祛寒逐风颗粒联合二乌止痛膏治疗膝骨关节炎风寒湿痹证临床研究  

Clinical Study on Quhan Zhufeng Granules Combined with Erwu Zhitong Plaster on Knee Osteoarthritis with Wind Cold Dampness Arthralgia Syndrome

作　　者：柴喜平 李盛华[2] 柳海平[2] 尤从新[2] 赵宁[2] 张锐[2] 李爱强[2] CHAI Xiping;LI Shenghua;LIU Haiping;YOU Congxin;ZHAO Ning;ZHANG Rui;LI Aiqiang(Clinical College of TCM,Gansu University of Chinese Medicine,Lanzhou 730000,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学中医临床学院,甘肃兰州730000 [2]甘肃省中医院,甘肃兰州730050

出　　处：《中国中医药信息杂志》2021年第5期94-99,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金地区基金(81560782/H2710);中医药行业科研专项(201507001-06);甘肃陇中正骨学术流派传承工作室建设项目(LP0128061)。

摘　　要：目的观察祛寒逐风颗粒联合二乌止痛膏治疗膝骨关节炎(KOA)风寒湿痹证临床疗效,以及对软骨代谢和肝、肾功能的影响。方法采用随机数字表法将186例KOA患者分为对照组90例和观察组96例。对照组患膝关节腔内注射玻璃酸钠注射液,每周1次;对乙酰氨基酚片,每次1片,每日3次,口服。观察组予祛寒逐风颗粒,每次10 g,每日3次,口服;二乌止痛膏,2 d 1次,外敷患膝。2组均连续治疗12周。观察2组临床疗效,比较2组治疗前后活动和静息时疼痛视觉模拟评分量表(VAS)评分、WOMAC骨关节炎指数评分、膝骨关节炎严重性指数(ISOA)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分;检测髌上囊积液深度、滑膜厚度、软骨病变情况、滑膜内血流分级及肝、肾功能。结果观察组总有效率为88.54%(85/96),对照组为76.67%(69/90),观察组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后活动和静息时VAS评分,WOMAC骨关节炎指数总分及疼痛、僵硬、关节功能评分,ISOA总分及症状体征、最大步行距离、日常生活能力评分,中医症状积分,SAS评分,SDS评分均下降(P<0.05);2组治疗后比较,观察组上述评分均明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后髌上囊积液深度、滑膜厚度、腘窝囊肿范围及滑膜内血流分级检出率明显降低,股骨内外髁软骨厚度升高(P<0.05);2组治疗后比较,观察组上述指标均明显优于对照组(P<0.05)。与本组治疗前比较,观察组碱性磷酸酶、尿酸、尿β2-微球蛋白、尿微量白蛋白水平及对照组碱性磷酸酶、尿酸水平明显下降(P<0.05);2组治疗后比较,观察组尿酸水平明显低于对照组(P<0.05)。结论祛寒逐风颗粒联合二乌止痛膏可明显减轻KOA风寒湿痹证患者临床症状,改善关节功能,提高生活质量,其作用机制可能与调节软骨代谢环境、抑制炎症反应、降低滑膜组织损伤及软骨病变、�Objective To study the clinical efficacy of Quhan Zhufeng Granules(QZG)combined with Erwu Zhitong Plaster(EZP)on knee osteoarthritis(KOA)with wind cold dampness arthralgia syndrome,and the effects on cartilage metabolism and liver and kidney function.Methods Totally 186 KOA patients were divided into control group(90 cases)and observation group(96 cases)according to random number table method.In the control group,sodium hyaluronate injection was injected into the knee joint once a week;acetaminophen tablets,1 tablet each time,3 times a day,orally.Patients in observation group got QZG,10 g per time,3 times a day,orally;EZP,2 d per time,external application of knee joint.The course of treatment was 12 weeks.The clinical efficacy of both groups was observed.Before and after treatment,active and resting pain visual analog scale(VAS)score,WOMAC osteoarthritis index score,knee osteoarthritis severity index(ISOA),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)score were compared;depth of suprapatellar sac effusion,thickness of synovium,cartilage lesions,blood flow in synovium and liver and kidney function were detected.Results The total effective rate of the observation group was 88.54%(85/96),and the control group was 76.67%(69/90).The observation group had better efficacy than the control group(P<0.05).Compared with before treatment,the VAS scores during activity and rest,WOMAC osteoarthritis index total scores and pain,stiffness,joint function scores,ISOA total scores and symptoms and signs,maximum walking distance score,daily activity score,TCM symptom score,SAS score and SDS score decreased(P<0.05);after treatment,the above scores of the observation group were significantly lower than those of the control group(P<0.05).Compared with before treatment,the depth of suprapatellar sac effusion,thickness of synovial membrane,popliteal cyst index of popliteal fossa and intrasynovial blood flow classification detection rate were significantly reduced,the thickness of medial and lateral femoral condyle c

关 键 词：膝骨关节炎 风寒湿痹证 祛寒逐风颗粒 二乌止痛膏 关节功能 超声检查 软骨代谢 肝肾功能 

分 类 号：R272.968.4[医药卫生—中医儿科学]