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Article(id=1322926385462915727, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.08.033, 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=1793339829077, onlineDateStr=2026-10-30, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339829077, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339829077, creator=13701087609, updateTime=1793339829077, 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=174, endPage=177, ext={EN=ArticleExt(id=1322926387245494928, articleId=1322926385462915727, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Curative Effect of Benefiting Vital Qi and Nourishing Heart Therapy on Degenerative Disease of Knee Joint with Insufficient Kidney Yang, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the curative effect of benefiting vital Qi and nourishing heart method（back Shu-acupoint warm acupuncture）on the degenerative degeneration of knee joint with insufficient kidney Yang.

Methods

A total of 80 patients with knee degenerative degeneration with insufficient kidney Yang（admitted from May 2021 to December 2022）were included in the study and divided into control group（40 cases）and observation group（40 cases）by random number table method.The patients in the control group received knee replacement treatment.The observation group was treated with benefiting vital Qi and nourishing heart method（back Shu-acupoint warm acupuncture）on the basis of control group.The data of each group was observed，including the rate of excellent and good curative effects，the TCM symptom scores before and after treatment，the pain score of patients 3 d，6 d and 9 d（visual analogue scale，VAS），and the levels of C-reactive protein（CRP），tumor necrosis factor-α（TNF-α）and interleukin-6（IL-6），Lysholm knee scale scores before and after treatment，the incidence of complications and the the MOS item short from health survey（SF-36）before treatment，2 and 4 weeks of treatment health survey.

Results

The rate of excellent and good treatment effect in the observation group（95.00%，38/40）was higher than that in the control group（80.00%，32/40）（P<0.05）.After treatment，TCM symptom scores decreased，inflammatory factors（CRP，TNF-α，IL-6）decreased significantly，and total Lysholm knee scale score increased significantly.TCM symptom scores and inflammatory factors（CRP，TNF-α，IL-6）in the observation group were lower than those in the control group.The total score of Lysholm knee scale was higher than that of control group（P<0.05）.VAS scores of the observation group were lower than those of the control group at 3 d，6 d and 9 d after surgery（P<0.05）. Compared with that of the control group（20.00%，8/40），the complication rate of the observation group（5.00%，2/40）was lower（P<0.05）.After 2 and 4 weeks of treatment，the SF-36 score of the observation group was higher than that of the control group（P<0.05）.

Conclusion

The benefiting vital Qi and nourishing heart method（back Shu-acupoint warm acupuncture）has a good effect on the treatment of kidney Yang deficiency type of knee degenerative diseases.The patient´s symptoms and the knee joint function are improved with less complications.It is a safe and reliable treatment，and the patient´s health is improved after treatment.It is worthy of application.

, authors=Baoqiu ZHANG, Ziyong LI, Xiaoshu CHEN, Yanzhu YANG, authorsList=Baoqiu ZHANG, Ziyong LI, Xiaoshu CHEN, Yanzhu YANG, authorCompany=null, correspAuthors=Yanzhu YANG, 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=1322926388642198171, articleId=1322926385462915727, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=培元养心法治疗肾阳不足型膝关节退行性病变疗效观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

观察培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变疗效。

方法

纳入肾阳不足型膝关节退行性病变患者80例，采取随机数字表法分为对照组40例与观察组40例，对照组接受膝关节置换术治疗，观察组在对照组治疗基础上结合培元养心法（背俞穴温针灸）治疗，观察各组数据情况：疗效优良率、治疗前后中医证候积分变化、术后3 d及术后6 d、术后9 d患者的疼痛评分［视觉模拟疼痛评分法（Visual analogue scale，VAS）］，治疗前后患者C反应蛋白（C-reactive protein，CRP）及肿瘤坏死因子α（Tumor necrosis factor-α，TNF-α）和白介素-6（Interleukin-6，IL-6）指标变化、治疗前后患者Lysholm膝关节量表评分变化、并发症发生率、治疗前、治疗2周及治疗4周身体健康评分（the MOS item short from health survey，SF-36）。

结果

观察组患者治疗效果优良率（95.00%，38/40）高于对照组（80.00%，32/40），差异有统计学意义（P<0.05）；各组患者治疗后中医证候积分下降，炎症因子（CRP、TNF-α、IL-6）均显著下降，Lysholm膝关节量表总评分显著上升，观察组治疗后中医证候积分及炎症因子（CRP、TNF-α、IL-6）均低于对照组，Lysholm膝关节量表总评分高于对照组，差异有统计学意义（P<0.05）；观察组患者术后3、6、9 d的VAS评分均比对照组更低，差异有统计学意义（P<0.05）；对照组并发症率为20.00%（8/40），比观察组的5.00%（2/40）更低，差异有统计学意义（P<0.05）；治疗2周及治疗4周后观察组患者的SF-36评分均高于对照组患者，差异有统计学意义（P<0.05）。

结论

培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变疗效良好，患者症状改善，膝关节功能改善，并发症少，治疗安全可靠，且患者治疗后身体健康好转，值得应用。

, authors=张保球, 李子勇, 陈小舒, 杨炎珠, authorsList=张保球, 李子勇, 陈小舒, 杨炎珠, authorCompany=null, correspAuthors=杨炎珠, authorNote=

张保球（1977-），男，广东佛山人，主任中医师，学士，研究方向：骨关节退行性病变及脊柱相关疾病。

, correspAuthorsNote=
杨炎珠（1981-），女，广东江门人，副主任中医师，学士，研究方向：针灸镇痛。E-mail：。
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张保球（1977-），男，广东佛山人，主任中医师，学士，研究方向：骨关节退行性病变及脊柱相关疾病。

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张保球（1977-），男，广东佛山人，主任中医师，学士，研究方向：骨关节退行性病变及脊柱相关疾病。

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journalName=上海针灸杂志, refType=null, unstructuredReference=代传国，瞿群威. 内热针治疗早中期膝骨关节炎的疗效观察及对血清IL-1β、YKL-40水平的影响［J］. 上海针灸杂志，2023，42（5）：526-530., articleTitle=内热针治疗早中期膝骨关节炎的疗效观察及对血清IL-1β、YKL-40水平的影响, refAbstract=null), Reference(id=1322926397823529706, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, doi=null, pmid=null, pmcid=null, year=2023, volume=42, issue=2, pageStart=170, pageEnd=174, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=牛朝旭, 王巧立, 张彦蕾, journalName=上海针灸杂志, refType=null, unstructuredReference=牛朝旭，王巧立，张彦蕾，等. 浮针联合药物治疗膝骨关节炎的疗效观察［J］. 上海针灸杂志，2023，42（2）：170-174., articleTitle=浮针联合药物治疗膝骨关节炎的疗效观察, refAbstract=null), Reference(id=1322926397882249963, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, doi=null, pmid=null, pmcid=null, year=2022, volume=33, issue=3, pageStart=656, pageEnd=658, url=null, language=null, rfNumber=［26］, rfOrder=25, authorNames=黄觅, 曾宇, 杜世阳, journalName=时珍国医国药, refType=null, unstructuredReference=黄觅，曾宇，杜世阳，等. 同源点针刺法治疗膝痹病（骨关节炎）的临床疗效评价研究［J］. 时珍国医国药，2022，33（3）：656-658., articleTitle=同源点针刺法治疗膝痹病（骨关节炎）的临床疗效评价研究, refAbstract=null), Reference(id=1322926397970330348, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, doi=null, pmid=null, pmcid=null, year=2023, volume=38, issue=1, pageStart=36, pageEnd=38，60, url=null, language=null, rfNumber=［27］, rfOrder=26, authorNames=高远航, 柴仪, 崔书国, journalName=河北中医药学报, refType=null, unstructuredReference=高远航，柴仪，崔书国，等. 针刺“肘缝穴”配合运动疗法治疗早期膝关节骨性关节炎的疗效研究［J］. 河北中医药学报，2023，38（1）：36-38，60., articleTitle=针刺“肘缝穴”配合运动疗法治疗早期膝关节骨性关节炎的疗效研究, refAbstract=null), Reference(id=1322926398050022125, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, doi=null, pmid=null, pmcid=null, year=2022, volume=42, issue=20, pageStart=5036, pageEnd=5039, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=陈付艳, 柯梓, 朱洪航, journalName=中国老年学杂志, refType=null, unstructuredReference=陈付艳，柯梓，朱洪航，等. 补肾活血方联合穴位针刺治疗老年膝骨性关节炎疗效及对骨代谢和膝关节功能的影响［J］. 中国老年学杂志，2022，42（20）：5036-5039., articleTitle=补肾活血方联合穴位针刺治疗老年膝骨性关节炎疗效及对骨代谢和膝关节功能的影响, refAbstract=null), Reference(id=1322926398175851246, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, doi=null, pmid=null, pmcid=null, year=2022, volume=24, issue=12, pageStart=4777, pageEnd=4786, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=赵金龙, 潘建科, 李嘉晖, journalName=世界科学技术-中医药现代化, refType=null, unstructuredReference=赵金龙，潘建科，李嘉晖，等. 苗医弩药针治疗膝骨关节炎临床疗效及安全性的Meta分析［J］. 世界科学技术-中医药现代化，2022，24（12）：4777-4786., articleTitle=苗医弩药针治疗膝骨关节炎临床疗效及安全性的Meta分析, refAbstract=null), Reference(id=1322926398242960111, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=9, pageStart=1381, pageEnd=1383，1401, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=洪秋阳, 毛雪文, 刘晓静, journalName=中国中医急症, refType=null, unstructuredReference=洪秋阳，毛雪文，刘晓静，等. 贺氏针灸三通法治疗膝骨关节炎急性发作（气滞血瘀证）的临床研究［J］. 中国中医急症，2022，31（9）：1381-1383，1401., articleTitle=贺氏针灸三通法治疗膝骨关节炎急性发作（气滞血瘀证）的临床研究, refAbstract=null)], funds=[Fund(id=1322926394245788369, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, awardId=20232168, language=CN, fundingSource=广东省中医药局科研项目(20232168), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322926388902245020, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, xref=null, ext=[AuthorCompanyExt(id=1322926388923216541, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, companyId=1322926388902245020, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Foshan Hospital of Traditional Chinese Medicine，Foshan 528000，Guangdong，China), AuthorCompanyExt(id=1322926388960965278, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, companyId=1322926388902245020, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=佛山市中医院，广东 佛山 528000)])], figs=[ArticleFig(id=1322926393071383235, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数优良可差总优良
对照组4014108832（80.00）
观察组402684238（95.00）
χ2值4.114 3
P值0.042 5
), ArticleFig(id=1322926393151075012, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表1, caption=

两组肾阳不足型膝关节退行性病变患者临床疗效优良率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数优良可差总优良
对照组4014108832（80.00）
观察组402684238（95.00）
χ2值4.114 3
P值0.042 5
), ArticleFig(id=1322926393222378181, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P
对照组4012.85±2.253.95±0.5424.326 30.000 0
观察组4012.94±2.161.94±0.6230.958 30.000 0
t值0.182 515.461 5
P值0.855 70.000 0
), ArticleFig(id=1322926393306264262, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表2, caption=

两组肾阳不足型膝关节退行性病变患者治疗前后的中医证候总积分比较（）

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组别例数治疗前治疗后t值P
对照组4012.85±2.253.95±0.5424.326 30.000 0
观察组4012.94±2.161.94±0.6230.958 30.000 0
t值0.182 515.461 5
P值0.855 70.000 0
), ArticleFig(id=1322926393381761735, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数术后3 d评分术后6 d评分术后9 d 评分
对照组405.34±0.343.12±0.341.01±0.32
观察组404.59±0.292.18±0.250.58±0.09
t值10.614 614.087 28.181 2
P值0.000 00.000 00.000 0
), ArticleFig(id=1322926393453064904, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表3, caption=

两组肾阳不足型膝关节退行性病变患者患者术后3 d及术后6 d、术后9 d的VAS评分比较（）

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组别例数术后3 d评分术后6 d评分术后9 d 评分
对照组405.34±0.343.12±0.341.01±0.32
观察组404.59±0.292.18±0.250.58±0.09
t值10.614 614.087 28.181 2
P值0.000 00.000 00.000 0
), ArticleFig(id=1322926393536950985, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间CRP/（mg/L）TNF-α/（μg/L）IL-6/（ng/L）
对照组40治疗前33.27±4.83　41.25±5.34　61.29±5.62
治疗后15.45±2.12*28.45±3.84*37.54±4.49*
观察组40治疗前32.96±5.1341.09±5.5061.38±5.71
治疗后10.13±2.06*#23.29±4.16*#26.49±6.23*#
), ArticleFig(id=1322926393620837066, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表4, caption=

两组肾阳不足型膝关节退行性病变患者治疗前后炎症因子指标变化比较（）

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组别例数治疗时间CRP/（mg/L）TNF-α/（μg/L）IL-6/（ng/L）
对照组40治疗前33.27±4.83　41.25±5.34　61.29±5.62
治疗后15.45±2.12*28.45±3.84*37.54±4.49*
观察组40治疗前32.96±5.1341.09±5.5061.38±5.71
治疗后10.13±2.06*#23.29±4.16*#26.49±6.23*#
), ArticleFig(id=1322926393734083275, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组4055.93±4.9274.83±5.2316.647 10.000 0
观察组4055.89±5.0185.94±4.8227.337 30.000 0
t值0.036 09.879 4
P值0.971 40.000 0
), ArticleFig(id=1322926393813775052, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表5, caption=

两组肾阳不足型膝关节退行性病变患者治疗前后Lysholm膝关节量表评分变化比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组4055.93±4.9274.83±5.2316.647 10.000 0
观察组4055.89±5.0185.94±4.8227.337 30.000 0
t值0.036 09.879 4
P值0.971 40.000 0
), ArticleFig(id=1322926393889272525, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数关节积液关节粘连关节僵硬总并发症
对照组403328（20.00）
观察组401012（5.00）
χ2值4.114 3
P值0.042 5
), ArticleFig(id=1322926393998324430, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表6, caption=

两组肾阳不足型膝关节退行性病变患者并发症发生率比较

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组别例数关节积液关节粘连关节僵硬总并发症
对照组403328（20.00）
观察组401012（5.00）
χ2值4.114 3
P值0.042 5
), ArticleFig(id=1322926394065433295, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数2周4周
对照组4084.34±0.7691.34±1.15
观察组4089.23±0.3795.45±1.19
t值36.587 915.707 5
P值0.000 00.000 0
), ArticleFig(id=1322926394145125072, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926385462915727, language=CN, label=表7, caption=

两组肾阳不足型膝关节退行性病变患者治疗2周及治疗4周的SF-36评分（）

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组别例数2周4周
对照组4084.34±0.7691.34±1.15
观察组4089.23±0.3795.45±1.19
t值36.587 915.707 5
P值0.000 00.000 0
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培元养心法治疗肾阳不足型膝关节退行性病变疗效观察
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张保球 , 李子勇 , 陈小舒 , 杨炎珠
中华中医药学刊 | 省级项目平台 2025,43(8): 174-177
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中华中医药学刊 |省级项目平台 2025 , 43 (8) : 174 -177
培元养心法治疗肾阳不足型膝关节退行性病变疗效观察
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张保球, 李子勇, 陈小舒, 杨炎珠
作者信息
  • 佛山市中医院，广东 佛山 528000
通讯作者:
杨炎珠（1981-），女，广东江门人，副主任中医师，学士，研究方向：针灸镇痛。E-mail：。
作者简介:

张保球（1977-），男，广东佛山人，主任中医师，学士，研究方向：骨关节退行性病变及脊柱相关疾病。

Curative Effect of Benefiting Vital Qi and Nourishing Heart Therapy on Degenerative Disease of Knee Joint with Insufficient Kidney Yang
Baoqiu ZHANG, Ziyong LI, Xiaoshu CHEN, Yanzhu YANG
Affiliations
  • Foshan Hospital of Traditional Chinese Medicine，Foshan 528000，Guangdong，China
出版时间: 2025-08-10 doi: 10.13193/j.issn.1673-7717.2025.08.033
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摘要
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目的

观察培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变疗效。

方法

纳入肾阳不足型膝关节退行性病变患者80例，采取随机数字表法分为对照组40例与观察组40例，对照组接受膝关节置换术治疗，观察组在对照组治疗基础上结合培元养心法（背俞穴温针灸）治疗，观察各组数据情况：疗效优良率、治疗前后中医证候积分变化、术后3 d及术后6 d、术后9 d患者的疼痛评分［视觉模拟疼痛评分法（Visual analogue scale，VAS）］，治疗前后患者C反应蛋白（C-reactive protein，CRP）及肿瘤坏死因子α（Tumor necrosis factor-α，TNF-α）和白介素-6（Interleukin-6，IL-6）指标变化、治疗前后患者Lysholm膝关节量表评分变化、并发症发生率、治疗前、治疗2周及治疗4周身体健康评分（the MOS item short from health survey，SF-36）。

结果

观察组患者治疗效果优良率（95.00%，38/40）高于对照组（80.00%，32/40），差异有统计学意义（P<0.05）；各组患者治疗后中医证候积分下降，炎症因子（CRP、TNF-α、IL-6）均显著下降，Lysholm膝关节量表总评分显著上升，观察组治疗后中医证候积分及炎症因子（CRP、TNF-α、IL-6）均低于对照组，Lysholm膝关节量表总评分高于对照组，差异有统计学意义（P<0.05）；观察组患者术后3、6、9 d的VAS评分均比对照组更低，差异有统计学意义（P<0.05）；对照组并发症率为20.00%（8/40），比观察组的5.00%（2/40）更低，差异有统计学意义（P<0.05）；治疗2周及治疗4周后观察组患者的SF-36评分均高于对照组患者，差异有统计学意义（P<0.05）。

结论

培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变疗效良好，患者症状改善，膝关节功能改善，并发症少，治疗安全可靠，且患者治疗后身体健康好转，值得应用。

膝关节退行性病变  /  肾阳不足型  /  培元养心法  /  背俞穴温针灸  /  疗效  /  并发症  /  疼痛  /  膝关节功能
Objective

To observe the curative effect of benefiting vital Qi and nourishing heart method（back Shu-acupoint warm acupuncture）on the degenerative degeneration of knee joint with insufficient kidney Yang.

Methods

A total of 80 patients with knee degenerative degeneration with insufficient kidney Yang（admitted from May 2021 to December 2022）were included in the study and divided into control group（40 cases）and observation group（40 cases）by random number table method.The patients in the control group received knee replacement treatment.The observation group was treated with benefiting vital Qi and nourishing heart method（back Shu-acupoint warm acupuncture）on the basis of control group.The data of each group was observed，including the rate of excellent and good curative effects，the TCM symptom scores before and after treatment，the pain score of patients 3 d，6 d and 9 d（visual analogue scale，VAS），and the levels of C-reactive protein（CRP），tumor necrosis factor-α（TNF-α）and interleukin-6（IL-6），Lysholm knee scale scores before and after treatment，the incidence of complications and the the MOS item short from health survey（SF-36）before treatment，2 and 4 weeks of treatment health survey.

Results

The rate of excellent and good treatment effect in the observation group（95.00%，38/40）was higher than that in the control group（80.00%，32/40）（P<0.05）.After treatment，TCM symptom scores decreased，inflammatory factors（CRP，TNF-α，IL-6）decreased significantly，and total Lysholm knee scale score increased significantly.TCM symptom scores and inflammatory factors（CRP，TNF-α，IL-6）in the observation group were lower than those in the control group.The total score of Lysholm knee scale was higher than that of control group（P<0.05）.VAS scores of the observation group were lower than those of the control group at 3 d，6 d and 9 d after surgery（P<0.05）. Compared with that of the control group（20.00%，8/40），the complication rate of the observation group（5.00%，2/40）was lower（P<0.05）.After 2 and 4 weeks of treatment，the SF-36 score of the observation group was higher than that of the control group（P<0.05）.

Conclusion

The benefiting vital Qi and nourishing heart method（back Shu-acupoint warm acupuncture）has a good effect on the treatment of kidney Yang deficiency type of knee degenerative diseases.The patient´s symptoms and the knee joint function are improved with less complications.It is a safe and reliable treatment，and the patient´s health is improved after treatment.It is worthy of application.

degeneration of knee joint  /  kidney Yang deficiency type  /  benefiting vital Qi and nourishing heart method  /  warm acupuncture on back Shu-acupoint  /  curative effect  /  complications  /  pain  /  knee joint function
张保球, 李子勇, 陈小舒, 杨炎珠. 培元养心法治疗肾阳不足型膝关节退行性病变疗效观察. 中华中医药学刊, 2025 , 43 (8) : 174 -177 . DOI: 10.13193/j.issn.1673-7717.2025.08.033
Baoqiu ZHANG, Ziyong LI, Xiaoshu CHEN, Yanzhu YANG. Curative Effect of Benefiting Vital Qi and Nourishing Heart Therapy on Degenerative Disease of Knee Joint with Insufficient Kidney Yang[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (8) : 174 -177 . DOI: 10.13193/j.issn.1673-7717.2025.08.033
正文
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膝关节退行性病变是临床常见疾病，患者膝关节机械负载过度或者应力分布失衡，导致患者软骨磨损而发病，该病女性发病率比男性更高，且多见于老年人群，疾病危害较大[1-3]。临床多以膝关节置换术治疗膝关节退行性病变，取得较好的临床疗效，具有一定优势，相关报道较多[4-6]。膝关节置换术可较好改善膝关节退行性病变患者膝关节功能以及疼痛，但手术创伤对患者身心造成影响，不利于患者康复[7-9]。故而，临床不断探究膝关节置换术后患者的有效康复方法[10-11]。中医将膝关节退行性病变归属于“痿证”范畴，培元养心法（背俞穴温针灸）具有较好培补元气及调神养心功效，治疗肾阳不足型膝关节退行性病变效果良好，值得深入探讨[12]。故而本次纳入80例肾阳不足型膝关节退行性病变患者进行分组，观察培元养心法（背俞穴温针灸）治疗效果，报道如下。
1　资料与方法
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1.1　一般资料
纳入2021年5月—2022年12月收治的80例肾阳不足型膝关节退行性病变患者，以随机数字表法平均分成对照组和观察组各40例。对照组40例，男11例，女29例，年龄55～80岁，平均（62.75±1.12）岁；病程1～7年，平均（3.38±0.42）年。观察组40例，男10例，女30例，年龄54～79岁，平均（62.80±1.08）岁；病程1～8年，平均（3.41±0.39）年。两组患者资料比较，差异无统计学意义（P>0.05）。
1.2　诊断标准
西医诊断膝关节退行性病变参照《骨关节炎诊治指南》[13]：膝关节反复疼痛、晨僵持续时间30 min，经X线片确诊。中医诊断肾阳不足型膝关节退行性病变参照《中药新药临床研究指导原则》[14]：关节肿胀及关节疼痛、功能障碍、绞锁、舌质红、苔薄白，脉滑等。
1.3　纳入排除标准
纳入标准：年龄50～80岁；符合膝关节置换术手术指征，可接受手术治疗；自愿加入研究；可接受培元养心法（背俞穴温针灸）治疗；伦理批准研究进行。排除标准：精神疾病；心理疾病；合并其他膝关节疾病；严重肝肾疾病；依从性差；无法沟通等。
1.4　治疗方法
对照组：给予膝关节置换术治疗。患者取平卧体位接受手术，术前准备，进行静吸复合气管插管全麻，手术切口长度15 cm，作纵向切口，位置为膝关节前正中，游离筋膜后暴露出髌骨，切开髌旁内侧，暴露关节囊，清除增生骨质以及关节腔内炎性物质等，并切除内外侧半月板、前后交叉韧带，确定截骨角度以及假体型号，股骨内翻5°～7°，胫骨远端截骨，松解髌骨外侧支持带、股骨、胫骨外侧关节囊，调配骨水泥，安装假体，以生理盐水冲洗关节、截骨面，进行止血后放置引流管引流，缝合切口，术后常规抗感染等。观察组：采取膝关节置换术治疗，术后给予患者培元养心法（背俞穴温针灸）治疗。取穴心俞、肾俞、肝俞、脾俞及膝关节内外膝眼、足三里、太溪穴等，采取华佗牌一次性针灸针进行针刺，斜刺心俞1～1.5寸；微斜向脊柱直刺肾俞，深1.5～2寸；斜刺肝俞1.5寸；向内斜刺脾俞0.5～0.8寸；直刺膝关节内外膝眼1寸；直刺足三里1～2寸；针刺太溪穴0.5～0.8寸。采取平补平泻法针刺，针刺后取2 cm艾条卷一段，置于针尾，点燃艾条，实施艾灸，艾条燃烧隔患者皮肤2.5～3 cm，于腧穴上隔一纸片，避免艾条燃烧灰烬烫伤患者皮肤，艾条燃完后取针，针刺1次/d，针刺2周。
1.5　观察指标
①患者临床疗效观察[15]：患者关节无压痛、无肿胀感，步行正常，关节活动度在120°以上为优；患者运动时轻微疼痛，静息时无疼痛感，关节位置轻微压痛，步行不受限，关节活动度在90°～120°为良；患者运动、静息时疼痛明显，关节位置压痛，步行距离400 m内，关节活动度<90°为可；症状恢复较差，未达到以上治疗后标准为差。比较各组患者优良率情况。②比较各组治疗前后中医证候积分，各项积分0～3分，总分越高表示证候越严重[16]。③比较各组患者术后3 d及术后6 d、术后9 d患者的视觉模拟疼痛评分法（Visual analogue scale，VAS）。VAS评分[17]：分值在0～10分，越低表明疼痛越轻。④对比各组患者治疗前及治疗1个月后的C反应蛋白（C-reactive protein，CRP）及肿瘤坏死因子α（Tumor necrosis factor-α，TNF-α）和白介素-6（Interleukin-6，IL-6）指标变化，测定方法为酶联免疫吸附法。⑤患者Lysholm膝关节量表评分对比。评分标准[18]：量表合计8个项目，满分为100分，分值越高表示患者膝关节功能恢复越好。⑥比较各组患者并发症情况。⑦比较各组患者治疗前、治疗2周及治疗4周身体健康评分（the MOS item short from health survey，SF-36），评分范围0～100分，分值越高表示生活质量越好[19]。
1.6　统计学方法
数据录入SPSS 27.0软件进行处理，计数资料与计量资料分别实施t/χ2检验，当P<0.05时，说明数据比较差异有统计学意义。
2　结果
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2.1　临床疗效优良率比较
表1可见，观察组患者治疗效果优良率（95.00%）高于对照组（80.00%），P<0.05。
2.2　中医证候总积分比较
表2可见，各组治疗后的中医证候积分均降低，观察组比对照组低，差异有统计学意义（P<0.05）。
2.3　术后3、6、9 d的VAS评分比较
表3可见，术后3、6、9 d，观察组患者VAS评分均低于对照组，差异有统计学意义（P<0.05）。
2.4　治疗前后炎症因子指标变化比较
表4可见，治疗后，各组患者炎症因子（CRP、TNF-α以及IL-6）均降低，观察组比对照组指标更低，差异有统计学意义（P<0.05）。
2.5　Lysholm膝关节量表评分比较
表5可见，两组患者治疗后的Lysholm膝关节量表评分均提升，观察组患者Lysholm膝关节量表评分高于对照组，差异有统计学意义（P<0.05）。
2.6　并发症发生率比较
表6可见，与对照组并发症（20.00%）相比，观察组并发症率（5.00%）更低，差异有统计学意义（P<0.05）。
2.7　治疗2周及治疗4周的SF-36评分比较
表7可见，治疗2周及治疗4周后观察组患者的SF-36评分均高于对照组患者，差异有统计学意义（P<0.05）。
3　讨论
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膝关节退行性病变属于慢性、进展性膝关节疾病，该病初期症状不明显，随着疾病进展，患者出现严重运动功能障碍，危害严重[20-21]。手术治疗膝关节退行性病变取得较好效果，临床应用广泛[22-23]。膝关节退行性病变发病后以膝关节置换术治疗效果较好，该手术可较好改善患者膝关节功能及缓解疼痛，深受医患好评。为了促进膝关节置换术治疗的膝关节退行性病变患者更好康复，术后给予患者中医方法，以达到最佳治疗效果[24-25]。
中医对膝关节退行性病变认识较深，将其归属于“痿证”“膝骨痹”“痹证”等范畴[26-27]。相关记载较多[28]。中医认为，膝关节退行性病变发病是由风寒湿邪入侵机体，导致气滞血瘀、筋脉关节失去濡养，故而发病[29]。肾阳不足乃膝关节退行性病变发病内在因素，肾为“先天之本”，肝主筋，肾藏精、主骨、生髓功能，筋骨同源，骨失所养，日久筋病。肾阳不足型膝关节退行性病变是临床常见证型，肾阳不足，肝失疏泄、脾失运化，化源不足，筋骨失养故而发病。而膝关节退行性病变患者病程长，久病伤及元气，损耗心神。机体元气充盛可抵御外邪、驱除外邪。培元养心法是广东省名中医、岭南“灸法名匠”老锦雄教授经过30多年的临床实践，不断验证总结而成，蕴含老教授对针灸理论独特的学术思想。培元养心灸法是“固本培元，养心安神”的简称，治神必先养心，心得所养则神凝，血脉气血旺而不衰[30]。膝关节退行性病变久病伤元气、心神，加之手术损伤机体，故而治疗当以培补元气及调神养心、疏经通络、活血化瘀、驱寒除痹之法治疗。故而本次取心俞、肾俞、肝俞、脾俞、背俞及膝关节内外膝眼、足三里、太溪穴等进行温针灸治疗，取得较好治疗效果。针刺心俞可补益心阳、宁心神、调气血；针刺肾俞可益肾助阳，针刺肝俞可疏肝利胆，理气；针刺脾俞可健脾和胃、益气升清；针刺膝关节内外膝眼可活血通络、疏利关节；针刺足三里可补中益气、健脾和胃、通经活络以及理气；针刺太溪穴可益肾滋阴、强腰壮阳、清热利湿。诸穴合刺可较好培元益气、调神养心、疏经通络、疏利关节，而施以艾条进行温针灸治疗，具有较好温经散寒、活血化瘀功效，可有效促进肾阳不足型膝关节退行性病变膝关节置换术患者恢复。本次数据显示，观察组患者治疗效果优良率（95.00%）高于对照组（80.00%），观察组治疗后中医证候积分低于对照组，提示培元养心法（背俞穴温针灸）可较好改善肾阳不足型膝关节退行性病变患者临床病症，提升膝关节置换术手术效果。膝关节退行性病变患者机体呈炎症状态，CRP、TNF-α、IL-6水平显著上升，加之手术损伤，患者CRP、TNF-α、IL-6急剧上升，而术后给予患者培元养心法（背俞穴温针灸）治疗，可较好抑制患者炎症反应，利于患者病情恢复。观察组治疗后Lysholm膝关节量表总评分高于对照组，提示培元养心法（背俞穴温针灸）可较好改善肾阳不足型膝关节退行性病变患者膝关节功能。术后3 d及术后6 d、术后9 d，观察组患者VAS评分均低于对照组，提示培元养心法（背俞穴温针灸）可较好缓解肾阳不足型膝关节退行性病变患者疼痛。与对照组并发症（20.00%）相比，观察组并发症率（5.00%）更低，提示培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变有助于减轻患者术后并发症，有助于患者术后恢复。观察组患者治疗2周、4周后的SF-36评分均比对照组更高，提示培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变可较好改善患者术后生活质量。
综上所述，培元养心法（背俞穴温针灸）治疗肾阳不足型膝关节退行性病变效果良好，患者术后并发症少，疼痛缓解，症状改善，术后膝关节功能恢复较好，且患者生活质量提升，值得应用。
基金
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  • 广东省中医药局科研项目(20232168)
文献
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2025年第43卷第8期
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doi: 10.13193/j.issn.1673-7717.2025.08.033
  • 首发时间：2026-10-30
  • 出版时间：2025-08-10
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广东省中医药局科研项目(20232168)
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    佛山市中医院，广东 佛山 528000

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杨炎珠（1981-），女，广东江门人，副主任中医师，学士，研究方向：针灸镇痛。E-mail：。
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
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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