独活寄生汤联合玻璃酸钠注射治疗膝痹病35例  

Duhuo Jisheng decoction Combined with Sodium Hyaluronate in the Treatment of Knee Osteoarthritis 35 cases

作　　者：倪强[1] 刘尚仑[1] 刘平[1] 

机构地区：[1]江苏省淮安市中医院骨伤科,淮安223001

出　　处：《光明中医》2017年第17期2547-2550,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

摘　　要：目的探讨独活寄生汤联合玻璃酸钠注射治疗膝痹病(膝关节骨性关节炎)的临床效果。方法选取2014年1月—2016年7月我科治疗的70例膝关节骨性关节炎患者作为研究对象,按照随机数字表法分为治疗组(35例)和对照组(35例),对照组采用关节腔注射玻璃酸钠治疗,治疗组在对照组的基础上联合独活寄生汤治疗,两组均连续治疗1个月。比较两组临床治疗效果,采用视觉模拟评分法(VAS)和膝关节评分表(KSS)评价并比较治疗前后两组患者疼痛感和膝关节功能;检测并比较两组治疗前后血清和关节液中相关指标水平的变化。结果治疗组临床治疗总有效率为91.43%,显著高于对照组的71.43%(P<0.05);与治疗前比较,治疗后两组VAS评分显著降低,KSS评分显著升高(P<0.01),两组间差异显著(P<0.05或P<0.01);治疗后两组肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制剂-1(TIMP-1)、一氧化氮(NO)水平均较治疗前显著降低,超氧化物歧化酶(SOD)水平较治疗前显著升高(P<0.05或P<0.01),且两组间差异显著(P<0.05或P<0.01)。结论独活寄生汤联合关节腔注射玻璃酸钠能改善膝关节骨性关节炎患软骨代谢平衡,消除炎症反应,起到保护膝关节软骨的作用,同时能缓解患者疼痛,改善患者膝关节功能,疗效显著。Objective To explore the clinical effect of Duhuo Jisheng decoction combined with sodium hyaluronate in the treatment of knee osteoarthritis. Methods 70 cases of patients with knee osteoarthritis in our department were selected from January 2014 to July 2016 as the research object,and they were randomly divided into the treatment group（ n = 35） and the control group（ n = 35）. The control group was treated with sodium hyaluronate,and the treatment group was treated with Duhuo Jisheng decoction on based on the control group. Two groups were treated for one month. Clinical therapeutic effect of the 2 groups was compared,the visual analogue scale（ VAS） and knee score（ KSS） were used to evaluate and compare pain and knee joint function of two groups before and after treatment,the levels of serum and synovial fluid of 2 groups before and after treatment were measured and compared. Results The total effective rate of the treatment was91. 43% which was significantly higher than 71. 43% of the control group（ P〈0. 05）. Compared with before treatment,VAS scores of the two groups after treatment decreased significantly,KSS scores of the two groups increased significantly（ P〈0. 01）,and the difference between two groups was significant（ P〈0. 05 or P〈0. 01）. The levels of tumor necrosis factor-α（ TNF-α）,matrix metalloproteinase-3（ MMP-3）,matrix metalloproteinase inhibitor-1（ TIMP-1）,nitric oxide（ NO） of the two groups after treatment were significantly lower than those before treatment,the levels of superoxide dismutase（ SOD） of the two groups were significantly higher than those before treatment（ P〈0. 05 or P〈0. 01）,and the difference between the two groups was significant（ P〈0. 05 or P〈0. 01）. Conclusion Duhuo Jisheng decoction combined with sodium hyaluronate in the treatment of knee osteoarthritis can improve the balance of cartilage metabolism,eliminate the inflammatory response,protect the knee cartilage,alleviate the pain of patients,improve the fu

关 键 词：骨痹 膝痹病 膝关节骨性关节炎 中西医结合疗法 独活寄生汤 膝关节功能 

分 类 号：R684.3[医药卫生—骨科学]