蠲痹汤与推拿手法联合西药治疗膝骨关节炎发作期临床研究  

Clinical Study on Juanbi Tang and Tuina Manipulation Combined with Western Medi⁃cine for Knee Osteoarthritis at Attack Stage

作　　者：梁鸿志[1] 周立[1] 姚树俊[1] 刘照树[1] 张潇[1] LIANG Hongzhi;ZHOU Li;YAO Shujun;LIU Zhaoshu;ZHANG Xiao

机构地区：[1]周口市中心医院骨二科,河南周口466015

出　　处：《新中医》2020年第12期83-86,共4页New Chinese Medicine

摘　　要：目的:观察蠲痹汤与推拿手法联合西药治疗膝骨关节炎发作期寒湿痹阻证的临床疗效。方法:将120例患者按随机数字表法分为对照组和观察组各60例。2组均服用塞来昔布胶囊、盐酸氨基葡萄糖胶囊,外用双氯芬酸钠凝胶涂抹膝关节处。观察组加用蠲痹汤加减内服与推拿手法治疗。2组疗程均为4周。治疗前后使用西安大略和麦马斯特大学骨关节炎指数可视化量表(WOMAC)评定膝关节的症状与功能情况,应用疼痛视觉模拟评分法(VAS)评定行走痛、静息痛的疼痛程度与膝关节的肿胀程度,应用关节炎生活质量测量量表2-短卷(AIMS2-SF)评价生活质量。比较2组的疗效。结果:治疗后,观察组临床疗效优于对照组(P<0.05)。2组WOMAC疼痛、僵硬、关节功能3个维度的评分及总分均较治疗前下降(P<0.01),观察组3个维度的评分及总分均低于对照组(P<0.01)。2组行走痛和静息痛评分、肿胀程度评分均较治疗前下降(P<0.01),观察组3项评分均低于对照组(P<0.01)。2组AIMS2-SF躯体、症状、影响、社会、工作评分及总分均较治疗前升高(P<0.01),观察组5个维度的评分及总分均高于对照组(P<0.01)。结论:在常规西药干预的基础上采用蠲痹汤加减联合推拿手法治疗膝骨关节炎发作期寒湿痹阻证患者,可进一步减轻关节的肿痛症状,促进关节功能的恢复,提高了患者的生活质量,临床疗效优于单纯采用西药治疗。Objective:To observe the clinical effect of Juanbi tang and tuina manipulation combined with western medicine for knee osteoarthritis at attack stage with cold-dampness obstruction syndrome.Methods:A total of 120 cases of patients were divided into the control group and the observation group according to the random number table method,60 cases in each group.Both groups were given oral administration of celecoxib capsules and glucosamine hydrochloride capsules,and external application of diclofenac sodium gel to the knee joint;the observation group was additionally treated with modified Juanbi tang and tuina manipulation.Both groups were treated for four weeks.Before and after treatment,the symptoms and function of knee joint were evaluated by Western Ontario and McMaster University Osteoarthritis Index(WOMAC);the degrees of walk-associated pain,rest pain and swelling in the knee joint were evaluated by Visual Analogue Scale(VAS);the quality of life of patients was evaluated by Short-form Arthritis Impact Measurement Scales 2(AIMS2-SF).Compared the clinical effect between the two groups.Results:After treatment,the clinical effect in the observation group was better than that in the control group(P<0.05).The WOMAC scores of the three dimensions including pain,stiffness and joint function as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.01);the above scores in the observation group were lower than those in the control group(P<0.01).The scores of walkassociated pain,rest pain and swelling degree in the two groups were decreased when compared with those before treatment(P<0.01);the above scores in the observation group were lower than those in the control group(P<0.01).The AIMS2-SF scores of body,symptom,influence,society and work as well as the total scores in the two groups were increased when compared with those before treatment(P<0.01);the above scores in the observation group were higher than those in the control group(P<0.01).Conclusion:Based on the inter

关 键 词：膝骨关节炎 寒湿痹阻证 中西医结合疗法 蠲痹汤 推拿手法 

分 类 号：R684.3[医药卫生—骨科学]