针刺联合穴位贴敷治疗非创伤性股骨头坏死的疗效观察及对骨代谢、炎症因子水平的影响OA

Objective To observe the clinical efficacy of acupuncture combined with acupoint application in treating non-traumatic osteonecrosis of the femoral head(NONFH)and analyze the impact on bone metabolism,bone marrow edema,and inflammatory factor levels.Method One hundred patients with NONFH were recruited and randomized into a control or observation group,with 50 cases in each group.The control group was treated with conventional Chinese patent drugs plus acupoint application,and the observation group received acupuncture treatment in addition to the intervention in the control group.The two groups were compared in terms of the post-treatment improvement in the pain visual analog scale(VAS)score,Harris score,bone metabolism indicators[serum bone-γ-carboxyglutamic acid-containing protein(BGP),serum β isomer of C-terminal telopeptide of type I collagen(β-CTX),and serum procollagen type Ⅰ N-terminal propeptide(PINP)],serum inflammatory factor levels[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],and bone marrow edema on magnetic resonance imaging(MRI).The clinical efficacy and adverse reactions were also compared.Result The observation group achieved a total effective rate of 93.6%,significantly higher than 81.6%in the control group(P＜0.05).After treatment,the VAS score decreased in both groups(P＜0.05)and was lower in the observation group than in the control group(P＜0.05).After treatment,both groups showed an increase in the Harris score(P＜0.05),and the observation group was higher than the control group(P＜0.05).MRI demonstrated post-treatment improvement in bone marrow edema grading in both groups(P＜0.05),and the observation group was superior to the control group(P＜0.05).After treatment,both groups showed improvement in serum bone metabolism indicators(elevated BGP and declined β-CTX)(P＜0.05),along with decreased inflammatory factor levels(P＜0.05);the observation group surpassed the control group in these measures(P＜0.05).Neither group experienced significant adverse reactions.Conclusion Based on conventional Chinese patent drugs,acupuncture plus acupoint application can improve clinical symptoms in NONFH,reducing pain,inhibiting inflammatory reactions,and further decreasing inflammatory factor levels.The additional use of acupuncture can strengthen the efficacy of acupoint application and oral medication,producing more significant efficacy,with a good safety profile.