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Title: [Effect of fire needling on mild to moderate knee osteoarthritis and related serum inflammatory cytokines].
Author: Fu YB, Chen JW, Li B, Yuan F, Sun JQ.
Journal: Zhongguo Zhen Jiu; 2021 May 12; 41(5):493-7. PubMed ID: 34002561.
Abstract:
OBJECTIVE: To compare the clinical effect of fire needling and filiform needling for mild to moderate knee osteoarthritis (KOA) and observe the influence on related serum inflammatory sytokines. METHODS: A total of 60 patients with mild to moderate KOA were randomly divided into an observation group (30 cases, 4 cases dropped off) and a control group (30 cases, 4 cases dropped off). Both groups were given basic health management, and the acupoints of the two groups were Liangqiu (ST 34), Xuehai (SP 10), Neixiyan (EX-LE 4), Dubi (ST 35), Yanglingquan (GB 34) and ashi point. The observation group was treated with fire needling, while the control group was treated with filiform needling. Both groups were treated once every other day, 3 times a week for 2 weeks. The Western Ontario and McMaster University osteoarthritis index (WOAMC) scores of the two groups were compared before treatment, in 1, 2 weeks of treatment and 2, 6 weeks of follow-up. ELISA method was used to detect the levels of serum interleukin 1α (IL-1α), tumor necrosis factor α (TNF-α) and matrix metalloproteinase 3 (MMP-3) before treatment and in 2 weeks of treatment. The clinical effect of the two groups was evaluated in 1, 2 weeks of treatment and 2, 6 weeks of follow-up. RESULTS: At each time point of treatment and follow-up, the pain, stiffness, difficulty of daily activities scores and WOMAC total scores of the two groups were lower than those before treatment (P<0.05); the stiffness score of the observation group was lower than that of the control group in 1 week of treatment (P<0.05); the various scores and total scores of the WOMAC scale of the observation group were lower than those of the control group in 1, 2 weeks of treatment and 2, 6 weeks of follow-up (P<0.05). In 2 weeks of treatment, the levels of serum MMP-3 and IL-1α in the observation group and IL-1α in the control group were higher than those before treatment (P<0.05). In 1 week of treatment and 2, 6 weeks of follow-up, the total effective rates of the observation group were higher than those in the control group (P<0.05). CONCLUSION: Fire needling can improve the pain, stiffness and joint dysfunction of patients with mild to moderate KOA, and increase serum MMP-3 and IL-1α levels. Its short and long term clinical effects are better than filiform needling. 目的：比较火针与毫针治疗轻中度膝骨关节炎（KOA）的临床疗效，观察其对相关血清炎性细胞因子的影响。方法：将60例轻中度KOA患者随机分为观察组（30例，脱落4例）和对照组（30例，脱落4例）。两组均予基础健康管理，取穴均为梁丘、血海、内膝眼、犊鼻、阳陵泉、阿是穴，观察组予火针治疗，对照组予毫针针刺治疗，均隔日治疗1次，每周3次，连续治疗2周。分别于治疗前，治疗第1、2周及随访第2、6周时观察两组患者西安大略和麦克马斯特大学骨关节炎指数（WOMAC）量表评分，采用ELISA法检测两组患者治疗前、治疗第2周血清白细胞介素1α（IL-1α）、肿瘤坏死因子α（TNF-α）、基质金属蛋白酶3（MMP-3）含量，并于治疗第1、2周和随访第2、6周时评定临床疗效。结果：治疗、随访各时间点两组患者疼痛、僵硬、日常活动难度评分及WOMAC总分均较治疗前降低（P<0.05）；治疗第1周观察组患者僵硬评分低于对照组（P<0.05），治疗第2周及随访第2、6周，观察组患者WOMAC量表各项评分及总分均低于对照组（P<0.05）。治疗第2周，观察组患者血清MMP-3、IL-1α含量及对照组IL-1α含量均高于治疗前（P<0.05）。治疗第1周及随访第2、6周时，观察组总有效率均高于对照组（P<0.05）。结论：火针可以改善轻中度KOA患者的疼痛、僵硬、关节活动障碍症状，升高血清MMP-3、IL-1α含量，其近远期临床疗效均优于毫针针刺。.

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