针灸临床杂志2025，Vol.41Issue(10)：32-38,7.DOI:10.19917/j.cnki.1005-0779.025193
基于经筋理论肌骨超声引导下针刀治疗膝骨关节炎疗效及相关机制初步探讨
Preliminary Study on Clinical Efficacy and Related Mechanisms of Acupotomy Therapy for KOA under Musculoskeletal Ultrasound Guidance Based on Meridian-Sinew Theory
摘要
Abstract
Objective:To observe the clinical efficacy of acupotomy therapy for knee osteoarthritis(KOA)under musculoskeletal ultrasound guidance based on meridian-sinew theory,and to conduct a preliminary analysis of its underlying mechanisms.Methods:A total of 107 patients with KOA were enrolled and randomly divided into the observation group(n=54,5 cases dropped off)and the contral group(n=53,4 cases dropped off).The control group(n=49)received Glucosamine Sulfate Potassium Chloride Capsule;on which basis,the observation group(n=49)was also treated with acupotomy therapy under musculoskeletal ultrasound guidance based on meridian-sinew theory.Clinical outcomes were assessed by comparing the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,synovial hyperplasia Szkudlarek grade,and suprapatellar bursa effusion depth before and after the treatment in both groups.Additionally,changes in rectus femoris muscle cross-sectional area,muscle thickness,and pennation angle were evaluated.Serum levels of nuclear factor kappa B(NF-κB),sphingosine kinase 1(SphK1),sphingosine-1-phosphate(S1P),and matrix metalloproteinase-3(MMP-3)were measured before and after the treatment in the two groups.The overall clinical efficacy was also compared between the two groups.Results:After the treatment,the observation group showed significantly lower scores than the control group in terms of joint pain,morning stiffness,and physical function(P＜0.01).The Szkudlarek grade for synovial hyperplasia was better in the observation group compared with the control group.The depth of suprapatellar bursa effusion was also significantly lower in the observation group(P＜0.01).In terms of muscle parameters,the rectus femoris cross-sectional area,muscle thickness,and pennation angle were all greater in the observation group than in the control group(P＜0.01).Regarding serum biomarkers,the levels of NF-κB,SphK1,S1P and MMP-3 were all significantly lower in the observation group compared with the control group(P＜0.01).The total effective rate was 89.80％(44/49)in the observation group,which was higher than 81.63％(40/49)in the control group(P＜0.05).Conclusion:Acupotomy therapy for KOA under musculoskeletal ultrasound guidance based on meridian-sinew theory can significantly alleviate inflammation,reduce the severity of synovitis,restore the morphological characteristics of the rectus femoris,and improve joint function.Its mechanism may be associated with the inhibition of the SphK1-S1P signaling pathway.关键词
膝骨关节炎/经筋理论/肌骨超声/针刀/机制Key words
Knee osteoarthritis/Meridian-sinew theory/Musculoskeletal ultrasound/Acupotomy/Mechanism分类
中医学引用本文复制引用
尹侃,夏晟宁,王玥..基于经筋理论肌骨超声引导下针刀治疗膝骨关节炎疗效及相关机制初步探讨[J].针灸临床杂志,2025,41(10):32-38,7.基金项目
湖南省自然科学基金,编号:2020JJ8066. （）
