蠲痹方加减配合毫火针治疗膝骨性关节炎的疗效及对NLRP3/Caspase-1信号通路相关因子的影响OA
Efficacy of modified Juanbi formula combined with filiform fire needle therapy in treating knee osteoarthritis and its impact on factors related to the NLRP3/Caspase-1 signaling pathway
目的:研究蠲痹方加减配合毫火针治疗膝骨性关节炎(KOA)的疗效及对NOD样受体蛋白3(NLRP3)/半胱氨酸天冬氨酸蛋白酶-1(Caspase-1)信号通路相关因子的影响.方法:选取2023年12月-2025年3月本院收治的120例KOA患者,随机分为联合组、汤剂组与针灸组,每组40例.汤剂组予以蠲痹方加减治疗,针灸组予以毫火针治疗,联合组予以蠲痹方加减联合毫火针治疗.比较三组疗效、不良反应、生活质量及治疗前后中医证候积分、疼痛视觉模拟评分(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、膝关节活动度、NLRP3/Caspase-1信号通路相关因子水平.结果:联合组的总有效率明显高于汤剂组和针灸组(P＜0.05);疗程结束后,与汤剂组和针灸组比较,联合组的中医证候主症、次症、总积分及VAS评分、WOMAC评分降低,膝关节活动度升高(P＜0.05);NLRP3、Caspase-1、凋亡相关斑点样蛋白(ASC)、白细胞介素(IL)-1β、IL-18水平降低(P＜0.05);三组均未出现明显的不良反应;联合组生活质量评分高于汤剂组及针灸组(P＜0.05).汤剂组与针灸组的上述指标差异均无统计学意义(P＞0.05).结论:蠲痹方加减配合毫火针治疗KOA患者,可提高临床疗效,改善患者的临床症状和膝关节功能,减轻炎症反应,提高生活质量,且安全可靠,其机制可能与抑制NLRP3/Caspase-1信号通路活化有关.
Objective To investigate the efficacy of modified Juanbi formula combined with filiform fire needle therapy in the treatment of knee osteoarthritis(KOA)and its impact on factors related to the NOD-like receptor protein 3(NLRP3)/cysteine aspartic protease-1(Caspase-1)signaling pathway.Methods A total of 120 patients with KO A from December 2023 to March 2025 were selected and randomly assigned to 3 groups,40 cases in each group.the decoction group was treated with modified Juanbi formula,and the acupuncture group was treated with filiform fire needle therapy,the combined group was treated with modified Juanbi formula combined with filiform fire needle therapy.The efficacy,adverse reactions and quality of life were compared among the three groups,as well as the TCM syndrome scores,visual analogue scale(VAS),Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),knee joint mobility,and NLRP3/Caspase-1 signaling pathway related factors before and after treatment.Results The total effective rate of the combined group was significantly higher than that of the decoction group and the acupuncture group(P＜0.05).After treatment,compared with the decoction group and the acupuncture group,the main symptoms,secondary symptoms,total scores,VAS scores and WOMAC scores of the combined group decreased,and the knee joint activity increased(P＜0.05).After treatment,compared with the decoction group and the acupuncture group,the levels of NLRP3,Caspase-1,ASC,IL-1 β and IL-18 in the combined group decreased(P＜0.05).There were no obvious adverse reactions in the three groups.The quality of life score of the combined group was higher than that of the decoction group and the acupuncture group(P＜0.05).The differences in the aforementioned indicators between the decoction group and the acupuncture group were not statistically significant(P＞0.05).Conclusion Modified Juanbi formula combined with filiform fire needle therapy in the treatment of KOA patients can improve clinical efficacy,improve clinical symptoms,knee joint function,reduce inflammatory response,improve quality of life,and is safe and reliable,which may be related to the inhibition of NLRP3/Caspase-1 signaling pathway activation.
付棣玮;翟宏华;尚林权;李辉;国树梅;王彪;孙国锋
衡水市第七人民医院睡眠科(河北衡水 053000)衡水市中医医院疼痛科(河北衡水 053000)衡水市中医医院疼痛科(河北衡水 053000)衡水市中医医院疼痛科(河北衡水 053000)衡水市第七人民医院睡眠科(河北衡水 053000)衡水市中医医院影像科(河北衡水 053000)衡水市中医医院疼痛科(河北衡水 053000)
医药卫生
膝骨性关节炎蠲痹方加减毫火针NOD样受体蛋白3半胱氨酸天冬氨酸蛋白酶-1炎症反应
Knee osteoarthritismodified Juanbi formulafiliform fire needleNOD-like receptor protein 3cysteine aspartic protease-1inflammatory response
《中国中西医结合外科杂志》 2026 (3)
367-372,6
2024年度中医药类科学研究课题计划项目(2024507)
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