目的 探讨热刺激对膝关节骨性关节炎患者疼痛介质及软骨代谢的影响。方法 选取2022年2月—2025年2月福州市中医院骨科收治的80例膝关节骨性关节炎患者作为研究对象,通过随机数表法分为对照组（依托考昔片与玻璃酸钠治疗）和观察组（加用红外线治疗仪治疗）,每组各40例。比较治疗前后两组患者在骨代谢及软骨修复因子、疼痛介质水平的差异。结果 治疗后,与对照组相比,观察组的骨特异性碱性磷酸酶（BALP）、骨钙素（BGP）、转化生长因子β（TGF-β）与纤维细胞生长因子2（FGF-2）更高,抗酒石酸盐酸性磷酸酶异构体（TRACP-5b）更低（P<0.05）。经过治疗后,观察组患者的疼痛介质水平显著下降,包括P物质（SP）、缓激肽（BK）和前列腺素E2（PGE2）等指标,均低于对照组（P<0.05）。结论 热刺激能够有效改善膝关节骨性关节炎患者的骨代谢及软骨修复因子水平,同时显著降低疼痛介质水平。该治疗方案具有较好的镇痛和软骨保护效果,值得在临床上推广应用。

Objective To investigate the effects of thermal stimulation on pain mediators and cartilage metabolism in patients with knee osteoarthritis. Methods A total of 80 patients with knee osteoarthritis admitted to the Department of Orthopedics, Fuzhou Traditional Chinese Medicine Hospital from February 2022 to February 2025 were selected as study subjects. The patients were randomly divided using a random number table into a control group （treated with etoricoxib tablets and sodium hyaluronate） and an observation group （additionally treated with an infrared therapy device）, with 40 patients in each group. The differences in bone metabolism and cartilage repair factors, and pain mediator levels between the two groups before and after treatment were compared. Results After treatment, compared with the control group, the observation group had higher levels of bone alkaline phosphatase （BALP）, bone glutamyl protein （BGP）, transforming growth factor-β （TGF-β）, and fibroblast growth factor-2 （FGF-2）, and lower levels of tartrate-resistant acid phosphatase-5b （TRACP-5b） （P<0.05）. After treatment, the levels of pain mediators in the observation group significantly decreased, including substance P （SP）, bradykinin （BK）, and prostaglandin E2 （PGE2） compared with the control group （P<0.05）. Conclusion Thermal stimulation can effectively improve bone metabolism and cartilage repair factor levels in patients with knee osteoarthritis, while significantly reducing pain mediator levels. This treatment plan has good analgesic and cartilage protective effects, and is worth promoting and applying in clinical practice.