Objectives: To compare the clinical effect between two acupoint regimens of moxibustion on knee osteoarthritis (KOA), and observe the influences on the serum content of interleukin 1α (IL-1α), interleukin-17A (IL-17A), tumor necrosis factor α (TNF-α), bone gla protein (BGP) and osteoprotegerin (OPG).
Methods: KOA patients were randomly divided into an observation group (40 cases, 2 cases dropped off) and a control group (40 cases, 3 cases dropped off). In the observation group, moxibustion was applied to Xiyan (EX-LE5), Dubi (ST35), Zusanli (ST36), Dazhu (BL11), Xuanzhong (GB39) and Yongquan (KI1) on the affected side. In the control group, EX-LE5, ST35 and ST36 were selected on the affected side. One session of treatment took 30 min in each group, delivered 3 times a week and the duration of treatment was 4 weeks. The scores of Western Ontario and McMaster University (WOMAC) and visual analogue scale (VAS) were observed and the serum content of IL-1α, IL-17A, TNF-α, BGP and OPG of the two groups were measured before and after treatment.
Results: Compared with those before treatment, the WOMAC score, VAS score and the serum content of IL-1α, IL-17A and TNF-α were decreased (P<0.05), and the content of BGP and OPG were increased (P<0.05) after treatment. Compared with the control group, the WOMAC score, VAS score and the serum content of IL-1α and TNF-α in the observation group were lower (P<0.05), and the content of BGP and OPG were higher (P<0.05). The total effective rate of the observation group was 89.5% (34/38), and that of the control group was 83.8% (31/37), with no statistically significant difference.
Conclusions: Moxibustion therapy of "nourishing the kidney and benefiting the marrow" can relieve joint pain, improve joint function, reduce the level of inflammatory factors and ameliorate bone metabolic indicators. The effect of the acupoint regimen in this moxibustion therapy is better than that of the local acupoint selection.
目的: 比较两种不同艾灸取穴方案治疗膝关节骨关节炎（KOA）的临床疗效，并观察其对患者血清白细胞介素（IL）-1α、IL-17A、肿瘤坏死因子α（TNF-α）、骨钙素（BGP）、骨保护素（OPG）含量的影响。方法: KOA患者随机分为观察组（40例，脱落2例）和对照组（40例，脱落3例）。观察组艾灸患侧内膝眼、犊鼻、足三里、大杼、悬钟、涌泉，对照组艾灸患侧内膝眼、犊鼻、足三里，每次30 min，每周治疗3次，治疗4周。观察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）评分和视觉模拟量尺（VAS）评分，检测两组患者治疗前后血清IL-1α、IL-17A、TNF-α、BGP、OPG含量。结果: 与本组治疗前比较，两组患者治疗后WOMAC评分、VAS评分及血清IL-1α、IL-17A、TNF-α含量均降低（P<0.05），血清BGP、OPG含量升高（P<0.05）。观察组的WOMAC评分、VAS评分及血清IL-1α、TNF-α含量低于对照组（P<0.05），血清BGP、OPG含量高于对照组（P<0.05）。观察组总有效率为89.5%（34/38），对照组总有效率为83.8%（31/37），差异无统计学意义。结论: “补肾益髓”的艾灸疗法可缓解关节疼痛，改善关节功能，降低炎性因子水平，改善骨代谢指标，作用优于局部取穴。.
Keywords: Bone metabolism; Inflammatory factors; Knee osteoarthritis; Moxibustion.