Objective: To compare the clinical efficacy between moxibustion and acupuncture for knee osteoarthritis (KOA), and to observe the effect on serum tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), superoxide dismutase (SOD) and malondialdehyde (MDA).
Methods: A total of 60 patients with KOA were randomized into a moxibustion group (30 cases, 2 cases dropped off) and an acupuncture group (30 cases, 2 cases dropped off). In the aucpuncture group, acupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Heding (EX-LE 2), Xuehai (SP 10), Liangqiu (ST 34), Zusanli (ST 36) and ashi point on the affected side for 30 min.In the moxibustion group, moxibustion was adopted at knee for 60 min. The treatment was given once every two days for 4 weeks, totally 14 times. Before and after treatment, the western ontario and McMaster universities osteoarthritis index (WOMAC) score was compared, and the therapeutic effect was evaluated in the two groups. The contents of serum TNF-αand IL-1β, the activity of serum SOD and the serum level of MDA were detected in the two groups.
Results: Compared before treatment, the WOMAC scores and the contents of serum TNF-α, IL-1β and MDA after treatment were reduced (P<0.05), the activity of serum SOD was increased (P<0.05) in the two groups. In the moxibustion group, the WOMAC score and the contents of serum TNF-α, IL-1β and MDA after treatment were lower than the acupuncture group (P<0.05), the activity of serum SOD was higher than the acupuncture group (P<0.05). The total effective rate was 89.3% (25/28) in the moxibustion group, which was superior to 42.9% (12/28) in the acupuncture group (P<0.05).
Conclusion: Moxibustion and acupuncture can relieve KOA symptoms, and the therapeutic effect of moxibustion is superior to acupuncture. The mechanism may be related to the reduction of serum inflammatory factor and oxidative stress factor.
目的：比较艾灸与针刺治疗膝骨关节炎（KOA）的临床疗效，并观察其对患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、超氧化物歧化酶（SOD）、丙二醛（MDA）的影响。方法：将60例KOA患者随机分为艾灸组（30例，脱落2例）和针刺组（30例，脱落2例）。针刺组穴取患侧内膝眼、犊鼻、鹤顶、血海、梁丘、足三里、阿是穴行针刺治疗，留针30 min；艾灸组采用艾灸箱于膝关节局部进行治疗，每次60 min，两组治疗均每两天1次，连续4周，共计14次。比较两组患者治疗前后西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分，并评定疗效；检测两组患者治疗前后血清TNF-α、IL-1β、MDA含量及血清SOD活力。结果：与治疗前比较，治疗后两组患者WOMAC评分，血清TNF-α、IL-1β及MDA含量均降低（P<0.05）；SOD活力均增高（P<0.05）。与针刺组比较，艾灸组患者治疗后WOMAC评分，血清TNF-α、IL-1β及MDA含量较低（P<0.05）；SOD活力较高（P<0.05）。艾灸组总有效率为89.3%（25/28），优于针刺组的42.9%（12/28，P<0.05）。结论：艾灸和针刺治疗均能减轻KOA症状，且艾灸疗效优于针刺，其作用机制可能与降低患者血清炎性因子和氧化应激因子水平有关。.
Keywords: acupuncture; inflammatory factor; knee osteoarthritis; moxibustion; oxidative stress factor.