温针灸联合塞来昔布胶囊对膝骨关节炎患者骨代谢指标和血清IL-6、IL-17、IL-18水平的影响

摘要 目的：观察温针灸联合塞来昔布胶囊对膝骨关节炎（KOA）患者骨代谢指标和血清白介素-6（IL-6）、白介素-17（IL-17）、白介素-18（IL-18）水平的影响。方法：纳入我院2017年4月~2020年12月间针灸科接收的KOA患者80例，将患者采用信封抽签法分为对照组和研究组，各为40例。对照组给予塞来昔布胶囊进行治疗，研究组给予温针灸联合塞来昔布胶囊进行治疗，均连续治疗8周。观察两组疗效、骨代谢指标[骨保护素（OPG）、降钙素（CT）、骨钙素（BGP）]、炎性因子、量表评分[视觉模拟评分法（VAS）、骨关节炎指数评分表（WOMAC）、Lysholm膝关节评分]等情况，记录治疗期间的不良反应发生率。结果：研究组的临床总有效率高于对照组（P<0.05）。研究组治疗8周后VAS、WOMAC较对照组低，Lysholm膝关节评分较对照组高（P<0.05）。研究组治疗8周后血清OPG、BGP较对照组高（P<0.05）。两组血清CT水平治疗8周后对比差异无统计学意义（P>0.05）。研究组治疗8周后血清IL-6、IL-17、IL-18较对照组低（P<0.05）。两组不良反应总发生率组间对比差异无统计学意义（P>0.05）。结论：温针灸联合塞来昔布胶囊治疗KOA患者，可有效减轻疼痛，促进膝关节功能恢复，同时还可抑制炎症因子，改善骨代谢指标，优化治疗效果。

Effects of Warm Acupuncture and Moxibustion Combined with Celecoxib Capsules on Bone Metabolism Indexes and Serum IL-6, IL-17 and IL-18 Levels in Patients with Knee Osteoarthritis

ABSTRACT Objective: To observe the effect of warm acupuncture and moxibustion combined with celecoxib capsules on bone metabolism indexes and serum interleukin-6(IL-6), interleukin-17(IL-17) and interleukin-18(IL-18) levels in patients with knee osteoarthritis (KOA). Methods: 80 patients with KOA who were admitted to the Department of acupuncture and moxibustion in our hospital from April 2017 to December 2020 were included. and the patients were divided into control group and study group by envelope drawing, 40 cases in each group. The control group was treated with celecoxib capsules, and the study group was treated with warm acupuncture and moxibustion combined with celecoxib capsules, all patients were treated for 8 weeks. The curative effect, bone metabolism indexes [osteoprotegerin (OPG), calcitonin (CT), osteocalcin (BGP)], inflammatory factors, scale score [visual analogue scale (VAS), osteoarthritis index score (WOMAC), Lysholm knee score] and other conditions of the two groups were observed, and the incidence of adverse reactions during treatment was recorded. Results: The clinical total effective rate of the study group was higher than that of the control group(P<0.05). 8 weeks after treatment, VAS and WOMAC of the study group were lower than those of the control group, and Lysholm knee score was higher than that of the control group(P<0.05). 8 weeks after treatment, serum OPG and BGP of the study group were higher than those of the control group (P<0.05). There was no significant difference in serum CT level between the two groups after 8 weeks of treatment(P>0.05). The serum IL-6, IL-17 and IL-18 of the study group at 8 weeks after treatment were lower than those of the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion: Warm acupuncture combined with celecoxib capsules in the treatment of KOA patients can effectively reduce pain, promote the recovery of knee function, inhibit inflammatory factors, improve bone metabolism indexes and optimize the treatment effect.