驳骨活血方联合盐酸氨基葡萄糖片治疗膝骨性关节炎临床48例临床分析  

Clinical Analysis on Bogu Huoxue Decoction Combined with Glucosamine Hydrochloride Tablets in Treating 48 Cases with Knee Osteoarthritis

作　　者：刘洪波[1] 靖春颖[1] 韩平[2] 

机构地区：[1]海南医学院中医学院,海口571199 [2]海南医学院附属医院,海口570102

出　　处：《中国实验方剂学杂志》2015年第15期164-167,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：海南省卫生厅科研专项课题(琼卫2011-37)

摘　　要：目的:观察驳骨活血方联合盐酸氨基葡萄糖片治疗膝骨性关节炎(KOA)的临床疗效及对关节液白细胞介素-1β(interleukin-1β,IL-1β),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),基质金属蛋白酶-3(matrix metalloproteinases-3,MMP-3),基质金属蛋白酶抑制剂-1(matrix metalloproteinase inhibitors-1,TIMP-1)水平的影响。方法:采用随机按就诊前后顺序将96例KOA患者分为对照组和观察组各48例。对照组口服盐酸氨基葡萄糖片,480 mg/次,3次/d,观察组在对照组治疗的基础上内服驳骨活血方,1剂/d。两组疗程均为6周。记录治疗前后视觉模拟评分法(VAS)疼痛评分和西部安大略麦克马斯特大学骨关节炎指数可视化量表(WOMAC)评分,检测治疗前后患者IL-1β,TNF-α,MMP-3,TIMP-1水平。结果:观察组愈显率为72.92%,高于对照组的39.58%(P<0.05);治疗后第3,6周,两组VAS评分均比治疗前下降(P<0.01);治疗后第3,6周,观察组VAS评分明显低于对照组(P<0.01);治疗后观察组日常活动积分、疼痛积分、关节僵硬积分和总积分均低于对照组(P<0.01);治疗后观察组关节液中TNF-α,IL-1β和MMP-3水平明显低于对照组(P<0.01),TIMP-1水平高于对照组(P<0.01)。结论:驳骨活血方联合盐酸氨基葡萄糖片可明显改善KOA患者术后的关节疼痛、关节僵硬及日常活动,临床疗效优于盐酸氨基葡萄糖片,其作用机制可能与其抑制患者关节液中IL-1β,TNF-α,MMP-3水平和升高TIMP-1水平有关。Objective： To observe the clinical efficacy of Bogu Huoxue decoction combined with glucosamine hydrochloride tablets in treating knee osteoarthritis（ KOA） and its influence on interleukin-1β（ IL-1β）,tumor necrosis factor-α（ TNF-α）,matrix metalloproteinases-3（ MMP-3）,matrix metalloproteinase inhibitors-1（ TIMP-1）. Method： Totally 96 patients with KOA were randomly divided into the control group and the observation group,with 48 patients in each group. The control group was orally administered with glucosamine hydrochloride tablets（ 480 mg / time,tid）. Based on the therapy of the control group,the observation group was additionally given Bogu Huoxue decoction（ 1 dose / d）. Both groups were treated for six weeks. The visual analogue scale（ VAS） score and Western Ontario and Mc Master Universities Osteoarthritis Index（ WOMAC） score were recorded before and after the treatment. The levels of IL-1β, TNF-α,MMP-3, TIMP-1 of the patients were detected before and after the treatment. Result： The obvious curative rate was 72. 92% in the observation group,which was higher than 39. 58% of the control group（ P 〈 0. 05）. The VAS scores in both groups were lower than before the treatment（ P 〈 0. 01）. The VAS score in the observation group was obviously lower than that of the control group at the 3rdand 6thweek after the treatment（ P 〈 0. 01）. The score for daily activities,pain score,joint stiffness score and total integral of the observation group were lower than that of the control group（ P 〈 0. 01）. The TNF-α,IL-1β,MMP-3 in the synovial fluid in the observation group were lower than that in the control group（ P 〈 0. 01）,but with the level of TIMP-1 higher than the control group（ P 〈 0. 01）. Conclusion： Bogu Huoxue decoction combined with glucosamine hydrochloride tablets in the treatment of KOA can significantly relieve postoperative arthralgia and ankylosis and improve daily movement,with superior clinical efficiency to glucosamine hydroc

关 键 词：驳骨活血方 膝骨性关节炎 白细胞介素-1Β 肿瘤坏死因子-α 基质金属蛋白酶-3 基质金属蛋白酶抑制剂-1 

分 类 号：R287[医药卫生—中药学]