电针治疗膝关节骨关节炎慢性疼痛患者的疗效及对中枢敏化的影响

杨琪琪; 姜天鑫; 李春宁; 张振丰; 李飞

doi:10.13703/j.0255-2930.20250807-k0001

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电针治疗膝关节骨关节炎慢性疼痛患者的疗效及对中枢敏化的影响

临床研究 | 更新时间：2026-07-09

- 电针治疗膝关节骨关节炎慢性疼痛患者的疗效及对中枢敏化的影响
- Effect of electroacupuncture on chronic pain in patients with knee osteoarthritis and its influence on central sensitization
- 中国针灸 2026年46卷第7期页码：1079-1089
- 作者机构：
  
  安徽中医药大学第二附属医院康复科，合肥　230061
- 作者简介：
  
  ✉李飞，教授、主任医师。E-mail：316029622@qq.com
- 基金信息：
  
  国家中医药管理局青年岐黄学者培养项目(国中医药人教函〔2022〕256号);第九批安徽省特支计划人才项目(皖组办字〔2023〕35号);2023年度安徽省自然科学基金面上项目(2308085MH297);安徽高校自然科学重大研究项目(2023AH040099);安徽省临床医学研究转化专项(202427b10020060);阜阳市重点研究与开发计划项目(FK20245541)
- DOI：10.13703/j.0255-2930.20250807-k0001
  中图分类号：
- 收稿：2025-08-07，
  
  网络首发：2026-02-25，
  
  纸质出版：2026-07-12
- 稿件说明：
移动端阅览
杨琪琪, 姜天鑫, 李春宁, 等. 电针治疗膝关节骨关节炎慢性疼痛患者的疗效及对中枢敏化的影响[J]. 中国针灸, 2026,46(7):1079-1089.

YANG Qiqi, JIANG Tianxin, LI Chunning, et al. Effect of electroacupuncture on chronic pain in patients with knee osteoarthritis and its influence on central sensitization[J]. Chinese Acupuncture & Moxibustion, 2026, 46(7): 1079-1089.
杨琪琪, 姜天鑫, 李春宁, 等. 电针治疗膝关节骨关节炎慢性疼痛患者的疗效及对中枢敏化的影响[J]. 中国针灸, 2026,46(7):1079-1089. DOI： 10.13703/j.0255-2930.20250807-k0001.

YANG Qiqi, JIANG Tianxin, LI Chunning, et al. Effect of electroacupuncture on chronic pain in patients with knee osteoarthritis and its influence on central sensitization[J]. Chinese Acupuncture & Moxibustion, 2026, 46(7): 1079-1089. DOI： 10.13703/j.0255-2930.20250807-k0001.

摘要

目的：

观察电针治疗膝关节骨关节炎（KOA）慢性疼痛患者的临床疗效及对中枢敏化相关血清标志物的影响。

方法：

将90例KOA慢性疼痛患者随机分为电针组（45例，脱落3例）和假电针组（45例，脱落5例，剔除1例）。两组均接受健康宣教，电针组取患侧内膝眼、犊鼻、鹤顶、血海等穴进行电针干预，予疏密波，频率2 Hz/100 Hz，电流1～2 mA，每次治疗30 min，每天1次，每周6次，连续治疗4周；假电针组予相同穴位与疗程的假电针治疗。以基线期为第0周（治疗前），分别于第0、2、4、8、16周观察两组患者静息与活动时疼痛数字评分法（NRS）评分、膝关节局部和远端部位压痛阈值（PPTs）；于第0、4、16周观察两组患者西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、SF-12健康调查简表（SF-12）评分；于第0、4周观察两组患者中枢敏化量表（CSI）评分及中枢敏化相关血清标志物[谷氨酸（Glu）、谷氨酰胺（Gln）、P物质（SP）、降钙素基因相关肽（CGRP）]水平。

结果：

与治疗前比较，电针组患者第2、4、8、16周后静息和活动时NRS评分，第4、16周后WOMAC分项评分和总分，第4周后CSI评分及血清Glu、Gln、SP、CGRP水平均降低（

0.05），第2、4、8、16周后膝关节局部和远端部位PPTs及第4、16周后SF-12身体健康、心理健康评分均升高（

0.05）。与治疗前比较，假电针组患者第2、4、8周后静息NRS评分和第4周后活动时NRS评分，第4、16周后WOMAC疼痛、功能评分和总分及第4周后血清CGRP水平均降低（

0.05），第2、4周后膝中心点PPTs及第4周后膝外侧点PPTs升高（

0.05）。治疗后及随访时各时间点，电针组静息和活动时NRS评分、WOMAC分项评分和总分、CSI评分及血清Glu、Gln、SP、CGRP水平均低于假电针组（

0.05），各部位PPTs（除第2周后膝外侧点PPTs和第16周后三角肌点PPTs）及SF-12评分（除第16周后心理健康评分）均高于假电针组（

0.05）。电针组静息及活动时NRS评分变化值与CSI评分变化值呈正相关（

0.05）。

结论：

电针疗法可有效缓解KOA慢性疼痛、改善关节功能并提高生活质量，其机制可能与抑制中枢敏化相关。

Abstract

Objective

To observe the clinical therapeutic effect of electroacupuncture (EA) on chronic pain in patients with knee osteoarthritis (KOA) and to investigate its influence on serum biomarkers related to central sensitization.

Methods

Ninety patients with chronic pain caused by KOA were randomly assigned to an EA group (45 cases

3 cases dropped out) and a sham-EA group (45 cases

5 cases dropped out and 1 case was eliminated). The patients in both groups received health education. Additionally

in the EA group

EA was performed at the acupoints such as Neixiyan (EX-LE4)

Dubi (ST35)

Heding (EX-LE2) and Xuehai (SP10) on the affected side

with dense-disperse wave

at the frequency of 2 Hz/100 Hz and the electric current of 1 mA to 2 mA

it was operated for 30 min in each session

once daily

6 sessions a week

and for 4 consecutive weeks. In the sham-EA group

sham-EA was operated at the same acupoints as the EA group

with the same duration of interventions

but without electric stimulation exerted. In the baseline (week 0)

and week 2

8 and 16

the score on numerical rating scale (NRS) for pain at rest and during activity

as well as pressure pain thresholds (PPTs) at the local and distal of knee joint were observed in the two groups separately. In week 0

and 16

the Western Ontario and McMaster universities osteoarthritis index (WOMAC) and the 12-item short form health survey (SF-12) were scored. In week 0 and 4

the score on central sensitization inventory (CSI) and the levels of serum biomarkers related to central sensitization

such as glutamate (Glu)

glutamine (Gln)

substance P (SP)

and calcitonin gene-related peptide (CGRP) were observed in the two groups.

Results

Compared with the baseline

the EA group showed the decrease in NRS scores at rest and during activity in week 2

and 16

in the scores on subscales and the total score of WOMAC in week 4 and 16

as well as in CSI score and serum levels of Glu

Gln

and CGRP in week 4 (

0.05); and presented higher PPTs at the local and distal knee joint in week 2

8 and 16 and the scores on physical and mental health of SF-12 in weeks 4 and 16 (

0.05). The sham-EA group presented the reduced resting-related NRS scores in week 2

and 8

the activity-related NRS score in week 4

the scores on pain and function subscales and the total score of WOMAC in week 4 and 16

and serum CGRP level in week 4 when compared with the baseline

separately (

0.05); and PPTs at the center

of knee point in week 2 and 4 and the lateral side in week 4 increased (

0.05). After treatment and at each time point of follow-up visit

NRS scores at rest and during activity

the scores on each subscale and the total score of WOMAC

the score of CSI and serum levels of Glu

Gln

and CGRP in the EA group were lower than those in the sham-EA group (

0.05); PPTs at each site (except at the lateral side of knee point in week 2 and the deltoid point in week 16) and the scores of SF-12 (except mental health score of SF-12 in week 16) were higher in the EA group when compared with the sham-EA group (

0.05). Change scores of NRS at rest and during activity were positively correlated with those of CSI in the EA group (

0.05).

Conclusion

Electroacupuncture effectively alleviates chronic pain of KOA

improves joint function and quality of life

which may be achieved through the inhibition of central sensitization.

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