基于中医“分筋恢刺”理论的水筋针治疗类风湿性膝关节炎的临床疗效评价研究

Study on the Clinical Efficacy Evaluation of Water Meridian Acupuncture in the Treatment of Rheumatoid Arthritis Based on the Theory of “Dividing Tendons and Restoring Needling” in Traditional Chinese Medicine

摘要: 目的：基于“分筋恢刺”学术思想，观察水筋针疗法对类风湿性膝关节炎患者血清炎性标志物及膝关节功能的干预效应，明确其临床实用价值。方法：纳入2024年6月至2025年12月于眉山市中医医院就诊的类风湿性膝关节炎患者318例，以随机数字表法均分为试验组与对照组各159例。前者施予水筋针松解联合经筋针刺干预，后者单用针刺方案，疗程7天并延续随访半年。于干预前后动态监测红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、白细胞介素-1 (IL-1)、白细胞介素-6 (IL-6)水平变化，同步记录视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及Lysholm膝关节评分，比较两组疗效差异。结果：试验组临床总有效率达90.57%，对照组为77.36%，组间差异具有统计学意义(P < 0.05)。干预后两组ESR、CRP、RF、IL-1、IL-6水平均较基线明显回落(P < 0.05)，且试验组各指标下降幅度优于对照组(P < 0.05)。VAS与WOMAC评分干预后均显著下降，Lysholm评分明显上升(P < 0.05)，试验组各量表改善幅度均优于对照组(P < 0.05)。结论：在中医“分筋恢刺”理论指导下应用水筋针技术，能够显著抑制类风湿性膝关节炎患者的滑膜炎症反应，减轻膝部疼痛，促进关节功能康复，其综合疗效优于单一针刺疗法，具备较好的临床应用前景。

Abstract: Objective: Guided by the “Fenjin Huici” theory of traditional Chinese medicine, this study aimed to investigate the clinical efficacy of water-tendon needle therapy in patients with rheumatoid knee arthritis and its impact on serological inflammatory markers. Methods: A total of 318 patients with rheumatoid knee arthritis treated at Traditional Chinese Medicine Hospital of Meishan from June 2024 to December 2025 were prospectively enrolled. Participants were randomly assigned in a 1:1 ratio to receive either water-tendon needle release combined with acupuncture (experimental group, n = 159) or acupuncture monotherapy (control group, n = 159) for 7 days, followed by 6 months of follow-up. Serological markers including ESR, CRP, rheumatoid factor (RF), IL-1, and IL-6 were measured at baseline and post-treatment time points. Clinical outcomes were assessed using VAS, WOMAC, and Lysholm knee scores. Results: The overall response rate was significantly higher in the experimental group (90.57%) than in the control group (77.36%, P < 0.05). Post-treatment levels of ESR, CRP, RF, IL-1, and IL-6 decreased markedly in both groups (P < 0.05), with more pronounced reductions observed in the experimental group (P < 0.05). VAS and WOMAC scores decreased significantly while Lysholm scores increased (P < 0.05), and the magnitude of improvement favored the experimental group (P < 0.05). Conclusion: Water-tendon needle therapy based on the “Fenjin Huici” theory effectively suppresses synovial inflammation, alleviates knee pain, and promotes functional recovery in rheumatoid knee arthritis, demonstrating superior clinical outcomes compared with acupuncture alone.