疗类风湿关节炎临床选穴规律探讨[J].亚太传统医药,2018,14(4):95-97.
[5]杨才德,鱼灵会,于灵芝,等.针刀枢椎棘突松解术对椎动脉型颈椎病疗效评价[J].世界中医药,2014,9(1):89-91.
[6]赵璐,何东仪.类风湿关节炎病因病机及辨证论治[J].风湿病与关节炎,2016,5(7):71-74.
[7]邢洁,姜萍,姜月华,等.和痹方对类风湿关节炎大鼠α7nAChR、STAT3蛋白表达及TNF-α、IL-6、IL-17表达的影响[J].中华中医药杂志,2018,33(2):730-733.
[8]汤荣华,黄建军.类风湿性关节炎患者血清GM-CSF、IL-6、IL-17和TNF-α的水平测定及临床意义[J].检验医学,2013,28(3):173-177.
[9]马过龙.小针刀联合手法复位治疗颈源性头痛50例[J].西部中医药,2018,31(4):96-98.
[10]高丙南.针刀激痛法治疗神经根型颈椎病临床研究[J].新中医,2017,49(7):85-87.
[11]Bala A,Mondal C,Haldar PK,et al.Oxidative stress in inflammatory cells of patient with rheumatoid arthritis:clinical efficacy of dietary antioxidants[J].Inflammopharmacology,2017,25(6):595-607.
[12]Mateen S,Moin S,Shahzad S,et al.Level of inflammatory cytokines in rheumatoid arthritis patients:Correlation with 25-hydroxy vitamin D and reactive oxygen species[J].PLo S One,2017,12(6):e0178879.
[13]龚新宇,饶贞权,张教明,等.针刀松解术结合穴位埋线治疗对慢性胃炎患者血清超氧化物歧化酶及丙二醛的影响[J].湖北中医药大学学报,2016,18(2):22-24.
[14]张昶,王瑞红,徐耀,等.针刀联合痛点阻滞改善冈上肌腱炎肩关节痛和肩关节活动度的临床研究[J].中国医药导报,2017,14(9):158-162.
[15]李少芳,林卓鹏,卢蓬,等.小针刀治疗膝关节骨关节炎临床研究[J].中医临床研究,2015,7(34):39-40.