云克联合筋骨痛消丸治疗膝骨关节炎的临床研究  

Clinical study on the curative effects and safety of Technetium-99 methylene diphosphonate injection combined with JINGU TONGXIAO pill in the treatment of knee osteoarthritis

作　　者：郭会利[1] 王军辉[1] 郭树农[1] 刘玉珂[1] 张斌青[1] 张敏[1] 郭艳幸[1] 

机构地区：[1]河南省洛阳正骨医院,河南洛阳471002

出　　处：《中医正骨》2013年第6期24-28,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：河南省中医管理局中医临床研究专项课题

摘　　要：目的:观察云克联合筋骨痛消丸治疗膝骨关节炎的临床疗效和安全性。方法:将纳入研究的180例膝骨关节炎患者随机分为云克治疗组、中药治疗组和联合治疗组,每组60例。云克治疗组患者静脉滴注云克注射液,中药治疗组患者口服筋骨痛消丸,联合治疗组患者静脉滴注云克注射液联合口服筋骨痛消丸,均连续治疗30 d。治疗结束后根据自拟影像学评价标准、潘中允制定的膝骨关节炎症状体征评分标准和安全性评价标准评定3种治疗方法的临床疗效和安全性。结果:①影像学评价结果。膝关节单光子发射型计算机断层成像-计算机体层摄影融合图像显示,云克治疗组和中药治疗组治疗后放射性核素浓聚范围和程度较治疗前轻度缩小,联合治疗组治疗后放射性核素浓聚范围和程度较治疗前均显著缩小。云克治疗组显效45例,有效10例,无效5例;中药治疗组显效28例,有效20例,无效12例;联合治疗组显效52例,有效6例,无效2例。3组患者影像学评价结果比较,差异有统计学意义(χ2=24.098,P=0.000);进一步两两比较(校正α'=0.017),联合治疗组优于中药治疗组(u=1 064.000,P=0.000);云克治疗组分别与中药治疗组和联合治疗组比较,差异均无统计学意义(u=1 180.000,P=0.021;u=1 585.000,P=0.100)。②症状体征评分结果。云克治疗组显效40例,有效15例,无效5例;中药治疗组显效29例,有效20例,无效11例;联合治疗组显效50例,有效7例,无效3例。3组患者治疗后症状体征评分比较,差异有统计学意义(χ2=16.536,P=0.000);进一步两两比较(校正α'=0.017),联合治疗组优于中药治疗组(u=1 145.000,P=0.011);云克治疗组分别与中药治疗组和联合治疗组比较,差异均无统计学意义(u=1 437.500,P=0.032;u=1 505.000,P=0.041)。③安全性评价结果。云克治疗组Ⅰ级45例,Ⅱ级13例,Ⅲ级2例;中药治疗组Ⅰ级51例,Ⅱ级8例,Ⅲ级1例;联合治疗组Ⅰ级44例,Ⅱ级14例,�Objective：To observe the clinical curative effects and safety of Technetium-99 （99Tc）methylene diphosphonate injection combined with JINGU TONGXIAO pill in the treatment of knee osteoarthritis （KOA）. Methods：One hundred and eighty patients with KOA enrolled in the study were randomly divided into YunKe treatment group, Chinese medicine treatment group and combined treatment group, 60 cases in each group. Patients in YunKe treatment group were administrated with intravenous drip of Technetium （99Tc） methylene diphosphonate injection,cases in Chinese medicine treatment group were administrated with oral application of JINGU TONGXIAO pill, while the rest in the combined treatment group were administrated with intravenous drip of Teehnetium（99Te）methylene diphosphonate in- jection combined with oral application of JINGU TONGXIAO pill, and they were all consecutively treated for 30 days. After the treatment, the clinical curative effects and safety of the 3 kinds of treatment methods were respectively evaluated according to self-designed imaging evaluation criterion, scoring scale of signs and symptoms for KOA and safety assessment standards designed by Pan Zhong-yun. Results ： The knee image of single photon emission computed tomography （SPECT） fusion with computed tomography, （CT） image showed that the range and degree of posttreatment radionuclide concentration for YunKe treatment group and Chinese medicine treatment group were all slightly decreased compared with those before the treatment, while they were decreased much more obviously in the combined treatment group. Forty-five patients achieved an excellent result, 10 good and 5 poor in YunKe treatment group ;28 cases achieved an excellent result,20 good and 12 poor in Chinese medicine treatment group;and 52 cases achieved an excellent resuh,6 good and 2 poor in combined treat- ment group. There was statistical difference in imaging evaluation results among the 3 groups （X2 = 24. 098, P = 0. 000 ）. Further multiple comparison �

关 键 词：骨关节炎 膝 锝 亚甲基二膦酸盐 筋骨痛消丸 单光子发射型计算机断层成像 体层摄影术 X线计算机 图像融合治疗 临床研究性 

分 类 号：R274[医药卫生—中医骨伤科学]