微创医学

目的基于经筋理论探讨三氧针刀联合三氧自体血回输治疗气滞血瘀证膝骨关节炎患者的临床疗效。方法选取60例气滞血瘀证膝骨关节炎患者作为研究对象，采用随机化分组方法将其分为对照组和观察组，每组30例。给予对照组三氧针刀治疗，给予观察组在三氧针刀治疗的基础上进行三氧自体血回输。比较两组患者疼痛视觉模拟评分法（VAS）评分、中医证候积分、西安大略和麦克马斯特大学骨关节炎（WOMAC）指数（包括疼痛、僵硬、关节功能3个维度）评分、关节液炎性因子［白细胞介素-1β、白细胞介素-18、肿瘤坏死因子（TNF）-α］水平、血清炎性因子（白细胞介素-1β、白细胞介素-6、TNF-α）水平、临床疗效，以及不良反应发生情况。结果治疗后（出院后当天）、治疗后1个月，两组患者疼痛VAS评分、中医证候积分、疼痛维度得分、僵硬维度得分、关节功能维度得分低于治疗前，且观察组患者上述得分低于对照组（P<0.05）。治疗后（出院后当天），观察组患者关节液及血清白细胞介素-1β、白细胞介素-6、TNF-α水平低于对照组（P<0.05）；观察组患者临床疗效优于对照组（P<0.05），两组患者均未出现治疗相关不良反应。结论基于经筋理论进行三氧针刀联合三氧自体血回输治疗气滞血瘀证膝骨关节炎患者的临床疗效确切，可能与其协同松解经筋瘀阻、调和气血运行、改善炎性微环境及高凝状态等多重机制有关。

Objective To observe the clinical efficacy of ozone akupotomye combined with ozone autohemotherapy in the treatment of knee osteoarthritis with qi stagnation and blood stasis syndrome based on the meridian sinew theory. Methods Sixty patients with knee osteoarthritis with qi stagnation and blood stasis syndrome were enrolled as the research subjects, and divided into a control group and an observation group (30 cases each) by a randomized grouping method. The control group received ozone akupotomye, and the observation group was treated with ozone autohemotherapy on the basis of ozone akupotomye. The visual analogue scale (VAS) scores for pain, Traditional Chinese Medicine syndrome scores, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index (including three dimensions of pain, stiffness, joint function) scores, levels of inflammatory factors in synovial fluid [interleukin-1β, interleukin-18, tumor necrosis factor (TNF)-α], levels of inflammatory factors in serum (interleukin-1β, interleukin-6, TNF-α), clinical efficacy, and the occurrence of adverse reactions were compared in both groups. Results After treatment on discharge day and at 1 month after treatment, the VAS pain scores, Traditional Chinese Medicine syndrome scores, pain dimension scores, stiffness dimension scores, and joint function dimension scores of both groups of patiants were lower than those before treatment, and the above scores in the observation group were lower than those in the control group (P<0.05). After treatment on discharge day, the synovial fluid and serum levels of interleukin-1β, interleukin-6 and TNF-α were lower in the observation group than in the control group (P<0.05), and the observation group achieved better clinical efficacy (P<0.05). No treatment-related adverse reactions were observed in either group. Conclusion Ozone akupotomye combined with ozone autohemotherapy based on the meridian sinew theory exerts definite clinical efficacy in knee osteoarthritis with qi stagnation and blood stasis syndrome, which may stem from its synergistic effects in relieving meridian sinew stagnation, regulating qi and blood circulation, ameliorating the inflammatory micro-environment and correcting the hypercoagulable state.