基于“气血津液理论”取穴的艾灸联合PRP注射对寒湿痹阻型膝骨关节炎的临床疗效观察及对炎症因子的影响

Observation of the Clinical Efficacy of Moxibustion Point Selection Based on the “Qi, Blood, and Body Fluid Theory” Combined with PRP Injection in Treating Cold-Damp Obstruction Type Knee Osteoarthritis and Its Effect on Inflammatory Factors

摘要: 本研究旨在探讨基于“气血津液理论”指导的艾灸取穴联合富血小板血浆(PRP)关节腔注射治疗寒湿痹阻型膝骨关节炎(KOA)的临床疗效及对炎症因子的影响。方法选取80例寒湿痹阻型KOA患者，按照随机数字表法分为观察组和对照组，每组40例。对照组给予PRP注射治疗，观察组在对照组基础上加用“气血津液理论”指导的艾灸取穴治疗。比较两组治疗前后关节活动度测量(ROM)、膝关节疼痛视觉模拟评分法(VAS)评分、膝关节功能Lysholm评分、临床疗效、中医证候积分及血清炎症因子水平，记录两组临床疗效及不良反应发生情况。结果治疗后，两组VAS、中医证候积分均较治疗前降低(P < 0.05)，且观察组低于对照组(P < 0.05)；两组Lysholm、临床疗效均较治疗前升高(P < 0.05)，且观察组高于对照组(P < 0.05)。两组血清白细胞介素-17，前列腺素E2、肿瘤坏死因子-α (TNF-α)水平均较治疗前降低(P < 0.05)，且观察组低于对照组(P < 0.05)。观察组总有效率为92.5%，高于对照组的77.5% (P < 0.05)。两组不良反应发生率比较差异无统计学意义(P > 0.05)。结论基于“气血津液理论”取穴的艾灸联合PRP注射治疗寒湿痹阻型KOA疗效显著，能有效减轻患者膝关节疼痛，改善膝关节功能及中医证候，降低血清炎症因子水平，且安全性较高。

Abstract: This study explores the clinical effects and impact on inflammatory factors of moxibustion point selection guided by the “Qi, Blood, and Body Fluid Theory” combined with platelet-rich plasma (PRP) joint cavity injection in treating cold-damp obstruction type knee osteoarthritis (KOA). Methods: 80 patients with cold-damp obstruction type KOA were selected and randomly divided into an observation group and a control group, 40 cases each. The control group received PRP injection treatment, while the observation group received moxibustion point selection guided by “Qi, Blood, and Body Fluid Theory” in addition to the PRP injections. Joint range of motion (ROM), knee pain using the visual analogue scale (VAS), knee function Lysholm score, clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, and serum inflammatory factor levels were compared before and after treatment. Clinical efficacy and adverse reactions were also recorded. Results: After treatment, VAS and TCM syndrome scores decreased in both groups compared to before treatment (P < 0.05), and were lower in the observation group than in the control group (P < 0.05). Lysholm scores and clinical efficacy increased in both groups (P < 0.05), and were higher in the observation group than in the control group (P < 0.05). Serum levels of interleukin-17, prostaglandin E2, and tumor necrosis factor-α (TNF-α) decreased in both groups after treatment (P < 0.05), again with lower levels in the observation group (P < 0.05). The total effective rate in the observation group was 92.5%, higher than the control group’s 77.5% (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Moxibustion point selection based on “Qi, Blood, and Body Fluid Theory” combined with PRP injection is significantly effective for treating cold-damp obstruction type KOA, relieving knee pain, improving knee function and TCM syndrome scores, reducing serum inflammatory factor levels, and has a relatively high level of safety.