长圆针经筋解结法通过调节TLR4信号转导通路治疗膝骨关节炎的疗效研究

Study on the Efficacy of Changyuan Needle Muscle-Region Node Release Method in Treating Knee Osteoarthritis by Modulating the TLR4 Signaling Pathway

摘要: 目的：探讨长圆针经筋解结法通过调节TLR4信号转导通路治疗膝骨关节炎的疗效。方法：2022年1月至2024年6月期间选择杭州市临安区中医院120例膝骨关节炎患者为研究对象，按照治疗方案分为对照组和长圆针组各60例，长圆针组在对照组基础上，增加长圆针经筋解结法进行治疗，对照组不进行常规干预。比较长圆针组治疗前、后视觉模拟评分法(VAS)、WOMAC指数评分、血清中TLR4信号转导通路相关蛋白TLR4、MyD88、TRAF6水平、临床疗效。结果：治疗后，长圆针治疗前后VAS评分明显低于治疗前和对照组，差异有统计学意义(P < 0.05)；长圆针组的WOMAC指数评分高于治疗前，高于对照组，数据指标对比存在显著差异(P < 0.05)。经治疗干预长圆针组的血清中TLR4信号转导通路相关蛋白TLR4、MyD88、TRAF6水平、TLR4、IL-1β、MyD88水平、TNF-α低于治疗前，低于对照组，差异有统计学意义(P < 0.05)；长圆针组疗效高于对照组，差异有统计学意义(P < 0.05)。结论：长圆针经筋解结法治疗膝骨关节炎，可以明显缓解患者的临床症状，提高膝关节功能，减轻疼痛，改善生化指标，提升疗效。

Abstract: Objective: To investigate the efficacy of the Changyuan needle muscle-region node release method in treating knee osteoarthritis (KOA) by modulating the TLR4 signaling pathway. Methods: From January 2022 to June 2024, 120 KOA patients at Hangzhou Lin’an District Hospital of Traditional Chinese Medicine were enrolled and divided into a control group (60 cases) and a Changyuan needle group (60 cases). The Changyuan needle group received the Changyuan needle muscle-region node release method in addition to the control group’s regimen, while the control group received no routine intervention. Visual analog scale (VAS) scores, WOMAC index scores, serum levels of TLR4 signaling pathway-related proteins (TLR4, MyD88, TRAF6), and clinical efficacy were compared before and after treatment. Results: After treatment, the VAS scores in the Changyuan needle group were significantly lower than those before treatment and in the control group, with statistically significant differences (P < 0.05). The WOMAC index scores in the Changyuan needle group were higher than pretreatment levels and those of the control group, with statistically significant differences (P < 0.05). After therapeutic intervention, the levels of TLR4 signaling pathway-related proteins TLR4, MyD88, and TRAF6 in the serum of the Changyuan needle group, as well as the levels of TLR4, IL-1β, MyD88, and TNF-α, were significantly lower than those before treatment and lower than those in the control group, with statistically significant differences (P < 0.05). Additionally, the therapeutic efficacy of the Changyuan needle group was higher than that of the control group, with a statistically significant difference (P < 0.05). Conclusion: The Changyuan needle therapy for treating knee osteoarthritis effectively alleviates clinical symptoms, enhances knee joint function, reduces pain, improves biochemical indicators, and enhances therapeutic efficacy.