独活寄生汤治疗肝肾亏虚型膝骨关节炎的临床效果观察  

Clinical observation of Duhuo Jisheng decoction in treatment of knee osteoarthritis with deficiency of liver and kidney

作　　者：曹洪[1] 邹海兵[1] 张磊[1] 张军[1] 

机构地区：[1]湖北医药学院附属人民医院骨关节外科,湖北省十堰市442000

出　　处：《中国医药》2017年第3期392-395,共4页China Medicine

基　　金：湖北省卫生和计划生育委员会科研立项项目（WJ2015Q042）;湖北医药学院省级大学生创新创业训练计划（201410929018）

摘　　要：目的观察独活寄生汤治疗肝肾亏虚型膝骨关节炎（KOA）的临床效果。方法选取2013年11月至2015年11月湖北医药学院附属人民医院骨关节外科收治的KOA患者42例，采用简单随机分组方法将患者分为对照组（20例）和观察组（22例）；对照组口服盐酸氨基葡萄糖胶囊（0．75g／次，2次／d）；观察组服用独活寄生汤（1剂／d，分早晚2次服）并取药渣再次煎煮熏洗患膝；2组均持续治疗12周。于治疗前后采用美国西部Ontario和McMaster大学骨关节炎指数（WOMAC）和疼痛视觉模拟量表（VAS）进行疗效评价。于治疗前后穿刺抽取膝关节液2ml，采用放射免疫法测定白细胞介素1（IL-1）含量。结果治疗前2组WOMAC评分、VAS评分、关节液IL-1含量比较差异无统计学意义（均P〉0．05）。治疗后2组WOMAC评分、VAS评分、关节液中IL-1含量均较治疗前明显下降[对照组：（34±7）分比（42±9）分、（2．1±1．3）分比（4．2±1．7）分、（386±40）ng／L比（472±47）ng／L，观察组：（26±7）分比（42±9）分、（1．7±1．1）分比（4．1±1．9）分、（316±31）ng／L比（469±48）ng／L]，且观察组明显低于对照组，差异均有统计学意义（均P〈0．05）。结论独活寄生汤治疗肝肾亏虚型KOA效果较好，可有效改善患者症状并降低关节液中IL-1的含量。Objective To analyze the clinical effect of Duhuo Jisheng decoction on knee osteoarthritis （KOA） with deficiency of liver and kidney. Methods A total of 42 patients with KOA from November 2013 to November 2015 in Renmin Hospital, Hubei University of Medicine were randomly divided into control group （n = 20） and observation group（n = 22）. The control group took glucosamine hydrochloride capsule 0. 75 g/time, 2 times/d; the observation group had Duhuo Jisheng decoction for oral medication （1 dose/d, twice a day in morning and evening ） and fumigation. Therapeutic effect was evaluated by Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） and Visual Analogue Scale （VAS） after 12 weeks of treatment. The content of interleukin-1 （ IL-1 ） in knee synovial fluid was determined by radioimmunoassay. Results WOMAC score, VAS score and IL-1 level had no significant differences between groups before treatment （P 〉 0. 05）. WOMAC score, VAS score and IL-1 level were significantly decreased after treatment in both groups [ control group ： （34 ± 7） scores vs （42 ± 9） scores, （2. 1 ± 1.3 ） scores vs （4. 2 ± 1.7） scores, （386 ± 40） ng/L vs （472 ± 47 ） ng/L ; observation group ： （ 26 ± 7 ） scores vs （42 ± 9 ） scores, （ 1.7 ± 1.1 ） scores vs （4. 1 ± 1.9 ） scores, （316 ±31）ng/L vs （469 ±48）ng/L] （P 〈0. 05）. WOMAC score, VAS score and IL-1 level after treatment in observation group were significantly lower than those in control group （ P 〈 0. 05 ）. Conclusion Duhuo Jisheng decoction has good curative effect on knee osteoarthritis with deficiency of liver and kidney; it can alleviate symptoms and reduce level of IL-1 in synovial fluid.

关 键 词：骨关节炎 膝 独活寄生汤 白细胞介素1 

分 类 号：R684.3[医药卫生—骨科学]