Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (12): 2975-2985.doi: 10.12307/2026.687
Previous Articles Next Articles
Ye Wei, Jiang Dongfu, Zhuang Jielin, Lai Huaxin
Received:
2025-03-26
Accepted:
2025-08-09
Online:
2026-04-28
Published:
2025-09-28
Contact:
Lai Huaxin, MS, Associate chief physician, Department of Orthopedics, Sanming Integrated Medicine Hospital, Sanming 365000, Fujian Province, China
About author:
Ye Wei, MS, Associate chief physician, Department of Orthopedics, Sanming Integrated Medicine Hospital, Sanming 365000, Fujian Province, China
Supported by:
CLC Number:
Ye Wei, Jiang Dongfu, Zhuang Jielin, Lai Huaxin. Effect of warm acupuncture combined with platelet-rich plasma injection on gait parameters and joint function recovery of knee osteoarthritis[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(12): 2975-2985.
Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks
频、步速、步长以及支撑相、摇摆相占比均服从正态分布且方差齐(P > 0.05)。Mauchly’s球形假设检验表明因变量步频、步速、步长以及支撑相、摇摆相占比的方差、协方差、矩阵均相等(χ2=3.525,P=0.506;χ2=4.530,P=0.411;χ2=4.327,P=0.258;χ2=3.679,P=0.330;χ2=5.176,P=0.324),故结果无需经Greenhouse-Geisser法校正。 两组患者治疗期间步频、步速、步长以及支撑相、摇摆相占比的分析结果显示:时间效应有统计学意义(P < 0.001),这表明两组患者治疗期间步频、步速、步长以及支撑相、摇摆相占比随时间而改变;两组患者步频、步速、步长以及支撑相、摇摆相占比组间效应差异有显著性意义(P < 0.001),这表明两组的步频、步速、步长以及支撑相、摇摆相占比存在差异;两组患者步频、步速、步长以及支撑相、摇摆相占比交互效应具有显著差异(P < 0.001),说明时间因素对步频、步速、步长以及支撑相、摇摆相占比的影响与治疗前的水平差异而有所不同,见表3及图3。"
2.5 两组患者治疗前后关节功能比较及主效应检验 与对照组相比,观察组患者在治疗后各时间点的WOMAC评分、VAS评分显著降低,HSS评分及MBI指数显著升高(P < 0.05),见表4。 两组患者治疗期间对不同时间点的关节功能指标进行正态性和方差齐性检验,结果显示两组患者的WOMAC指数、VAS评分、HSS评分及MBI指数均服从正态分布且方差齐(P > 0.05)。Mauchly’s球形假设检验表明因变量步频、步速、步长以及支撑相、摇摆相占比的方差、协方差、矩阵均相等(χ2=4.172,P=0.423;χ2=3.558,P=0.215;χ2=3.720,P=0.446;χ2=4.682,P=0.273),故结果无需经Greenhouse-Geisser法校正。 两组患者治疗期间WOMAC指数、VAS评分、HSS评分及MBI指数的分析结果显示:时间效应有"
2.7 步态参数与关节功能指标的相关性分析 如表7所示,在未校正混杂因素前,步频、步速、步长以及支撑相、摇摆相占比与WOMAC指数、HSS评分、VAS评分、MBI指数存在相关性(P < 0.05);在调整其他影响因素后,步频、步速、步长以及支撑相、摇摆相占比与WOMAC指数、HSS评分、VAS评分、MBI指数的相关性依然存在(P < 0.05),说明步频、步速、步长以及支撑相、摇摆相占比与WOMAC指数、HSS评分、VAS评分、MBI指数密切相关。 2.8 WOMAC指数、HSS评分、VAS评分、MBI指数双重差分模型分析 以WOMAC指数、HSS评分、VAS评分、MBI指数作为因变量,以组别、治疗前后、组别与治疗前后的交互项为自变量,年龄、性别和体质量指数作为协变量纳入双重差分模型进行回归分析。结果显示WOMAC指数治疗前后的β系数为-3.254 (P < 0.05),说明治疗后比治疗前的WOMAC指数平均下降3.254分;组别×治疗前后的β系数对WOMAC指数产生明显的影响(β=-2.117,P < 0.001),观察组的WOMAC指数治疗后下降的幅度比对照组平均多2.117分;HSS评分治疗前后的β系数为4.238 (P < 0.001),说明治疗后比治疗前的HSS评分平均升高4.238分;组别×治疗前后的β系数对HSS评分产生明显的影响(β=3.270,P < 0.001),观察组的HSS评分在治疗后上升的幅度比对照组平均多3.270分;VAS评分治疗前后的系数为-4.320(P < 0.05),说明治疗后比治疗前的VAS评分平均下降4.320分;组别×治疗前后的β系数对VAS评分产生明显的影响(β=-3.105,P < 0.001),观察组的VAS评分在治疗后下降的幅度比对照组平均多3.105分;MBI指数治疗前后的β系数为3.259(P < 0.001),说明治疗后比治疗前的FMA评分平均升高3.259分;组别×治疗前后的β系数对MBI指数产生明显的影响(β=2.774,P < 0.001),观察组的MBI指数治疗后上升的幅度比对照组平均多2.774分,见表8。 2.9 两组不良反应比较 观察组不良反应发生率为6%,对照组不良反应发生率为9%,两组相比差异无显著性意义(P > 0.05),见表9。"
[1] 王虎, 陈顺喜, 陈益丹. 温针灸配合中药外敷治疗膝关节骨性关节炎对炎症反应及膝关节功能的影响[J]. 中华中医药学刊,2022, 40(7):63-66. [2] 洪秀娥, 张霖云, 林旺, 等. 基于扶阳理论督灸联合温针灸治疗阳虚寒凝型膝关节骨关节炎疗效观察[J]. 中国针灸,2022,42(12): 1357-1362. [3] 张茜玥, 李昀姝, 赵杰瑞, 等. 中医药联合富血小板血浆治疗膝骨关节炎进展[J]. 中药材,2024,47(1):261-267. [4] 武永利, 李龙, 刘君伟, 等. 温针灸抑制NLRP3炎症小体激活改善兔膝骨关节炎的软骨损伤[J]. 中国组织工程研究,2023,27(20): 3202-3208. [5] 徐旭, 张丽丽, 马红梅, 等. 温针灸联合加味阳和汤治疗老年膝关节骨性关节炎临床疗效及对炎症因子水平的影响[J]. 湖北中医药大学学报,2021,23(5):89-92. [6] AKPABIO A, AKINTAYO R, YERIMA A, et al. Frequency, pattern, and associations of generalized osteoarthritis among Nigerians with knee osteoarthritis. Clin Rheumatol. 2021;40(8):3135-3141. [7] 中华医学会骨科学分会. 骨关节炎诊治指南(2007年版)[J]. 中华骨科杂志,2007,27(10):793-796. [8] ATERFIELD J, SIM J. Clinical assessment of pain by the visual analogue scale. Br J Ther Rehabil. 2013;3(2):94-97. [9] 何栩,彭倩,路怀民,等. 温针灸治疗膝骨关节炎的临床疗效及对膝关节功能的影响[J]. 河北中医,2021,43(9):1537-1540,1545. [10] LUAN L, BOUSIE J, PRANATA A, et al. Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis. Clin Rehabil. 2021;35(4):522-533. [11] LIU B, XU HY, ZHANG R, et al. An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis. J Ultrasound Med. 2023;42(7):1413-1422. [12] 晋帅锋, 乔晋琳, 丁宇, 等. 针刀联合富血小板血浆注射疗法治疗膝关节骨性关节炎的临床疗效研究[J]. 世界中医药,2022,17(15): 2203-2206. [13] 杨亚崇, 帅世超, 岳立辉, 等. 富血小板血浆治疗膝关节骨性关节炎的研究进展[J]. 中国输血杂志,2023,36(1):90-93. [14] BENNELL KL, PATERSON KL, METCALF BR, et al. Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA. 2021;326:2021-2030. [15] BELK JW, LIM JJ, KEETER C, et al. Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis. Arthroscopy. 2023;39:1714-1734. [16] BELK JW, KRAEUTLER MJ, HOUCK DA, et al. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2021; 49:249-260. [17] 李迩, 吴俊敏, 李思远, 等. 射频电极刃针松解术治疗膝关节骨性关节炎的临床疗效观察[J]. 时珍国医国药,2023,34(8):1920-1922. [18] PARK YB, KIM JH, HA CW, et al. Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid. Am J Sports Med. 2021;49:487-496. [19] 冯雷, 邰东旭. 温针灸联合中药熏蒸对膝关节骨性关节炎骨代谢指标及炎性因子的影响[J]. 辽宁中医杂志,2022,49(1):150-154. [20] 谈倩, 李佳, 李柏村, 等. 温针灸减轻膝骨性关节炎大鼠软骨组织的氧化损伤和炎性反应[J]. 针刺研究,2022,47(4):321-328. [21] 杨荣荣, 郭萍, 张惠环. 基于膝关节功能、疼痛程度及生活质量评价温针灸辅助治疗膝关节骨性关节炎的疗效[J]. 辽宁中医杂志, 2024,51(7):152-155. [22] 付聪聪, 张美丽, 王晓宁, 等. 当归通痹汤联合温针灸阳陵泉对膝骨性关节炎患者膝关节液炎性因子及血液黏滞度的影响[J]. 中国老年学杂志,2024,44(6):1382-1385. [23] JIN S, GUAN X. A systematic review and meta-analysis of the comparative curative effects of warm acupuncture and other traditional Chinese medicines in the treatment of knee osteoarthritis. Ann Palliat Med. 2022;11:708-716. [24] 王甜, 顾彦冬. 正骨推拿联合温针灸对膝骨性关节炎(寒湿痹阻型)患者的步态及炎性相关因子水平的影响[J]. 天津中医药,2024, 41(7):875-879. [25] YAGI M, TANIGUCHI M, TATEUCHI H, et al. Properties of the iliotibial band and their relationships with gait parameters among patients with knee osteoarthritis. J Orthop Res. 2023;41:1177-1185. [26] COSTA LAV, LENZA M, IRRGANG JJ, et al. How Does Platelet-Rich Plasma Compare Clinically to Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review and Meta-analysis. Am J Sports Med. 2023;51:1074-1086. [27] BARIA MR, VASILEFF WK, BORCHERS J, et al. Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review. Am J Sports Med. 2022; 50:273-281. [28] OEDING JF, VARADY NH, FEARINGTON FW, et al. Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2024;52(12):3147-3160. [29] LEWIS E, MERGHANI K, ROBERTSON I, et al. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint J. 2022;104-B:663-671. [30] GU C, MAO Y, DONG H, et al. Nomogram in Knee Instability: 3D Gait Analysis of Knee Osteoarthritis Patients. Indian J Orthop. 2022; 56:1554-1564. [31] 包杭生, 冯宗权, 邹勇根. 基于步态分析探究骨补丸干预老年膝骨关节炎患者炎症因子表达[J]. 中国老年学杂志,2024,44(2):331-334. [32] 张帅攀, 朱清广, 程艳彬, 等. 易筋经功法干预膝骨关节炎患者步态生物力学的随机对照试验[J]. 中华中医药杂志,2023,38(10): 5081-5086. [33] 李永杰, 付申宇, 夏渊, 等. 膝骨关节炎女性伸膝肌力、步态时空参数与峰值膝关节屈曲/内收力矩关系[J]. 中国组织工程研究, 2024,28(9):1354-1358. [34] PFEUFER D, MONTEIRO P, GILILLAND J, et al. Immediate Postoperative Improvement in Gait Parameters following Primary Total Knee Arthroplasty Can Be Measured with an Insole Sensor Device. J Knee Surg. 2022;35:692-697. [35] BATAILLER C, LORDING T, NAAIM A, et al. No difference of gait parameters in patients with image-free robotic-assisted medial unicompartmental knee arthroplasty compared to a conventional technique: early results of a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2023;31:803-813. [36] BACON KL, FELSON DT, JAFARZADEH SR, et al. Gait Alterations and Association With Worsening Knee Pain and Physical Function: A Machine Learning Approach With Wearable Sensors in the Multicenter Osteoarthritis Study. Arthritis Care Res (Hoboken). 2024;76:984-992. [37] WANG Z, LU J, LI Z, et al. Qualitative and Quantitative Measures in the Infrapatellar Fat Pad in Older Adults: Associations with Knee Pain, Radiographic Osteoarthritis, Kinematics, and Kinetics of the Knee. Acad Radiol. 2024;31:3315-3326. [38] 李宏恩, 马恺, 石春花, 等. 步态分析用于膝骨性关节炎诊断与功能评定的研究进展[J]. 生物医学工程与临床,2024,28(2):281-286. [39] IWASAKI K, OHKOSHI Y, HOSOKAWA Y, et al. Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy. Am J Sports Med. 2023;51:977-984. [40] 马淑敏, 高谦, 徐峰, 等. 膝骨关节炎患者股四头肌功能水平及髋关节步态运动学特征分析[J]. 中国康复,2023,38(6):345-349. [41] TAWY GF, BIANT LC, MCNICHOLAS MJ. Gait kinematics and knee stability 10-years following posterior-stabilised total knee arthroplasty comparable to healthy adults >55. Knee Surg Sports Traumatol Arthrosc. 2024;32:54-63. |
[1] | Chen Qiuhan, Yang Long, Yuan Daizhu, Wu Zhanyu, Zou Zihao, Ye Chuan. Peri-knee osteotomy for treatment of knee osteoarthritis: optimization of treatment strategies [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(9): 2303-2312. |
[2] | Li Linzhen, Jiao Hongzhuo, Chen Weinan, Zhang Mingzhe, Wang Jianlong, Zhang Juntao. Effect of icariin-containing serum on lipopolysaccharide-induced inflammatory damage in human chondrocytes [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(6): 1368-1374. |
[3] | Zhou Jian, Zhang Tao, Zhou Weili, Zhao Xingcheng, Wang Jun, Shen Jie, Qian Li, Lu Ming. Effects of resistance training on quadriceps mass and knee joint function in patients with osteoporosis and sarcopenia [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(5): 1081-1088. |
[4] | Gu Fucheng, Yang Meixin, Wu Weixin, Cai Weijun, Qin Yangyi, Sun Mingyi, Sun Jian, Geng Qiudong, Li Nan. Effects of Guilu Erxian Glue on gut microbiota in rats with knee osteoarthritis: machine learning and 16S rDNA analysis [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(4): 1058-1072. |
[5] | Li Xiaomin, Tian Xiangdong, Wang Chaolu. High tibial osteotomy on a single plane: femorofibular angle as a reference marker for mechanical axis correction [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(3): 570-576. |
[6] | Guo Jingwen, Wang Qingwei, He Zijun, Hu Zihang, Chen Zhi, Zhu Rong, Wang Yuming, Liu Wenfei, Luo Qinglu. Intra-articular injection of different concentrations of silicon-based bioceramics in treatment of knee osteoarthritis in rats [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(2): 288-295. |
[7] | Li Yijin, Li Jiahao, Zhang Haitao, Huang Yiwei, Chen Jinlun, Zeng Yirong, Feng Wenjun. GJK Tablets intervene in cartilage homeostasis to protect articular cartilage of mice with knee osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(12): 2994-3004. |
[8] | Liu Yan, Wang Kai, Wu Min. Relationship between coronal angle fluctuation of ankle point and recovery of joint function after ankle fracture [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(9): 1820-1826. |
[9] | Ma Chi, Wang Ning, Chen Yong, Wei Zhihan, Liu Fengji, Piao Chengzhe. Application of 3D-printing patient-specific instruments combined with customized locking plate in opening wedge high tibial osteotomy [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(9): 1863-1869. |
[10] | Sun Yundi, Cheng Lulu, Wan Haili, Chang Ying, Xiong Wenjuan, Xia Yuan. Effect of neuromuscular exercise for knee osteoarthritis pain and function: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(9): 1945-1952. |
[11] | Wang Juan, Wang Guanglan, Zuo Huiwu. Efficacy of exercise therapy in the treatment of anterior cruciate ligament reconstruction patients: #br# a network meta-analysis #br# [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(8): 1714-1726. |
[12] | Wang Peiguang, Zhang Xiaowen, Mai Meisi, Li Luqian, Huang Hao. Generalized equation estimation of the therapeutic effect of floating needle therapy combined with acupoint embedding on different stages of human knee osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(8): 1565-1571. |
[13] | He Guanghui, Yuan Jie, Ke Yanqin, Qiu Xiaoting, Zhang Xiaoling. Hemin regulates mitochondrial pathway of oxidative stress in mouse chondrocytes [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(6): 1183-1191. |
[14] | Ma Haoyu, Qiao Hongchao, Hao Qianqian, Shi Dongbo. Causal effects of different exercise intensities on the risk of osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(6): 1305-1311. |
[15] | Wu Guangtao, Qin Gang, He Kaiyi, Fan Yidong, Li Weicai, Zhu Baogang, Cao Ying . Causal relationship between immune cells and knee osteoarthritis: a two-sample bi-directional Mendelian randomization analysis [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(5): 1081-1090. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||