目的   探讨“五穴四针”针刺法治疗膝骨关节炎患者的效果及其对血清生长修复因子水平的影响。方法   选取开封市第二中医院骨科2022年6月至2023年12月膝骨关节炎患者共126例作为研究对象，并按随机数字表分为两组，各63例，对照组给予综合康复治疗，研究组给予联合“五穴四针”针刺法治疗，对比两组患者临床疗效、疼痛程度、膝关节功能、血清生长修复因子水平。结果   治疗后，与对照组总有效率74.60%相比，研究组总有效率88.89%更高，差异有统计学意义(P<0.05)；两组患者西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分水平、疼痛视觉模拟评分(VAS)水平均降低(P<0.05)，研究组VAS评分、WOMAC评分低于对照组(P<0.05)；研究组Lysholm评分水平、膝关节活动度较对照组患者高(P<0.05)；研究组患者血清胰岛素样生长因子1(IGF-1)、成纤维细胞生长因子2(FGF-2)水平升高幅度大于对照组患者，研究组转化生长因子β(TGF-β)高于治疗前(P<0.05)；对照组治疗前后TGF-β、治疗后两组患者间TGF-β水平相比，差异无统计学意义(P>0.05)；并发症发生率两组差异无统计学意义(P>0.05)。结论   常规康复治疗联合“五穴四针”针刺法能有效减轻患者疼痛，改善膝关节功能，提高临床疗效，且不增加不良反应发生风险，其修复关节组织的机制可能与改善血清IGF-1、FGF-2及TGF-β等修复生长因子水平有关。

Objective   To investigate the effect of "Five acupoints and four needles" acupuncture treatment on patients with knee osteoarthritis and its influence on the level of serum growth repair factor.Methods   A total of 126 patients with knee osteoarthritis from the Department of Orthopedics of the Second TCM Hospital of Kaifeng City from June 2022 to December 2023 were selected as the research objects,and were divided into two groups according to random number table,with 63 cases in each group.The control group was given comprehensive rehabilitation treatment,and the study group was given combined "Five points and four needles" acupuncture treatment.The clinical efficacy,pain degree,knee joint function and serum growth repair factor levels of the two groups were compared.Results   After treatment,the clinical efficacy of the study group was 88.89%,higher than that of the control group

74.60%,and the difference was statistically significant(P<0.05).The score levels of Western Ontario and McMaster University osteoarthritis index(WOMAC) and visual analogue scale(VAS) were decreased in both groups(P<0.05),and the VAS and WOMAC scores in the study group were lower than those in the control group(P<0.05).The Lysholm score and knee motion range of the study group were higher than those of the control group(P<0.05).The level rising amplitude of serum insulin-like growth factor 1(IGF-1) and fibroblast growth factor 2(FGF-2) in the study group were higher than those in the control group,and transforming growth factor β(TGF-β) in the study group was higher than before treatment(P<0.05).There was no difference of statistical significance in TGF-β level in the control group before and after treatment,and in the two groups after treatment(P>0.05).There was no difference of statistical significance in complication rate between the two groups(P>0.05).Conclusion   Conventional rehabilitation therapy combined with Five acupoints and four needles" acupuncture can effectively reduce the pain of patients,improve the function of the knee joint,improve clinical efficacy,and do not increase the risk of adverse reactions.The mechanism of joint tissue repair may be related to the improvement of serum IGF-1,FGF-2 and TGF-β levels of repair growth factors.