中药内服外用联合玻璃酸钠治疗中重度膝骨关节炎临床观察  

Clinical Observation on the Treatment of Medium-severe Knee Osteoarthritis by External and Internal Application of Chinese Medicine Combined with Sodium Hyaluronate

作　　者：李慧英[1] 于建伟[1] 汪利合[1] 

机构地区：[1]河南中医学院第一附属医院,河南郑州450000

出　　处：《风湿病与关节炎》2015年第12期13-15,19,共4页Rheumatism and Arthritis

基　　金：河南省科技攻关课题(122102310186);河南省中医药科学研究专项课题(2013ZY03015)

摘　　要：目的:观察中药内服外用联合玻璃酸钠治疗中重度膝骨关节炎的临床疗效。方法:将60例中重度膝骨关节炎患者随机分为对照组和治疗组,每组30例。治疗组辨证给予口服独活寄生汤加减,外敷双黄散,关节腔内注射玻璃酸钠;对照组给予口服双醋瑞因胶囊,外用吡罗昔康贴片,关节腔内注射玻璃酸钠。3周为1个疗程。观察两组患者临床疗效,治疗前后膝关节视觉模拟评分法(VAS)评分及西安大略和麦克马斯特大学骨关节炎调查表(WOMAC)评分。结果:治疗组临床治愈3例,显效8例,有效15例,无效4例,总有效率为86.67%;对照组临床治愈3例,显效7例,有效14例,无效6例,总有效率为80.00%。两组比较,差异无统计学意义(P>0.05)。治疗后,两组膝关节VAS评分、WOMAC评分较治疗前均有显著改善(P<0.05),且治疗组优于对照组(P<0.05)。结论:中药内服外用联合玻璃酸钠治疗中重度膝骨关节炎,在改善患者临床症状、减轻关节疼痛、改善关节功能方面疗效确切,值得临床推广。Objective：To observe the clinical effect of external and internal application of Chinese medicine combined with sodium hyaluronate in the treatment of medium-severe knee osteoarthritis.Methods：60 cases of medium-severe knee osteoarthritis were randomly divided into a control group and a treatment group,30 cases in each.The treatment group was orally given modified Duhuo Jisheng Tang（独活寄生汤）,externally applied Shuanghuang San（双黄散）and given intra-articular injections of sodium hyaluronate.While the the control group was orally given diacerein capsules,externally applied piroxicam patches and given intra-articular injections of sodium hyaluronate.The treatment course was 3 weeks.The clinical effects,VAS scores and WOMAC scores of the two groups before and after treatment were observed.Results：In the treatment group,3 cases were cured,8 cases were markedly effective,4 cases were effective,and 15 cases were ineffective,the total effective rate being 86.67%;while in the control group,3 cases were cured,7 cases were markedly effective,6 cases were effective,and 14 cases were ineffective,the total effective rate being 80%.There was no significant difference between the two groups（P 〉 0.05）.After treatment,the VAS scores and WOMAC scores of the two groups were significantly improved（P 〈 0.05）,and the treatment group was better than the control group（P 〈 0.05）.Conclusion：External and internal application of Chinese medicine combined with sodium hyaluronate has a certain curative effect in the treatment of medium-severe knee osteoarthritis on the aspects of improving clinical symptoms,relieving joint pain,and improving joint function,worthy of clinical promotion.

关 键 词：骨关节炎 膝 独活寄生汤 双黄散 内服外用 玻璃酸钠 

分 类 号：R684.3[医药卫生—骨科学]