行湿汤与温针灸结合西医常规疗法治疗急性期膝关节炎临床研究  

Clinical effect of oral Xingshi decoction combined with warming needle moxibustion in treating acute knee osteoarthritis

作　　者：许挺[1] 谷婷婷[2] 李婷[3] 卢明峰 Xu Ting;Gu Tingting;Li Ting;Lu Mingfeng(Department of Orthopedics,the Hospital of Traditional Chinese Medicine in Foshan City,Foshan 528000,China;Department of Acupuncture,the Hospital of Traditional Chinese Medicine in Foshan City,Foshan 528000,China;Department of Internal Medicine,the Hospital of Traditional Chinese Medicine in Foshan City,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院骨15科(运动医学科),528000 [2]广东省佛山市中医院针灸科,528000 [3]广东省佛山市中医院内三科,528000

出　　处：《国际中医中药杂志》2019年第5期467-471,共5页International Journal of Traditional Chinese Medicine

基　　金：佛山市卫生和计生局医学科研课题(20170068).

摘　　要：目的评价行湿汤与温针灸结合西医常规疗法治疗急性期膝关节炎的疗效。方法将符合入选标准的86例急性期膝关节炎患者采用随机数字表法分为2组,每组43例。对照组口服双氯芬酸胶囊并每周服用1次甲氨蝶呤,观察组在对照组基础上联合口服中药及温针灸。2组均治疗2周。采用ELISA法检测类风湿因子(rheumatoid factor, RF)、超敏C反应蛋白(high sensitive C reactive protein, hs-CRP)及IL-1β;采用McGill疼痛问卷简表(Short-form McGill Pain Questionnaire, SF-MPQ)从疼痛分级指数(pain rating index, PRI)、VAS、疼痛强度(present pain intensity, PPI)方面评价关节疼痛程度;采用本院自制的膝关节功能评分量表评估膝关节功能;依据28个关节疾病活动度-血沉评分结果评价疗效。结果观察组总有效率为88.4%(38/43)、对照组为62.8%(27/43),2组比较差异有统计学意义(Z=2.678,P=0.007)。治疗后,观察组ESR[(30.95±3.14)mm/h比(55.13±3.28)mm/h,t=34.919]、RF[(81.36±5.13)U/ml比(121.73±7.25)U/ml,t=29.807]、hs-CRP[(10.13±3.12)mg/L比(34.26±3.17)mg/L,t=35.575]、IL-1β[(58.13±3.12)pg/ml比(96.76±3.17)pg/ml,t=56.952]低于对照组(P<0.01);观察组SF-MPQ中PRI、VAS、PPI评分均低于对照组(t值分别为19.661、11.056、23.524,P值均<0.01);膝关节功能评分量表中步行、肿胀、稳定感、绞锁、上下楼梯评分均高于对照组(t值分别为11.071、13.464、9.102、9.804、10.012,P值均<0.01)。结论口服行湿汤联合温针灸可有效改善急性期膝关节炎患者的膝关节功能,减轻膝关节疼痛,降低患者炎性细胞因子水平,提高临床疗效。Objective To evaluate the effect of Xingshi decoction combined with warming needle moxibustion combined with conventional western medicine on acute knee arthritis.Methods A total of 86 patients with acute knee arthritis were randomly divided into two groups,43 in each group.The control group took diclofenac capsules orally and methotrexate once a week,while the observation group took Xingshi decoction and warming needle moxibustion on the basis of the control group.Both groups were treated for 2 weeks.The Rheumatoid factor (RF),high sensitive C reactive protein (hs-CRP) and IL-1β were detected by ELISA,and pain rating index (PRI),VAS and present pain intensity (PPI) were evaluated by McGill pain questionnaire (SF-MPQ).The knee function was assessed by the evaluation scale,and the curative effect was evaluated by 28 joint disease activity-erythrocyte sedimentation rate (ESR) scores.Results The total effective rate was 88.4%(38/43) in the observation group and 62.8%(27/43) in the control group.There was significant difference between the two groups (Z=2.678,P=0.007).After treatment,ESR (30.95 ± 3.14 mm/h vs.55.13 ± 3.28 mm/h,t=34.919),RF (81.36 ± 5.13 U/ml vs.121.73 ± 7.25 U/ml,t=29.807),hs-CRP (10.13 ± 3.12 mg/L vs.34.26 ± 3.17 mg/L,t=35.575),IL-1β(58.13 ± 3.12 pg/ml vs.96.76 ± 3.17 pg/ml,t=56.952) of the observation group were significantly lower than those of control group (P<0.01);and PRI,VAS and PPI scores of SF-MPQ in observation group were significantly lower than those of control group (t values were 19.661,11.056 and 23.524,respectively,P<0.01) and the scores of walking,swelling,sense of stability,strangulation and stair-climbing were significantly higher than those of the control group (t values were 11.071,13.464,9.102,9.804,10.012,respectively,P<0.01).Conclusions The Xingshi decoction combined with warming needle moxibustion is effective in treating acute knee arthritis.It can effectively relieve pain and inflammation of patients,thus improving knee joint function.It has certain clinical appli

关 键 词：关节炎 急性疼痛 行湿汤 针刺穴位 温针疗法 湿敷疗法 疗效比较研究 

分 类 号：R684.3[医药卫生—骨科学]