骨增定痛汤治疗膝骨性关节炎的临床疗效及对关节功能、骨代谢、血清炎症因子水平的影响  

Clinical Effect of Guzeng Dingtong Decoction on Knee Osteoarthritis and Its Influence on Joint Function,Bone Metabolism and Serum Inflammatory Factors

作　　者：吴炅[1] 周正球[1] 周定华[1] 谭亚菊[1] 金艳[1] 黄佳珉[1] 周琪[1] WU Jiong;ZHOU Zheng-qiu;ZHOU Ding-hua;TAN Ya-ju;JIN Yan;HUANG Jia-min;ZHOU Qi(Department of Rheumatology,Changzhou Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Changzhou 213003)

机构地区：[1]南京中医药大学附属常州市中医医院风湿病科

出　　处：《河北中医药学报》2019年第4期10-14,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：江苏省中医药科技研究专项:No.HZ07003

摘　　要：目的:分析骨增定痛汤在膝骨关节炎(KOA)治疗中的临床疗效和安全性,观察其对患者关节功能、骨代谢、血清炎症因子水平的影响。方法:选择64例KOA患者,按照随机数字表法分为观察组和对照组,每组各32例。对照组患者给予抗骨增生胶囊口服,观察组患者则给予自拟骨增定痛汤内服,比较2组的临床疗效,评价治疗前后膝关节功能变化,检测骨代谢指标、血清炎症因子指标变化,对比不良反应发生率。结果:对照组的总有效率为62.50%,较观察组的总有效率93.75%明显为低,差异有显著性(P<0.05)。治疗后,2组患者的膝关节功能较治疗前提高,Lyshom评分明显高于治疗前,关节僵硬、疼痛明显减轻,西安大略和麦克马斯特大学骨关节炎调查表(WOMAC)、视觉模拟评分法(VAS)评分明显低于治疗前,血清骨代谢指标骨钙素(BGP)、骨保护素(OPG)、骨特异性碱性磷酸酶(BALP)水平明显高于治疗前,I型胶原C端肽(CTX-I)水平则明显低于治疗前,肌体炎症较治疗前明显减轻,血清中炎症因子白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、环氧合酶(COX-2)水平显著低于治疗前;组间比较,观察组患者的各指标水平变化程度较对照组更明显,差异有显著性(P<0.05)。观察组、对照组的不良反应的发生率分别为3.13%、6.25%,差异无显著性(P>0.05)。结论:在KOA的治疗中,中药骨增定痛汤疗效更确切,更利于提高膝关节功能,减轻关节僵硬、疼痛等症状,且在改善骨代谢、减轻炎症损伤方面有更好的效果,且不良反应发生率更低。Objective:To analyze the clinical efficacy and safety of Guzeng Dingtong Decoction in the treatment of knee osteoarthritis(KOA),and to observe its effects on joint function,bone metabolism and serum inflammatory factors.Methods:Sixty-four patients with KOA were selected and randomly divided into observation group and control group,32 in each group.The control group were given Anti-hyperostosis Capsule orally,while the patients in the observation group were given Guzeng Dingtong Decoction orally.The clinical effects of the two groups were compared,the changes of knee joint function before and after treatment were evaluated,the changes of bone metabolism index and serum inflammatory factors index were detected,and the incidences of adverse reactions were compared.Results:The effective rate of the control group was 62.50%,which was significantly lower than that of the observation group(93.75%,P<0.05).After treatment,the knee joint function of the two groups was improved,Lyshom score was significantly higher than that before treatment,and joint stiffness and pain were significantly alleviated.The scores of West Ontario and McMaster University Osteoarthritis Index(WOMAC)and visual analogue scale(VAS)were significantly lower than those before treatment,and the serum bone metabolism indicators,osteocalcin(BGP),osteoprotegerin(OPG)and bone specific alkaline phosphatase(BALP),were significantly higher than those before treatment,while the levels of collagen type I C-terminal peptide(CTX-I)were significantly lower than those before treatment.The inflammation of the body was significantly reduced compared with that before treatment.The inflammatory factors such as interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and cyclooxygenase(COX-2)were significantly lower than those before treatment.The changes of each index level in the observation group were more obvious than that in the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group were 3.13%and 6.25%,respectively,with no

关 键 词：膝骨关节炎 膝痹 骨增定痛汤 抗骨增生胶囊 肝肾亏虚 骨代谢 炎症因子 

分 类 号：R285.6[医药卫生—中药学]