Clinical study of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for chondromalacia patellae

Abstract

Objective

To observe the therapeutic efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate in treating chondromalacia patellae and its effect on inflammatory factors in knee joint fluid.

Methods

Sixty-eight patients with chondromalacia patellae were randomized into a control group and an observation group, with 34 cases in each group. The control group was treated with intra-articular injection of sodium hyaluronate, while the observation group was given additional warm needling moxibustion treatment. Before and after treatment, the two groups were scored using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS), examined by magnetic resonance imaging (MRI) and determined for the levels of nuclear factor-KB (NF-kB), tumor necrosis factor (TNF)-α and interleukin (IL)-1β in knee joint fluid. Clinical efficacy was estimated after treatment.

Results

The effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the scores of pain, stiffness and daily activities, as well as the general score of WOMAC declined significantly in both groups (all P<0.05), and were lower in the observation group than in the control group (all P<0.05); the time cost for climbing up and down one staircase and VAS score decreased markedly in both groups (all P<0.05), and were shorter or lower in the observation group than in the control group (both P<0.05); the MRI grading showed no significant change in the control group after intervention (P>0.05), while the grading in the observation group showed notable improvement (P<0.05), and was better than that in the control group (P<0.05); the levels of NF-kB and IL-1β in knee joint fluid dropped significantly in the control group after treatment (both P<0.05), while the levels of NF-kB, TNF-α and IL-1β in knee joint fluid all decreased significantly in the observation group (all P<0.05) and were lower than those in the control group (all P<0.05).

Conclusion

Warm needling moxibustion plus intra-articular injection of sodium hyaluronate can produce definite efficacy in treating chondromalacia patellae; it can mitigate the clinical symptoms, improve the lesion extent of chondromalacia and down-regulate the levels of NF-kB, TNF-α and IL-1β in knee joint fluid.

【摘要】

目的: 观察温针灸加玻璃酸钠关节腔注射治疗髌骨软化症的疗效及其对膝关节液炎症因子的影响。方法: 将 68例髌骨软化症患者随机分为对照组及观察组, 每组34例。对照组予玻璃酸钠关节腔注射, 观察组在此基础上加用 温针灸治疗。治疗前后进行西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评分及疼痛程度的视觉模拟量表(VAS) 评分, 进行磁共振成像(MRI)检查, 并测定膝关节液核因子-κB(NF-κB)、肿瘤坏死因子-α(TNF-α)及白介素-1β(IL-1β)水平。 治疗后评定临床疗效。结果: 观察组有效率高于对照组(P<0.05)。治疗后, 两组疼痛、僵硬、日常活动评分及WOMAC 总分均显著降低(均P<0.05), 观察组疼痛、僵硬、日常活动评分及WOMAC总分均低于对照组(均P<0.05); 两组上下 一层楼梯用时及VAS评分均明显下降(均P<0.05), 观察组上下一层楼梯用时及VAS评分均低于对照组(均P<0.05); 治 疗后, 对照组MRI分级与治疗前无统计学差异(P>0.05), 观察组MRI分级较治疗前显著改善(P<0.05), 且优于对照组 (P<0.05);对照组膝关节液NF-κB及IL-1β水平显著下降(均P<0.05), 观察组膝关节液NF-κB、TNF-α及IL-1β水平均显著下 降(均P<0.05), 且均低于对照组(均P<0.05)。结论: 温针灸加玻璃酸钠关节腔注射治疗髌骨软化症疗效确切, 可缓解 患者临床症状, 改善髌骨软骨病变程度, 降低膝关节液NF-κB、TNF-α及IL-1β水平。