循经火疗联合中药外敷在寒湿痹阻型老年膝骨性关节炎中的疗效分析  

Analysis of Therapeutic Effect of Fire Therapy along Meridians Combined with External Application of Traditional Chinese Medicine on Senile Knee

作　　者：鲁林[1] 戴正香[2] LU Lin;DAI Zheng-xiang(Department of Geriatrics,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing Jiangsu 210029;Infection Control Office,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing Jiangsu 210029)

机构地区：[1]江苏省中医院老年科,江苏南京210029 [2]江苏省中医院感染控制办公室,江苏南京210029

出　　处：《世界中西医结合杂志》2020年第11期2134-2139,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：江苏省中医药局第二批科技项目(国家中医临床研究基地开放课题)(JD201707)。

摘　　要：目的观察循经火疗联合中药外敷治疗寒湿痹阻型老年膝骨性关节炎患者临床疗效并探讨其作用机制。方法选取2017年11月—2019年2月期间在江苏省中医院老年科收治的寒湿痹阻型膝骨性关节炎老年患者128例为研究对象,随机分为四组,对照组分别采取中药外敷、循经火疗、空白对照,试验组给予循经火疗联合中药外敷,评定四组患者治疗前后中医证候评分、Lysholm(利肖姆)膝关节功能评分、血清白细胞介素-1(interleukin-1,IL-1)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子(Tumor necrosis factor,TNF)生活质量评分的变化,观察临床疗效和不良反应。结果治疗后循经火疗联合中药外敷组总有效率83.3%,中药外敷组总有效率26.7%,循经火疗组总有效率38.0%,对照组总有效率22.6%;循经火疗联合中药外敷可显著提升KOA的治疗有效率,明显优于其他三组(P<0.05,P<0.01),而其他三组在总有效率方面未见明显差异。四组患者接受治疗后中医证候积分均明显下降,与治疗前比较差异有统计学意义(P<0.05,P<0.01);且循经火疗联合中药外敷组患者接受治疗后中医证候积分均明显下降,与循经火疗组比较差异有统计学意义(P<0.05),与中药外敷组、对照组比较差异有统计学意义(P<0.01)。治疗后四组患者膝关节功能均明显提高,与治疗前比较差异有统计学意义(P<0.05,P<0.01);且循经火疗联合中药外敷组关节活动功能改善最为显著,与其他三组比较差异有统计学意义(P<0.05,P<0.01),循经火疗组与对照组比较差异有统计学意义(P<0.01),但中药外敷组与对照组比较差异无统计学意义(P>0.05)。治疗后四组患者血清炎症因子IL-1、IL-6、TNF水平明显降低,与治疗前比较差异有统计学意义(P<0.05,P<0.01);且循经火疗联合中药外敷组较其他三组可以显著降低IL-1水平(P<0.01),中药外敷组、循经火疗组、循经火疗联合中药外敷组对IL-6水平的�Objective To explore the clinical effect and mechanism of fire therapy combined with external therapy of Traditional Chinese medicine(TCM)in the treatment of elderly patients with Knee osteoarthritis(KOA),and to establish a comprehensive external treatment program for KOA.Methods A total of 128 patients with knee osteoarthritis who were admitted to the Department of Geriatrics,Jiangsu Provincial Hospital of Traditional Chinese Medicine from November2017 to February 2019 were selected as the research subjects.The patients were randomly divided into four groups.The control group received external application of traditional Chinese medicine,meridian fire therapy,and blank control.The test group received external application of meridian fire therapy combined with external application of traditional Chinese medicine.TCM syndrome scores and Lysholm knee function scores before and after treatment were assessed.,Serum interleukin-1,6,changes in the quality of life score,observe the clinical efficacy and adverse reactions.Results After treatment,the total effective rate of the meridian fire therapy combined with external application of Chinese medicine was83.3%,the total effective rate of the traditional Chinese medicine external application group was 26.7%,the total effective rate of the meridian fire therapy group was 38.0%,and the total effective rate of the blank control group was 22.6%;Combined with external application of traditional Chinese medicine can significantly improve the TCM syndrome score of KOA patients and increase the effective rate of KOA treatment,which is significantly better than the other three groups(P<0.05,P<0.01).There was no significant difference in the total effective rate of the other three groups.The scores of TCM syndromes of the four groups of patients decreased significantly after treatment,and the differences were statistically significant compared with those before treatment(P<0.05,P<0.01);and the scores of TCM syndromes of patients in the meridian-based fire therapy combined with exte

关 键 词：火疗 外敷 贴敷 膝骨性关节炎 

分 类 号：R684.3[医药卫生—骨科学]