通络外治法治疗瘀血阻滞型早中期膝骨关节炎疗效观察  

Observation of curative effect of external therapy for unblocking collaterals on early and middle knee osteoarthritis of syndrome of blood stasis

作　　者：张宁 霍珍 马琳[2] 罗亚萍[2] 潘利敏[2] 侯小双 冯媛媛 ZHANG Ning;HUO Zhen;MA Lin;LUO Yaping;PAN Limin;HOU Xiaoshuang;FENG Yuanyuan(Graduate School of Hebei College of Traditional Chinese Medicine, Shijiazhuang 050091, Hebei,China;Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang 050011,Hebei,China;The People’s Hospital of Shijiazhuang,Shijiazhuang 050011,Hebei,China)

机构地区：[1]河北中医学院研究生院,河北石家庄050091 [2]河北省中医院,河北石家庄050011 [3]河北省石家庄市人民医院,河北石家庄050011

出　　处：《现代中西医结合杂志》2020年第25期2747-2751,2761,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省政府资助临床医学优秀人才培养和基础课题研究项目(2017043637);石家庄市科学技术与发展指导计划课题项目(111461123)。

摘　　要：目的观察通络外治法治疗瘀血阻滞型早中期膝骨关节炎的临床疗效与安全性。方法选择2017年1月—2018年10月在河北省中医院风湿病科门诊就诊的瘀血阻滞型早中期膝骨关节炎患者60例,按照随机数字表分成治疗组与对照组各30例。治疗组采用通络外治法治疗(局部拍打、中药热奄包外敷、刺络放血),对照组给予硫酸氨基葡萄糖胶囊口服,2组均治疗6周。统计2组治疗3周、6周后临床疗效,观察2组治疗前和治疗3周、6周后WOMAC骨关节炎指数评分、疼痛VAS评分的变化,检测2组治疗前和治疗6周后血清红细胞沉降率(ESR)及C反应蛋白(CRP)水平,记录2组不良反应发生情况。结果治疗3周后,治疗组总有效率为76.7%(23/30),对照组为50.0%(15/30),治疗组明显高于对照组(P<0.05);治疗6周后,治疗组总有效率为93.3%(28/30),对照组为86.7%(26/30),2组比较差异无统计学意义(P>0.05)。治疗3周后,治疗组疼痛、僵硬、躯体功能积分和VAS评分均明显低于本组治疗前及同期对照组(P均<0.05),对照组各项积分和VAS评分与治疗前比较差异均无统计学意义(P均>0.05)。治疗6周后,2组疼痛、僵硬、躯体功能积分和VAS评分均明显低于本组治疗前(P均<0.05),但2组间疼痛、僵硬、躯体功能积分和VAS评分比较差异均无统计学意义(P均>0.05)。治疗6周后,2组ESR、CRP均无明显变化(P均>0.05),且2组间比较差异均无统计学意义(P均>0.05)。治疗过程中,对照组2例出现恶心,治疗组1例出现局部皮肤发红、瘙痒,均不影响治疗。结论通络外治法能明显减轻瘀血阻滞型早中期膝骨关节炎病情及疼痛,虽然治疗6周后疗效与硫酸氨基葡萄糖胶囊相当,但起效更快,且安全性高。Objective It is to observe the clinical efficacy external therapy for unblocking collaterals on early and middle knee osteoarthritis of syndrome of blood stasis.Methods Sixty patients with early and middle knee osteoarthritis of syndrome of blood stasis in the outpatient department of the Department of Rheumatology,Hebei Provincial Hospital of Traditional Chinese Medicine from January 2017 to October 2018 were divided into treatment group and control group according to the random number table,30 cases in each group.The treatment group was treated with external therapy for unblocking collaterals(the combination of external application of traditional Chinese medicine hot electoral package,blood-letting by pricking collaterals and local beating),and the control group was given glucosamine sulfate capsules by oral administration.The clinical efficacy of the 2 groups after 3 weeks and 6 weeks of treatment was calculated.The changes of WOMAC osteoarthritis index score and pain VAS score before treatment and after 3 weeks and 6 weeks of treatment were observed in the two groups.The levels of serum erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)before treatment and 6 weeks after treatment in the two groups were measured,and the occurrence of adverse reactions in the two groups was recorded.Results After 3 weeks of treatment,the total effective rate was 76.7%(23/30)in the treatment group and 50.0%(15/30)in the control group,the rate in the treatment group was higher than that in the control group(P<0.05).After 6 weeks of treatment,the total effective rate was 93.3%(28/30)in the treatment group and 86.7%(26/30)in the control group,there was no statistically significant difference between the two groups(P>0.05).After 3 weeks of treatment,the scores of pain,stiffness,physical function and VAS scores of the treatment group were significantly lower than those before treatment and in the control group during the same period(P<0.05),but the scores of every item of WOMAC and VAS scores of the control group were not

关 键 词：膝骨关节炎 瘀血阻滞型 通络外治法 硫酸氨基葡萄糖 

分 类 号：R684.3[医药卫生—骨科学]