基于关节超声评价独活寄生汤治疗肝肾亏虚型膝关节骨性关节炎临床疗效  

Efficacy Evaluation of Duhuo Jisheng Decoction in Treating Knee Osteoarthritis with Liver and Kidney Deficiency Syndrome by Ultrasound

作　　者：周小莉[1] 邵勤[1] 张莹[1] 肖芳[1] 

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中国中医药信息杂志》2015年第1期18-21,共4页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：重庆市自然科学基金计划(cstc2011jj A10108);重庆市卫生局中医药科技重点项目(ZY20131024)

摘　　要：目的基于关节超声评价独活寄生汤治疗肝肾亏虚型膝关节骨性关节炎(KOA)的近期临床疗效。方法将120例肝肾亏虚型KOA患者随机分为2组,每组60例。对照组予盐酸氨基葡萄糖胶囊口服,治疗组在对照组治疗基础上加用独活寄生汤,均治疗8周。观察2组KOA患者治疗前后红细胞沉降率(ESR)、C反应蛋白(CRP)、WOMAC评分、关节肿胀积分、中医证候评分变化,采用高频关节超声监测2组患者治疗前后膝关节髌上囊积液、滑膜厚度、软骨及骨质破坏、滑膜血流信号声像图的变化特征。结果治疗组在改善WOMAC评分、关节肿胀积分、中医证候评分等方面较对照组有明显优势,差异有统计学意义(P<0.05,P<0.01);治疗后患者关节腔积液减少,膝关节滑膜厚度变薄,关节滑膜血流信号减少(P<0.05,P<0.01)。结论独活寄生汤治疗肝肾亏虚型KOA临床效果显著。超声可以清晰地观察KOA患者关节腔积液、滑膜厚度、滑膜血流信号等改变,为临床药物治疗KOA提供较好的影像学评价依据。Objective To evaluate the clinical efficacy of Duhuo Jisheng Decoction in treating liver and kidney deficiency syndrome of knee osteoarthritis （KOA） by ultrasound. Methods A total of 120 cases of KOA patients with liver and kidney deficiency syndrome were randomly divided into two groups （each contains 60 cases）. Control group took hydrochloric acid glucosamine capsules, while treatment group took Duhuo Jisheng Decoction additionally for 8 weeks. ESR, CRP, WOMAC, joint swelling scores, and TCM syndrome scores of the two groups were determined, and the sonographic characteristics of knee-joint effusion in patellar fabricius, synovial membrane, cartilage and bone erosions were compared before and after treatment. Results There were significant differences in ESR, CRP, WOMAC, joint swelling scores, and TCM syndrome scores between before and after treatment in both groups （P〈0.05, P〈0.01）. The knee-joint synovial membrane got thinner after therapy in osteoarthritis patients, and the effusion in knee-joint also decreased. The vessel flow signals in knee-joint synovial membrane of osteoarthritis decreased after drug therapy （P〈0.05, P〈0.01）. Conclusion Duhuo Jisheng Decoction can improve clinical efficacy of KOA with liver and kidney deficiency syndrome. Ultrasound can clearly observe the changes of effusion in patellar fabricius, and synovial membrane, and can provide good imaging assessment for the drug therapy for KOA patients.

关 键 词：独活寄生汤 膝关节骨性关节炎 肝肾亏虚 超声 

分 类 号：R272.968.4[医药卫生—中医儿科学]