雷火灸联合塞来昔布治疗膝骨性关节炎的临床研究

目的 观察先后使用雷火灸与塞来昔布联合治疗膝骨性关节炎（KOA）的临床疗效差异性。方法 将45例KOA患者随机分为先塞来昔布组和先雷火灸组:先塞来昔布组先进行2周塞来昔布治疗，洗脱1周后，再进行2周雷火灸治疗;先雷火灸组反之，治疗结束后随访4周。观察治疗前后及随访期膝关节压痛程度、肿胀度、活动度以及WOMAC功能评分。结果 治疗2周后，2组膝关节压痛程度、肿胀度、活动度均较治疗前明显改善（P<0.05），WOMAC功能总评分也较前降低（P<0.05），组间比较，先雷火灸组膝关节压痛程度、肿胀度、活动度改善优于先塞来昔布组（P<0.05），WOMAC总评分降低较先塞来昔布组显著（P<0.05）；经过1周洗脱后，先塞来昔布组在4个方面的改善较治疗前无显著差异，而先雷火灸组较治疗前差异仍有显著性(P<0.05)；治疗全部结束时且随访期内，2组膝关节压痛程度、肿胀度、活动度较治疗前均有明显改善（P<0.05），且WOMAC总评分较治疗前明显降低（P<0.05），但组间差异无统计学意义。结论 雷火灸与塞来昔布均能改善KOA患者的关节压痛、肿胀度、活动度及功能障碍，但雷火灸对于KOA的关节压痛、肿胀度、活动度等功能改善更有优势，无论使用先后，联合了2种治疗的患者，疗效相当。 

Clinical Study of Thunder Fire Moxibustion Combined Celecoxib for Treatment of Knee Osteoarthritis

OBJECTIVE To observe the clinical efficacy difference of the thunder-fire moxibustion combined with celecoxib for knee osteoarthritis (KOA) before and after the treatment. METHODS Forty five patients with KOA were randomly divided into the celecoxib-intervened first group and the thunder-fire moxibustion-intervened first group. The celecoxib-intervened first group was treated by celecoxib for two weeks， then treated by thunder-fire moxibustion for another two weeks after one week of elusion， and the thunder-fire moxibustion-intervened first group was treated conversely. Four weeks' follow-up was performed for both groups after the treatment. The degree of tenderness， swelling， activity and WOMAC function score of knee joints were observed before and after the treatment. RESULTS After two weeks of treatment， the degree of tenderness， swelling and activity of knee joint in two groups improved significantly (P<0.05)， and WOMAC function total score also decreased (P<0.05). The degree of tenderness and swelling， activity improvement of the knee joints in the thunder-fire moxibustion-intervened first group were better than those of the celecoxib-intervened first group (P<0.05)， and WOMAC total score decreased more significantly than that of the celecoxib-intervened first group (P<0.05). After one week of elution， there was no significant improvements of the four aspects in the celecoxib-intervened first group， while the improvements of the above four aspects in the thunder-fire moxibustion-intervened first group were significantly different compared with pre-treatment (P<0.05). During the follow-up period of the end of the treatment the degree of tenderness， swelling and activity of knee joints in both groups were significantly improved than those of the pre-treatment (P<0.05)， and WOMAC total score decreased significantly than that of the pre-treatment (P<0.05). But there was no significant difference between two groups. CONCLUSION Thunder-fire moxibustion and celecoxib can improve the joint tenderness， swelling， activity and dysfunction of KOA patients， but the thunder-fire moxibustion shows more advantages in improving KOA patients' joint tenderness， swelling， activity and other functions. The combination of thunder-fire moxibustion and celecoxib shows similar effects no matter which one is used first.