通痹胶囊联合针刺治疗膝骨关节炎  

The clinical study of Tongbi capsule combined with acupuncture in the treatment of knee osteoarthritis

作　　者：王晓磊[1] 武晔[2] 姜淑华[1] 平利峰[1] 胡丽伟[1] 孙凤艳[1] 孙志娟 Wang Xiaolei;Wu Ye;Jiang Shuhua;Ping Lifeng;Hu Liwei;Sun Fengyan;Sun Zhijuan(Department of Second Rheumatism,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou 061000,China;Department of Orthopaedic,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院风湿二科,061000 [2]河北省沧州中西医结合医院骨九科,061000

出　　处：《国际中医中药杂志》2019年第2期141-145,共5页International Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局基金(2017137).

摘　　要：目的 评价通痹胶囊联合针刺治疗膝骨关节炎(knee osteoarthritis, KOA)的疗效。方法 将符合入选标准的88例KOA患者按随机数字表法分为2组,每组44例。对照组口服塞莱昔布胶囊,研究组口服通痹胶囊联合针刺治疗。2组均治疗2个月。采用西安大略和麦克马斯特大学骨关节炎指数量表(Western Ontario and McMaster Universities, WOMAC)评价症状严重程度,采用关节压痛指数评价疼痛程度,采用晨僵评分评价关节活动度;采用中医证候评分评价临床疗效;采用ELISA法测定血清TNF-α、IL-1β及IL-6水平;采用全自动生化分析仪检测全血高切黏度、全血低切黏度、全血黏度、ESR、纤维蛋白原及红细胞变形指数,评价临床疗效。结果 研究组总有效率为93.2%(41/44)、对照组为72.7%(32/44),2组比较差异有统计学意义(χ^2=6.510,P=0.011)。治疗后,研究组WOMAC评分[(31.3±6.1)分比(36.2±7.1)分,t=-3.477]、关节压痛指数[(1.8±0.5)分比(2.1±0.5)分,t=-3.366]及晨僵评分[(1.6±0.5)分比(2.1±0.5)分,t=-4.690]均低于对照组(P<0.01);血清TNF-α[(7.36±1.45)pg/ml比(8.02±1.54)pg/ml,t=-2.070]、IL-1β[(27.82±5.22)μg/ml比(33.05±5.17)μg/ml,t=-4.722]及IL-6[(2.81±0.58)ng/ml比(3.34±0.53)ng/ml,t=-4.475]水平均低于对照组(P<0.05或P<0.01);全血高切黏度[(12.09±3.46)mPa·s比(14.22±3.51)mPa·s,t=-2.867]、全血低切黏度[(2.53±0.68)mPa·s比(3.32±0.71)mPa·s,t=-5.330]、全血黏度[(1.35±0.29)mPa·s比(1.60±0.41)mPa·s,t=-3.302]、ESR[(7.10±2.06)mm/h比(8.02±2.13)mm/h,t=-2.059]、纤维蛋白原[(2.71±0.53)g/L比(3.42±0.65)g/L,t=-5.615]及红细胞变形指数[(0.57±0.16)比(0.71±0.19),t=-3.739]均低于对照组(P<0.05或P<0.01)。结论 通痹胶囊联合针刺可改善膝骨关节炎患者的血液流变学指标,降低炎症反应程度。Objective To explore the clinical effect of Tongbi capsule combined with acupuncture for the patients with knee osteoarthritis and explore the mechanism of inflammatory response and hemorrheology. Methods According to the random table method, 88 KOA patients in our hospital from February 2016 to January 2017 were divided into the control group and the research group with 44 in each group. Patients in the control group were treated bycelecoxib capsule, while the patients in the research group were treated by Tongbi capsule combined with acupuncture. The treatment courses of two groups were two months. The clinical total effective rate of two groups of patients were compared after treatment. At the same time, the osteoarthritis index visual scale (WOMAC) and morning stiffness, joint tenderness index score were detected and compared after the treatment.The levels of serum tumor necrosis factor-α(TNF-α), interleukin (IL)-1β and IL-6 were detected by enzyme linked immunosorbent assay before and after the treatment. The hemorheology indexes were tested by automatic biochemical analyzer. In addition, the incidence of adverse reactions of two groups of patients was observed during treatment. Results The clinical total effective rate of the research group was 93.18% (41/44), which was significantly higher than the control group72.73% (32/44), and the difference was statistically significant (χ2=6.510, P=0.011). After treatment, the WOMAC (31.26 ± 6.12 vs. 36.17 ± 7.09, t=-3.477), joint tenderness index (1.75 ± 0.46 vs. 2.11 ± 0.54, t=-3.366) and morning stiffness score (1.62 ± 0.53 vs. 2.14 ± 0.51, t=-4.690) of the research group were significantly lower than those of the control group (P<0.05). The levels of TNF-α (7.36 ± 1.45 pg/ml vs. 8.02 ± 1.54 pg/ml, t=-2.070), IL-1β (27.82 ± 5.22 μg/ml vs. 33.05 ± 5.17 μg/ml, t=-4.722), IL-6 (2.81 ± 0.58 ng/ml vs. 3.34 ± 0.53 ng/ml, t=-4.475) of the research group were significantly lower than those of the control group (P<0.05). The whole blood high shear visco

关 键 词：骨关节炎 膝 针刺疗法 通痹胶囊 肿瘤坏死因子-Α 白细胞介素 血液流变学 

分 类 号：R274.9[医药卫生—中西医结合]