长安郭氏骨伤学术流派经典方三花膏治疗急性期膝关节滑膜炎临床研究  

Clinical study on the treatment of acute knee joint synovitis with Sanhua ointment of classic prescription of Guo’s academic school of bone trauma in Chang’an

作　　者：王秋霞 史传道[1] 郭浩[1,2] 李欢欢[1] 王博 张伪松[1] 袁明权 鲁超 WANG Qiuxia;SHI Chuandao;GUO Hao(The First Clinical Medical College of Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi 712000)

机构地区：[1]陕西中医药大学第一临床医学院,陕西咸阳712000 [2]西安交通大学附属红会医院骨坏死与关节重建科,陕西西安710000

出　　处：《河北中医》2019年第6期849-854,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：陕西省长安郭氏骨伤学术流派工作室建设项目(陕中医药发[2019]9号);中国博士后科学基金资助项目(编号:2017M613179)

摘　　要：目的 观察长安郭氏骨伤学术流派经典膏方三花膏治疗急性期膝关节滑膜炎患者的临床疗效。方法 将162例急性期膝关节滑膜炎患者按照随机数字表法分为3组,每组54例。其中对照1组予塞来昔布胶囊口服治疗;对照2组予塞来昔布胶囊口服联合双氯芬酸二乙胺乳胶剂外涂治疗;治疗组予塞来昔布胶囊口服联合三花膏外敷治疗。3组均以7d为1个疗程,2个疗程后统计临床疗效,并观察3组治疗前及治疗3、7、14d后红细胞沉降率(ESR)、C反应蛋白(CRP)水平及疼痛视觉模拟评分法(VAS)评分、症状体征积分、美国特种外科医院膝关节评分(HSS)情况。结果 治疗3d后,3组ESR、CRP水平与本组治疗前及3组组间比较差异均无统计学意义(P>0.05);疼痛VAS评分、症状体征积分及HSS评分方面,对照1组与本组治疗前比较差异均无统计学意义(P>0.05),对照2组、治疗组VAS评分、症状体征积分均低于本组治疗前(P<0.05),HSS评分均高于本组治疗前(P<0.05)。治疗7、14d后,3组ESR、CRP水平及疼痛VAS评分均低于本组治疗前(P<0.05),且对照2组、治疗组均低于同期对照1组(P<0.05);在症状体征积分及HSS评分方面,3组症状体征积分均低于本组治疗前(P<0.05),HSS评分均高于本组治疗前(P<0.05)。治疗3、7、14d后治疗组症状体征积分及HSS评分改善均优于对照1组、对照2组同期(P<0.05),对照1组、对照2组比较差异均无统计学意义(P>0.05)。对照1组、对照2组、治疗组总有效率分别为79.6%、87.0%、96.3%,组间两两比较差异均有统计学意义(P<0.05)。结论 3种治疗方法治疗急性期膝关节滑膜炎均有疗效,其中单纯口服塞来昔布胶囊可有效减轻炎症,但在疼痛缓解、症状体征及膝关节功能的改善方面起效明显较晚,单独应用效果相对较差;而双氯芬酸二乙胺乳胶剂联合用药与三花膏联合用药在抗炎镇痛方面疗效相当,但三花膏联合用药在改善患者症状�Objective To observe the clinical efficacy of Sanhua ointment classic prescription of Guo's academic school of bone trauma in Chang'an in the treatment of acute knee joint synovitis. Methods 162 patients with acute knee synovitis were divided into three groups according to random number table method, with 54 cases in each group. The control group 1 was treated by celecoxib capsule orally. The control group 2 was treated by celecoxib capsule orally combined with diclofenac diethylamine latex externally. The treatment group was treated by celecoxib capsule orally combined with Sanhua ointment externally. The three groups were treated for 7 days as a course of treatment. The clinical efficacy was counted after 2 courses of treatment. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, pain visual analogue score (VAS), symptom and sign score, and knee joint score of American special surgery hospital (HSS) were observed before treatment and at 3, 7 and 14 days after treatment. Results After 3 days of treatment, there was no significant difference in ESR and CRP levels between the three groups before and after treatment ( P >0.05). There was no significant difference in the pain VAS score, symptom score and HSS score between the control group 1 and the pre-treatment ( P >0.05). The VAS score, symptoms and signs score in control group 2 and treatment group were lower than those in the group before treatment ( P <0.05), and HSS score was higher than those in the group before treatment ( P <0.05). After 7 and 14 days of treatment, the levels of ESR, CRP and pain VAS score in the three groups were lower than those in the group before treatment ( P <0.05), and the control group 2 and the treatment group were lower than those in the control group 1 ( P <0.05). The scores of symptoms and signs and HSS in the three groups were lower than those in the group before treatment ( P <0.05), and the scores of HSS were higher than those in the group before treatment ( P <0.05). After 3, 7 and 14 days of treatmen

关 键 词：滑膜炎 膝关节 急性期 三花膏 中医药疗法 

分 类 号：R686.705.31[医药卫生—骨科学]