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Article(id=1322927628117737542, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.08.016, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340125349, onlineDateStr=2026-10-30, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340125349, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340125349, creator=13701087609, updateTime=1793340125349, updator=13701087609, issue=Issue{id=1322926217711726961, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='8', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1754755200000', pubDateStr='2025-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339789083, creator='13701087609', updateTime=1793340517761, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929274071679978, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929274071679979, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=71, endPage=75, ext={EN=ArticleExt(id=1322927629644464199, articleId=1322927628117737542, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effects of Acupuncture Combined with Novel Adjustable Three-Point Knee Joint Traction Device on Pain，Function and Inflammation Indexes in Patients with Degenerative Knee Osteoarthritis, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the effects of acupuncture and moxibustion combined with a novel adjustable three-point knee joint traction device on pain，function and inflammation indexes in patients with degenerative knee osteoarthritis.

Methods

A total of 180 patients with degenerative knee osteoarthritis were included as the study objects.They were divided into 3 groups by random number table method：acupuncture and moxibustion group（60 cases）was treated with acupuncture and moxibustion，traction group（60 cases）was treated with adjustable three-point knee traction，and combined group（60 cases）was treated with acupuncture and moxibustion combined with adjustable three-point knee traction.The treatment effect，symptom score，pain，joint function，inflammatory factors，knee distance and tibiofemoral angle were compared between the two groups.

Results

The total effective rate of the combined group was96.67%（58/60），which was much higher than that of acupuncture and moxibustion group（80.00%，48/60）and traction group（81.67%，49/60），and the difference was significant（P<0.05）.After treatment，the combined therapy group showed significantly lower TCM symptom scores-including joint pain，joint swelling，restricted flexion-extension，and soreness and weakness in the lumbar region and knees-as well as lower VASscores，compared with the acupuncture group and the traction group（P<0.05）.After treatment，the Lequesne MG score and WOMAC score of the combined group were lower than those of the acupuncture and moxibustion group and traction group（P<0.05）.After treatment，the levels of interleukin-6（IL-6），interleukin-1β（IL-1β）and hypersensitive C-reactive protein（hs-CRP）in the combined group were lower than those in the acupuncture group and moxibustion and traction group（P<0.05）.After treatment，the tibiofemoral angle of the combined group was greater than that of the acupuncture and moxibustion group and traction group，and the knee distance was smaller than that of acupuncture group and traction group，and the difference was significant（P<0.05）.

Conclusion

Acupuncture and moxibustion combined with adjustable three-point knee traction for patients with degenerative knee osteoarthritis has a clear effect，which can effectively improve the symptoms of patients，reduce the degree of pain，reduce the levels of inflammatory factors，reduce the expressions of hs-CRP，IL-1βand IL-6 by correcting the internal and external inversion of the knee joint，improve the mobility of the knee joint and promote the functional recovery of the knee joint.

, authors=Liang ZHANG, Hu WANG, Xiaoting FU, Cuijuan WANG, Hang ZHU, Jun LE, authorsList=Liang ZHANG, Hu WANG, Xiaoting FU, Cuijuan WANG, Hang ZHU, Jun LE, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927631045361748, articleId=1322927628117737542, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=针灸联合新型可调三点式膝关节牵引装置对退行性膝关节骨关节炎患者疼痛、功能及炎症指标的影响, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析针灸联合新型可调三点式膝关节牵引装置对退行性膝关节骨关节炎患者疼痛、功能及炎症指标的影响。

方法

纳入退行性膝关节骨关节炎患者180例为研究对象，随机数字表法分为3组，针灸组60例采用针灸治疗，牵引组60例采用可调式三点膝关节牵引治疗，联合组60例采用针灸联合可调三点式膝关节牵引治疗，对比两组治疗效果、中医症状积分、疼痛情况、关节功能、炎症因子以及膝间距和胫股角情况等。

结果

联合组治疗总有效率为96.67%（58/60），远高于针灸组的80.0%（48/60）、牵引组的81.67%（49/60），组间比较差异有统计学意义（P<0.05）；治疗后联合组关节疼痛、关节肿胀、屈伸不利、腰膝酸软4项中医症状积分、VAS评分均低于针灸组、牵引组（P<0.05）；治疗后联合组Lequesne髋膝关节功能评分（LequesneMG评分）、WOMAC关节炎指数（WOMAC评分）低于针灸组、牵引组（P<0.05）；治疗后联合组白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、高敏C反应蛋白（hs-CRP）低于针灸组、牵引组（P<0.05）；治疗后联合组胫股角大于针灸组、牵引组，膝间距小于针灸组、牵引组，组间差异有统计学意义（P<0.05）。

结论

对退行性膝关节骨关节炎患者采用针灸联合可调三点式膝关节牵引治疗效果明确，能有效改善患者症状，减轻疼痛程度，利用纠正膝关节内外翻情况，减轻炎症因子水平，下调hs-CRP、IL-1β、IL-6表达，提高膝关节活动度，促进膝关节功能恢复。

, authors=张亮, 王虎, 傅晓婷, 王翠娟, 朱杭, 乐军, authorsList=张亮, 王虎, 傅晓婷, 王翠娟, 朱杭, 乐军, authorCompany=null, correspAuthors=null, authorNote=

张亮（1985-），男，浙江杭州人，主治医师，博士，研究方向：老年性退行性骨关节炎中医治疗。

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张亮（1985-），男，浙江杭州人，主治医师，博士，研究方向：老年性退行性骨关节炎中医治疗。

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张亮（1985-），男，浙江杭州人，主治医师，博士，研究方向：老年性退行性骨关节炎中医治疗。

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Knee，2022，36：20-26., articleTitle=Transcatheter arterial embolization of abnormal neovessels in a swine model of knee arthritis, refAbstract=null), Reference(id=1322927639442358436, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2023, volume=21, issue=14, pageStart=24, pageEnd=28, url=null, language=null, rfNumber=［21］, rfOrder=20, authorNames=韩凡, 林旺, journalName=中外医学研究, refType=null, unstructuredReference=韩凡，林旺. 针灸对膝骨关节炎患者膝关节功能恢复、疼痛程度及疾病相关实验室指标水平的影响［J］. 中外医学研究，2023，21（14）：24-28., articleTitle=针灸对膝骨关节炎患者膝关节功能恢复、疼痛程度及疾病相关实验室指标水平的影响, refAbstract=null), Reference(id=1322927639513661605, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2023, volume=43, issue=2, pageStart=332, pageEnd=337, url=null, language=null, rfNumber=［22］, rfOrder=21, authorNames=李亚, 陈立早, 祁芳, journalName=湖南中医药大学学报, refType=null, unstructuredReference=李亚，陈立早，祁芳，等. 基于“筋骨平衡理论”探讨温针灸联合运动康复对膝骨关节炎疼痛及膝关节功能的影响［J］. 湖南中医药大学学报，2023，43（2）：332-337., articleTitle=基于“筋骨平衡理论”探讨温针灸联合运动康复对膝骨关节炎疼痛及膝关节功能的影响, refAbstract=null), Reference(id=1322927639584964774, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2023, volume=38, issue=11, pageStart=679, pageEnd=682, url=null, language=null, rfNumber=［23］, rfOrder=22, authorNames=谢冰, 肖乐, 刘超, journalName=中国康复, refType=null, unstructuredReference=谢冰，肖乐，刘超，等. Mulligan动态关节松动术联合超短波及针灸治疗膝骨关节炎的临床疗效观察［J］. 中国康复，2023，38（11）：679-682., articleTitle=Mulligan动态关节松动术联合超短波及针灸治疗膝骨关节炎的临床疗效观察, refAbstract=null), Reference(id=1322927639660462247, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2022, volume=26, issue=35, pageStart=5596, pageEnd=5601, url=null, language=null, rfNumber=［24］, rfOrder=23, authorNames=武永利, 刘娣, 王铎, journalName=中国组织工程研究, refType=null, unstructuredReference=武永利，刘娣，王铎，等. 温针灸调控膝骨关节炎模型兔关节软骨中PI3K/Akt信号通路的变化［J］. 中国组织工程研究，2022，26（35）：5596-5601., articleTitle=温针灸调控膝骨关节炎模型兔关节软骨中PI3K/Akt信号通路的变化, refAbstract=null), Reference(id=1322927639727571112, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2023, volume=45, issue=9, pageStart=1530, pageEnd=1534, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=傅聪, 郭运岭, 佟成成, journalName=河北中医, refType=null, unstructuredReference=傅聪，郭运岭，佟成成，等. 弹拨牵引松解三部平衡法联合塞来昔布对膝骨关节炎患者膝关节功能及基质金属蛋白酶3、转化生长因子β1、内皮素-1的影响［J］. 河北中医，2023，45（9）：1530-1534., articleTitle=弹拨牵引松解三部平衡法联合塞来昔布对膝骨关节炎患者膝关节功能及基质金属蛋白酶3、转化生长因子β1、内皮素-1的影响, refAbstract=null), Reference(id=1322927639803068585, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2019, volume=8, issue=10, pageStart=14, pageEnd=18, url=null, language=null, rfNumber=［26］, rfOrder=25, authorNames=张洪丽, 吕柳, 王利春, journalName=风湿病与关节炎, refType=null, unstructuredReference=张洪丽，吕柳，王利春，等. 基于足底压力检测下牵引联合深部热疗治疗膝骨关节炎对照研究［J］. 风湿病与关节炎，2019，8（10）：14-18., articleTitle=基于足底压力检测下牵引联合深部热疗治疗膝骨关节炎对照研究, refAbstract=null), Reference(id=1322927639870177450, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=3, pageStart=93, pageEnd=96, url=null, language=null, rfNumber=［27］, rfOrder=26, authorNames=徐耀, 刘国振, 李腾飞, journalName=中国中医骨伤科杂志, refType=null, unstructuredReference=徐耀，刘国振，李腾飞. 弹拨牵引松解三步疗法治疗膝骨关节炎50例［J］. 中国中医骨伤科杂志，2024，32（3）：93-96., articleTitle=弹拨牵引松解三步疗法治疗膝骨关节炎50例, refAbstract=null), Reference(id=1322927639937286315, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2021, volume=40, issue=2, pageStart=111, pageEnd=112, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=陆华宇, journalName=内蒙古中医药, refType=null, unstructuredReference=陆华宇. 膝骨关节炎采用针刀结合下肢皮牵引治疗对关节疼痛与功能的改善作用［J］. 内蒙古中医药，2021，40（2）：111-112., articleTitle=膝骨关节炎采用针刀结合下肢皮牵引治疗对关节疼痛与功能的改善作用, refAbstract=null), Reference(id=1322927640016978092, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2024, volume=37, issue=4, pageStart=32, pageEnd=36, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=李洋, 楚天首, 曹向阳, journalName=中医研究, refType=null, unstructuredReference=李洋，楚天首，曹向阳，等. 膝关节平衡力线手法治疗内翻型膝骨关节炎的研究［J］. 中医研究，2024，37（4）：32-36., articleTitle=膝关节平衡力线手法治疗内翻型膝骨关节炎的研究, refAbstract=null), Reference(id=1322927640092475565, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, doi=null, pmid=null, pmcid=null, year=2024, volume=55, issue=1, pageStart=29, pageEnd=31, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=易周萍, 朱在师, 茆敏, journalName=福建中医药, refType=null, unstructuredReference=易周萍，朱在师，茆敏，等. 从经筋理论探析膝骨关节炎筋骨同治的诊疗策略［J］. 福建中医药，2024，55（1）：29-31., articleTitle=从经筋理论探析膝骨关节炎筋骨同治的诊疗策略, refAbstract=null)], funds=[Fund(id=1322927636237910158, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, awardId=2022YFC3501204, language=CN, fundingSource=国家重点研发计划项目(2022YFC3501204), fundOrder=null, country=null), Fund(id=1322927636300824719, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, awardId=2024KY1377, 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figs=[ArticleFig(id=1322927635357106306, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
针灸组6025（41.67）23（38.33）12（20.0）48（80.0）
牵引组6029（48.33）20（33.33）11（18.33）49（81.67）
联合组6047（78.33）11（18.33）2（3.33）58（96.67）
χ2值9.584 2
P值0.000 0
), ArticleFig(id=1322927635428409475, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=CN, label=表1, caption=

3组退行性膝关节骨关节炎患者治疗效果比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
针灸组6025（41.67）23（38.33）12（20.0）48（80.0）
牵引组6029（48.33）20（33.33）11（18.33）49（81.67）
联合组6047（78.33）11（18.33）2（3.33）58（96.67）
χ2值9.584 2
P值0.000 0
), ArticleFig(id=1322927635499712644, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数关节疼痛关节肿胀屈伸不利腰膝酸软
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
针灸组605.13±1.252.11±0.174.59±1.142.03±0.24*3.23±1.172.15±0.47*2.69±1.271.53±0.25*
牵引组605.12±1.042.12±0.17*4.57±1.132.01±0.25*3.25±1.242.16±0.19*2.67±1.191.52±0.19*
联合组605.11±1.021.15±0.14*4.58±1.111.12±0.27*3.26±1.141.14±0.26*2.68±1.251.04±0.27*
F值0.708 09.717 10.189 313.587 40.357 713.489 70.214 75.489 5
P值0.480 60.000 00.248 90.000 00.194 30.000 00.195 60.000 0
), ArticleFig(id=1322927635579404421, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=CN, label=表2, caption=

3组退行性膝关节骨关节炎患者中医症状积分变化情况比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数关节疼痛关节肿胀屈伸不利腰膝酸软
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
针灸组605.13±1.252.11±0.174.59±1.142.03±0.24*3.23±1.172.15±0.47*2.69±1.271.53±0.25*
牵引组605.12±1.042.12±0.17*4.57±1.132.01±0.25*3.25±1.242.16±0.19*2.67±1.191.52±0.19*
联合组605.11±1.021.15±0.14*4.58±1.111.12±0.27*3.26±1.141.14±0.26*2.68±1.251.04±0.27*
F值0.708 09.717 10.189 313.587 40.357 713.489 70.214 75.489 5
P值0.480 60.000 00.248 90.000 00.194 30.000 00.195 60.000 0
), ArticleFig(id=1322927635650707590, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数VAS/（分）t值P值
治疗前治疗后
针灸组606.25±1.232.22±0.2425.548 70.000 0
牵引组606.27±1.212.26±0.2719.578 20.000 0
联合组606.24±1.241.11±0.2335.247 70.000 0
F值0.248 69.864 2
P值0.319 10.000 0
), ArticleFig(id=1322927635717816455, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=CN, label=表3, caption=

3组退行性膝关节骨关节炎患者疼痛情况比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数VAS/（分）t值P值
治疗前治疗后
针灸组606.25±1.232.22±0.2425.548 70.000 0
牵引组606.27±1.212.26±0.2719.578 20.000 0
联合组606.24±1.241.11±0.2335.247 70.000 0
F值0.248 69.864 2
P值0.319 10.000 0
), ArticleFig(id=1322927635784925320, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数Lequesne-MG评分WOMAC评分
治疗前治疗后治疗前治疗后
针灸组6012.70±2.329.56±1.76*51.25±5.5625.85±8.42*
牵引组6012.73±2.29 10.04±2.18*50.48±7.8526.52±6.85*
联合组6012.79±2.346.58±2.1950.39±6.7916.88±5.78
F值0.186 24.932 30.235 89.658 2
P值0.289 40.015 20.158 70.024 8
), ArticleFig(id=1322927635856228489, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=CN, label=表4, caption=

3组退行性膝关节骨关节炎患者膝关节功能及严重程度比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数Lequesne-MG评分WOMAC评分
治疗前治疗后治疗前治疗后
针灸组6012.70±2.329.56±1.76*51.25±5.5625.85±8.42*
牵引组6012.73±2.29 10.04±2.18*50.48±7.8526.52±6.85*
联合组6012.79±2.346.58±2.1950.39±6.7916.88±5.78
F值0.186 24.932 30.235 89.658 2
P值0.289 40.015 20.158 70.024 8
), ArticleFig(id=1322927635931725962, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/（pg/mL）IL-1 β/（pg/mL）hs-CRP/（mg/L）
治疗前治疗后治疗前治疗后治疗前治疗后
针灸组6019.56±2.1414.25±2.15*28.95±3.7613.74±1.47*69.57±7.3719.25±3.75*
牵引组6019.55±2.1715.26±3.17*29.48±3.7512.95±2.17*69.69±7.5719.58±3.57*
联合组6019.73±2.136.25±1.02*29.62±3.257.25±1.42*69.92±6.2510.26±2.27*
F值0.881 214.435 71.228 719.239 30.247 815.374 2
P值0.381 40.000 00.223 20.000 00.189 20.000 0
), ArticleFig(id=1322927635990446219, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=CN, label=表5, caption=

3组退行性膝关节骨关节炎患者血清炎症因子水平比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/（pg/mL）IL-1 β/（pg/mL）hs-CRP/（mg/L）
治疗前治疗后治疗前治疗后治疗前治疗后
针灸组6019.56±2.1414.25±2.15*28.95±3.7613.74±1.47*69.57±7.3719.25±3.75*
牵引组6019.55±2.1715.26±3.17*29.48±3.7512.95±2.17*69.69±7.5719.58±3.57*
联合组6019.73±2.136.25±1.02*29.62±3.257.25±1.42*69.92±6.2510.26±2.27*
F值0.881 214.435 71.228 719.239 30.247 815.374 2
P值0.381 40.000 00.223 20.000 00.189 20.000 0
), ArticleFig(id=1322927636061749388, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胫股角/（°）膝间距/（cm）
治疗前治疗后治疗前治疗后
针灸组60155.62±7.95 157.62±5.17*5.51±1.764.42±1.25*
牵引组60155.48±8.14 158.25±5.18*5.52±1.774.43±1.06*
联合组60155.74±9.26 163.25±8.49*5.51±1.752.53±1.21*
F值0.267 712.958 70.147 715.846 25
P值0.182 80.000 00.248 70.000 0
), ArticleFig(id=1322927636124663949, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927628117737542, language=CN, label=表6, caption=

3组退行性膝关节骨关节炎患者膝间距和胫股角情况比较（）

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组别例数胫股角/（°）膝间距/（cm）
治疗前治疗后治疗前治疗后
针灸组60155.62±7.95 157.62±5.17*5.51±1.764.42±1.25*
牵引组60155.48±8.14 158.25±5.18*5.52±1.774.43±1.06*
联合组60155.74±9.26 163.25±8.49*5.51±1.752.53±1.21*
F值0.267 712.958 70.147 715.846 25
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针灸联合新型可调三点式膝关节牵引装置对退行性膝关节骨关节炎患者疼痛、功能及炎症指标的影响
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张亮 , 王虎 , 傅晓婷 , 王翠娟 , 朱杭 , 乐军
中华中医药学刊 | 国家项目点击 2025,43(8): 71-75
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中华中医药学刊 |国家项目点击 2025 , 43 (8) : 71 -75
针灸联合新型可调三点式膝关节牵引装置对退行性膝关节骨关节炎患者疼痛、功能及炎症指标的影响
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张亮（1985-），男，浙江杭州人，主治医师，博士，研究方向：老年性退行性骨关节炎中医治疗。

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张亮（1985-），男，浙江杭州人，主治医师，博士，研究方向：老年性退行性骨关节炎中医治疗。

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张亮, 王虎, 傅晓婷, 王翠娟, 朱杭, 乐军
作者信息
  • 浙江中医药大学附属杭州市中医院，浙江 杭州 310007
作者简介:

张亮（1985-），男，浙江杭州人，主治医师，博士，研究方向：老年性退行性骨关节炎中医治疗。

Effects of Acupuncture Combined with Novel Adjustable Three-Point Knee Joint Traction Device on Pain，Function and Inflammation Indexes in Patients with Degenerative Knee Osteoarthritis
Liang ZHANG, Hu WANG, Xiaoting FU, Cuijuan WANG, Hang ZHU, Jun LE
Affiliations
  • Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University，Hangzhou 310007，Zhejiang，China
出版时间: 2025-08-10 doi: 10.13193/j.issn.1673-7717.2025.08.016
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摘要
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目的

分析针灸联合新型可调三点式膝关节牵引装置对退行性膝关节骨关节炎患者疼痛、功能及炎症指标的影响。

方法

纳入退行性膝关节骨关节炎患者180例为研究对象，随机数字表法分为3组，针灸组60例采用针灸治疗，牵引组60例采用可调式三点膝关节牵引治疗，联合组60例采用针灸联合可调三点式膝关节牵引治疗，对比两组治疗效果、中医症状积分、疼痛情况、关节功能、炎症因子以及膝间距和胫股角情况等。

结果

联合组治疗总有效率为96.67%（58/60），远高于针灸组的80.0%（48/60）、牵引组的81.67%（49/60），组间比较差异有统计学意义（P<0.05）；治疗后联合组关节疼痛、关节肿胀、屈伸不利、腰膝酸软4项中医症状积分、VAS评分均低于针灸组、牵引组（P<0.05）；治疗后联合组Lequesne髋膝关节功能评分（LequesneMG评分）、WOMAC关节炎指数（WOMAC评分）低于针灸组、牵引组（P<0.05）；治疗后联合组白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、高敏C反应蛋白（hs-CRP）低于针灸组、牵引组（P<0.05）；治疗后联合组胫股角大于针灸组、牵引组，膝间距小于针灸组、牵引组，组间差异有统计学意义（P<0.05）。

结论

对退行性膝关节骨关节炎患者采用针灸联合可调三点式膝关节牵引治疗效果明确，能有效改善患者症状，减轻疼痛程度，利用纠正膝关节内外翻情况，减轻炎症因子水平，下调hs-CRP、IL-1β、IL-6表达，提高膝关节活动度，促进膝关节功能恢复。

退行性膝关节骨关节炎  /  针灸  /  可调三点式膝关节牵引  /  关节功能  /  炎症因子  /  中西医结合疗法
Objective

To analyze the effects of acupuncture and moxibustion combined with a novel adjustable three-point knee joint traction device on pain，function and inflammation indexes in patients with degenerative knee osteoarthritis.

Methods

A total of 180 patients with degenerative knee osteoarthritis were included as the study objects.They were divided into 3 groups by random number table method：acupuncture and moxibustion group（60 cases）was treated with acupuncture and moxibustion，traction group（60 cases）was treated with adjustable three-point knee traction，and combined group（60 cases）was treated with acupuncture and moxibustion combined with adjustable three-point knee traction.The treatment effect，symptom score，pain，joint function，inflammatory factors，knee distance and tibiofemoral angle were compared between the two groups.

Results

The total effective rate of the combined group was96.67%（58/60），which was much higher than that of acupuncture and moxibustion group（80.00%，48/60）and traction group（81.67%，49/60），and the difference was significant（P<0.05）.After treatment，the combined therapy group showed significantly lower TCM symptom scores-including joint pain，joint swelling，restricted flexion-extension，and soreness and weakness in the lumbar region and knees-as well as lower VASscores，compared with the acupuncture group and the traction group（P<0.05）.After treatment，the Lequesne MG score and WOMAC score of the combined group were lower than those of the acupuncture and moxibustion group and traction group（P<0.05）.After treatment，the levels of interleukin-6（IL-6），interleukin-1β（IL-1β）and hypersensitive C-reactive protein（hs-CRP）in the combined group were lower than those in the acupuncture group and moxibustion and traction group（P<0.05）.After treatment，the tibiofemoral angle of the combined group was greater than that of the acupuncture and moxibustion group and traction group，and the knee distance was smaller than that of acupuncture group and traction group，and the difference was significant（P<0.05）.

Conclusion

Acupuncture and moxibustion combined with adjustable three-point knee traction for patients with degenerative knee osteoarthritis has a clear effect，which can effectively improve the symptoms of patients，reduce the degree of pain，reduce the levels of inflammatory factors，reduce the expressions of hs-CRP，IL-1βand IL-6 by correcting the internal and external inversion of the knee joint，improve the mobility of the knee joint and promote the functional recovery of the knee joint.

degenerative knee osteoarthritis  /  acupuncture  /  adjustable three-point knee joint traction  /  joint function  /  inflammatory factors  /  integrative therapy
张亮, 王虎, 傅晓婷, 王翠娟, 朱杭, 乐军. 针灸联合新型可调三点式膝关节牵引装置对退行性膝关节骨关节炎患者疼痛、功能及炎症指标的影响. 中华中医药学刊, 2025 , 43 (8) : 71 -75 . DOI: 10.13193/j.issn.1673-7717.2025.08.016
Liang ZHANG, Hu WANG, Xiaoting FU, Cuijuan WANG, Hang ZHU, Jun LE. Effects of Acupuncture Combined with Novel Adjustable Three-Point Knee Joint Traction Device on Pain，Function and Inflammation Indexes in Patients with Degenerative Knee Osteoarthritis[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (8) : 71 -75 . DOI: 10.13193/j.issn.1673-7717.2025.08.016
正文
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退行性膝关节骨关节炎多是由于年龄增加、劳损、创伤等因素等导致的关节软骨退化损伤引起的，而其中膝关节生物力学失衡是导致该病发生的重要原因，表现为骨质增生、软骨磨损等生物力学结构的改变[1-2]。因此纠正失衡，重塑膝关节周围软组织平衡对治疗本病有重要意义。自行研发的新型可调三点式膝关节矫形牵引装置利用其既能有传统牵引缓解膝关节压迫、改善疼痛和放松肌肉的优势，又能利用三点力线原理，在下肢轴向牵引的同时，利用气囊充气在冠状位对膝关节远近端施压，三点力学纠正膝关节的下肢力线，使膝内外翻平衡形成良性循环[3-4]；针灸为中医特色外治疗法，正气不足和风、寒、湿外邪侵袭为本病主要病机，通过针灸活血通络、祛风除湿，可有效改善局部血液循环，进而达到治疗目的[5]。鉴于此，本次研究对退行性膝关节骨关节炎患者采用针灸联合可调三点式膝关节牵引治疗，获得较好效果。现报道如下。
1　临床资料
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1.1　一般资料
纳入2022年7月—2024年7月我院收治的退行性膝关节骨关节炎患者180例为研究对象，随机数字表法分为3组。针灸组60例，男31例，女29例，年龄42～75岁，平均（61.25±5.89）岁，病程2～5年，平均（1.67±1.24）年，其中单侧发病49例，双侧发病11例。牵引组60例，男28例，女32例，年龄41～79岁，平均（60.35±5.27）岁，病程2～5年，平均（1.62±1.25）年，其中单侧发病48例，双侧发病12例；联合组60例，男33例，女27例，年龄41～76岁，平均（60.59±5.29）岁，病程2～6年，平均（1.69±1.27）年，其中单侧发病47例，双侧发病13例。3组上述相关临床数据资料比较差异无统计学意义（P>0.05），有良好可比性。患者对此次研究均知情且同意，同时研究也经伦理委员会审核通过。
1.2　诊断标准
1.2.1　西医诊断标准
患者均符合《中国骨关节炎诊疗指南（2021年版）》[6]中关于退行性膝关节骨关节炎的相关诊断标准，1）近1个月期间，膝关节频繁出现疼痛的不适症状；2）X线检查显示关节缘存在明显骨质增生情况，关节间隙出现一定程度的狭窄，软骨下骨区域呈现硬化现象；3）多次（至少两次）检查，关节液清亮，并伴有黏稠的触感，白细胞数量未超过2000个/mL；4）年龄40岁以上的中老年患者；5）晨起僵硬时间不超过30 min；6）活动感受到骨骼摩擦的异常感觉。上述部分症状并结合相关实验室检查等即可明确诊断。
1.2.2　中医辨证标准
参照《中药新药临床研究指导原则》[7]及《膝骨关节炎中医诊疗指南（2020年版）》[8]中相关诊断标准，辨证为寒湿型，主症：关节疼痛、关节肿胀、屈伸不利；次症：畏寒恶风，受寒邪可发作，疼痛难忍，关节不利、肢体沉重，舌质淡白、苔白腻且薄，脉浮缓。兼具上述主症及2项以上次症，结合舌、脉即可明确诊断。
1.3　纳入标准
①患者均符合上述中西医相关诊断标准；②近2周内未服用相关药物治疗；③患者家属签署知情同意书；④年龄42～79岁。
1.4　排除标准
①合并类风湿性关节炎、骨关节结核、痛风性疾病者；②存在局部皮肤感染者、关节严重畸形者；③合并代谢性骨病、恶性肿瘤、强直性脊柱炎者；④肝肾功能存在严重器质性疾病者；⑤合并精神疾病及认知功能障碍者。
2　方法
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2.1　治疗方法
3组均予以石药集团欧意药业有限公司所生产的塞来昔布胶囊（国药准字H20203297，规格0.2 g）口服，0.2 g/次，1次/d。
2.1.1　针灸组
予以针灸治疗。选择内外膝眼、阳陵泉、足三里、血海、梁丘穴，取患者仰卧位，选用一次性针灸针，华佗牌，规格0.30 mm×40 mm，苏州医疗用品厂有限公司；常规消毒后对内外膝眼采用内斜刺法刺入2.5寸，对血海、梁丘、阳陵泉穴直刺1寸，对足三里穴直刺1.5寸。所有穴位得气后，施以平补平泻小幅度提插捻转手法，然后将长度在2 cm左右艾条置于针柄上点燃，燃尽后再点1壮，留针30 min。隔日1次。持续治疗4周。
2.1.2　牵引组
予以可调三点式膝关节牵引治疗患膝佩戴矫形牵引装置后牵拉延展伸缩杆充分牵拉膝关节，使关节间隙增加；固定小腿固定牵引带，做轴线牵引，牵引重量控制在患者体质量1/10，约5～8 kg；再根据患者下肢力线及内外翻情况将气囊充气，尽量恢复患者原下肢力线，以患者自觉疼痛为度。1次/d，30 min/次。持续治疗4周。
2.1.3　联合组
予以针灸联合可调三点式膝关节牵引治疗。方法与针灸组、牵引组治疗方式相同。持续治疗4周。
2.2　观察指标及方法
2.2.1　治疗效果
经过治疗后患者膝关节疼痛、肿胀情况改善，关节活动度恢复正常，关节功能显著恢复，则为治疗显效；治疗后患者症状有所改善，关节活动功能轻微受限，则为治疗有效；治疗后膝关节肿痛情况改善不明显，关节活动受限明显，则为治疗无效。总有效率＝显效率+有效率。
2.2.2　中医症状积分
参照《中药新药临床研究指导原则》对关节疼痛、关节肿胀、屈伸不利、腰膝酸软4项主要症状进行评分，依据无、轻、中、重分别赋予0、2、4、6分，最高24分，分值越高表示患者病情越严重。
2.2.3　疼痛程度
采用数字视觉模拟疼痛（VAS）评分对两组治疗前后疼痛情况进行评价，0～10分，0分表示无痛，10分表示剧烈难以忍受的疼痛，观察两组治疗前后疼痛变化情况。
2.2.4　关节功能
采用骨关节炎指数量表（WOMAC）、Lequesne髋膝关节功能评分（Lequesne-MG）对患者膝关节功能、严重程度进行评价，其中WOMAC量表包括疼痛（20分）、僵硬（8分）、功能活动（68分）3个维度，最高分96分，分值越高表示功能越差；Lequesne-MG量表评估对患者病情严重程度，量表包括关节活动痛、夜间痛、晨僵、行走能力等7个方面，得分0～23分，得分越高表示患者症状越明显，病情越严重。
2.2.5　血清炎症因子
于治疗前采用无菌方式抽取其膝关节炎2 mL，采用酶联免疫吸附实验检测其白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、高敏C反应蛋白（hs-CRP）水平变化情况。
2.2.6　膝间距和胫股角情况
膝间距（IC）：并拢双侧踝关节后，测量双侧股骨内踝间的距离，<3 cm为轻度，3～10 cm为中度，>10 cm为重度；胫股角（TFA）：膝关节正位X线片，对股骨轴线、胫骨轴线向下张开的角度进行测量，正常为170°，若补角超过10°，则表示膝内翻畸形。
2.3　统计学方法
数据采集采用SPSS 25.0处理分析，数据资料均符合正态分布，治疗效果用［例（%）］表示，采用χ2检验；中医症状评分、疼痛程度、关节功能、炎症因子等指标用（）表示，用t检验。P<0.05为差异有统计学意义。
3　结果
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3.1　治疗效果比较
联合组治疗总有效率为96.67%，远高于针灸组的80.0%、牵引组的81.67%，组间比较差异有统计学意义（P<0.05）。见表1。
3.2　中医症状积分变化情况比较
治疗前3组关节疼痛、关节肿胀、屈伸不利、腰膝酸软四项中医症状积分比较差异无统计学意义（P>0.05）；治疗后3组上述症候积分均有所降低（P<0.05），且相较于针灸组、牵引组，联合组分值降低更为显著（P<0.05）。见表2。
3.3　疼痛情况比较
治疗前3组VAS评分比较差异无统计学意义（P>0.05）；治疗后两组分值均有所降低，且相较于针灸组、牵引组，联合组分值降低更为明显，组间差异有统计学意义（P<0.05）。见表3。
3.4　膝关节功能及严重程度比较
干预前3组Lequesne-MG评分、WOMAC评分比较差异无统计学意义（P>0.05）；干预后两组上述评分均有所降低（P<0.05），且与针灸组、牵引组比较，联合组分值下降更为明显（P<0.05）。见表4。
3.5　血清炎症因子水平比较
治疗前3组IL-6、IL-1β、hs-CRP比较差异无统计学意义（P>0.05）；治疗后3组上述指标均较治疗前降低（P<0.05），相较于针灸组、牵引组，联合组降低更为显著（P<0.05）。见表5。
3.6　膝间距和胫股角情况比较
治疗后联合组胫股角大于针灸组、牵引组，膝间距小于针灸组、牵引组，组间差异有统计学意义（P<0.05）。见表6。
4　讨论
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退行性膝关节骨关节炎为中老年人常见、高发疾病之一，其中60岁以上患病率达到78.5%[9]。该病临床表现有晨僵、关节痛胀、活动受限等，且多数患者存在不同程度的膝关节内外翻畸形，尤其以内翻畸形最常见[10]。临床针对本病主要以非甾体类药物治疗、功能锻炼、激素类药物治疗以及手术治疗等方式为主，以缓解患者症状，减轻疼痛，延缓病情发展，但效果均差强人意[11]。本次研究拟采用针灸联合可调三点式膝关节牵引治疗，以为临床诊治提供新的思路。
退行性膝关节骨关节炎在祖国医学中属于“膝痹”“痹证”等范畴。《素问·痹论篇》指出“风寒湿三气杂至，合而为痹”，表明本病的发病外因与风寒湿邪有密切关系[12]。《中藏经》又指出：“骨痹者……，伤于肾也”[13]。肝主筋，肾主骨，指出本病的发病内因与肝肾也有密切联系。可见该病属于本虚标实之证，患者多年迈体衰，肝肾亏虚，正气不足，腠理不密，卫外不固，致风寒湿外邪乘虚而入，久之痹阻于经络关节，气血不足，运行不畅，筋骨失去濡养，津液凝滞于关节，所谓不通则痛，通则不痛，从而引起疼痛、肿胀、屈伸不利，发为膝痹[14-15]。因此针对本病应采用祛风散寒、滋养肝肾、温经通络的方法。本次研究对退行性膝关节骨关节炎患者采用针灸联合可调三点式膝关节牵引治疗，结果发现治疗后联合组关节疼痛、关节肿胀、屈伸不利、腰膝酸软四项中医症状积分、VAS评分均低于针灸组、牵引组（P<0.05）。可见该种方式治疗能改善患者关节肿痛、疼痛等情况，减轻疼痛程度。这是由于针灸为中医特色外治疗法，为针法和灸法的总称。针刺以经络学说为基础，认为人体是以经络为联系，以脏腑为中心的有机整体。通过针刺结合穴位功效，能更充分激发穴位经气和调整全身脏腑气血，使气血经脉畅通，从阴引阳，从阳引阴，导气下行，起到调节阴阳平衡，纠正代谢紊乱的作用[16-17]。配以灸法，可对穴位起到温灼的作用。《灵枢·官能》就有记载：“针所不为，灸之所宜”[18]。故针灸有内病外治的功效，可调和营卫，平衡阴阳。本次选穴内外膝眼、阳陵泉、足三里、血海、梁丘穴，膝眼为治疗关节肿痛必选主穴之一，针刺之有利关节、散风寒、通经络的功效；梁丘穴属于足阳明经的郄穴，为经气血深聚之处，有通经活络、祛风化湿的功效[19]；血海为足太阴脾经腧穴，具有祛瘀止痛、温经活络的功效[20]；阳陵泉穴为足少阳胆经合穴，为治疗筋骨麻痹之要穴，有通痹止痛、养肝柔筋、补肾壮骨的作用[21]；足三里穴为足阳明经合穴，疏经活络、消痈止痛、行气止痛的功效，为治疗下肢痿痹的要穴[22]。通过针刺上述穴位使气血经脉畅通、行气止痛，再配以灸法将热通过针体传递至腧穴深部，起到通络止痛、温经散寒的作用，温煦足，气血通的效果。
同时本组治疗后联合组胫股角大于针灸组、牵引组，膝间距小于针灸组、牵引组。可见该种方式能缩小膝间距、纠正外翻畸形情况。这是由于牵引作为一种操作简便、安全的治疗方式在该病有很大的运用空间，但现阶段的膝关节牵引多以轴向牵引为主，虽然能对膝关节产生蠕变效应，加大关节间隙，促进组织循环，从而减轻膝关节内压力来减轻关节疼痛，但轴向牵引无法改变牵引力的作用点，对改善患者内、外翻畸形和下肢力线矫正的作用不明显[23-24]。本次运用自行设计研制一种新型可调三点式膝关节矫形牵引装置，该装置在轴线膝关节牵引基础上，用可调气囊在冠状位对膝关节远近端施压充气，使得固定充气矫形气囊与移动充气矫形气囊之间形成了三点式结构关系，其中两个固定充气矫形气囊位与一侧，而移动充气矫形气囊位于另一侧，形成三点式结构，三点式可调充气膝关节牵引，在下肢轴向牵引的同时，利用球囊充气在冠状位对膝关节远近端施压，三点力学纠正膝关节的内外翻，可以有效改善下肢轴向牵引力线，使膝关节周围力学失衡-软骨损伤-加重力学失衡的恶性循环关系被打破，重塑膝关节周围软组织结构平衡[25-26]。
IL-1β、IL-6、hs-CRP为常见炎症因子，可增强NK细胞的活性，促使中性粒细胞聚集，参与炎症反应中，在退行性膝关节骨关节炎病情发展中发挥着重要作用。本组治疗后联合组IL-1β、IL-6、hs-CRP水平低于针灸组、牵引组（P<0.05）。可见该种方式能减轻炎症因子水平，减少刺激作用。这是由于针刺针灸疗法通过针刺特定的穴位，能够产生直接的刺激效应；另一方面，艾灸疗法则通过热能效应来发挥作用，艾灸在穴位上产生局部的热辐射效应，这种热辐射不仅能够温暖局部的组织，还能够通过针体传递到腧穴的深部，从而起到温经散寒、通络止痛的作用[27-28]。此外，持续的温度刺激还能够使穴位深部的组织细胞发生变性，改变血清中分子的表达，从而调动人体的免疫系统，起到扶正祛邪、调和阴阳的作用[29-30]。故将针灸联合可调三点式膝关节牵引联合应用可充分发挥其各自优势，促进血液循环，改善膝关节内部微环境，最终达到改善患者膝关节功能的目的。
综上所述，对退行性膝关节骨关节炎患者采用针灸联合可调三点式膝关节牵引治疗效果明确，能有效改善患者症状，减轻疼痛程度，利用纠正膝关节内外翻情况，减轻炎症因子水平，下调hs-CRP、IL-1β、IL-6表达，提高膝关节活动度，促进膝关节功能恢复。
基金
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  • 国家重点研发计划项目(2022YFC3501204)
  • 浙江省医药卫生科技计划项目(2024KY1377)
文献
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2025年第43卷第8期
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doi: 10.13193/j.issn.1673-7717.2025.08.016
  • 首发时间：2026-10-30
  • 出版时间：2025-08-10
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基金
国家重点研发计划项目(2022YFC3501204)
浙江省医药卫生科技计划项目(2024KY1377)
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    浙江中医药大学附属杭州市中医院，浙江 杭州 310007
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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