基于"经筋理论"针刀治疗对早中期膝骨关节炎患者骨代谢指标和血清TIMP-1、MMP-3、MMP-13的影响

摘要 目的：探讨基于"经筋理论"针刀治疗对早中期膝骨关节炎（KOA）患者骨代谢指标和血清金属蛋白酶抑制物-1（TIMP-1）、基质金属蛋白酶（MMP）-3、MMP-13的影响。方法：根据随机数字表法,将2021年1月至2023年1月期间就诊于新疆医科大学附属第一医院的120例早中期KOA患者分为对照组（n=60,常规治疗）和研究组（n=60,对照组的基础上接受"经筋理论"针刀治疗）。对比两组疗效、量表评分[疼痛视觉模拟评分（VAS）、西安大略和麦克马斯特大学骨关节炎调查表（WOMAC）]、骨代谢指标[抗酒石酸盐酸性磷酸酶异构体（TRACP-5b）、骨特异性碱性磷酸酶（BALP）、骨钙素（BGP）]和血清TIMP-1、MMP-3、MMP-13。结果：与对照组相比,研究组的临床总有效率更高（P<0.05）。与对照组相比,研究组治疗后WOMAC、VAS评分和血清MMP-3、MMP-13、TRACP-5b水平更低,TIMP-1、BALP、BGP水平更高（P<0.05）。结论：基于"经筋理论"针刀治疗早中期KOA患者,可有效减轻疼痛症状,提高临床治疗效果,可能与改善骨代谢指标和血清TIMP-1、MMP-3、MMP-13水平有关。

Effect of Acupotomy Therapy Based on "Meridian Sinew Theory" on Bone Metabolism Indexes and Serum TIMP-1, MMP-3 and MMP-13 in Patients with Early and Middle Stage Knee Osteoarthritis

ABSTRACT Objective: To explore the effect of acupotomy therapy basesd on "meridian sinew theory" on bone metabolism indexes and serum metalloproteinase inhibitor-1 (TIMP-1), matrix metalloproteinase (MMP)-3 and MMP-13 in patients with early and middle stage knee osteoarthritis (KOA). Methods: According to the random number table method, 120 patients with early and middle stage KOA who were treated in The First Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2023 were divided into control group (n=60, routine treatment) and study group (n=60, treated with acupotomy of "meridian sinew theory" on the basis of control group). The efficacy, scale scores [visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Survey (WOMAC)], bone metabolism indicators [tartrate-resistant acid phosphatase isomer (TRACP-5b), bone-specific alkaline phosphatase (BALP), osteocalcin (BGP)] and serum TIMP-1, MMP-3, MMP-13 were compared between two groups. Results: Compared with control group, the total clinical effective rate in study group was higher(P<0.05). Compared with control group, WOMAC, VAS scores and serum MMP-3, MMP-13, TRACP-5b levels were lower in study group after treatment, and TIMP-1, BALP, BGP levels were higher (P<0.05). Conclusion: Acupotomy therapy based on "meridian sinew theory" in the treatment of early and middle KOA patients, which can effectively relieve pain symptoms, and improve clinical treatment effect, and may be relate to the improvement of bone metabolism indexes and serum TIMP-1, MMP-3 and MMP-13 levels.