基于天癸理论的补肾活血方治疗绝经后膝骨关节炎的临床疗效观察  

Clinical Observation of Bushen Huoxue Decoction for the Treatment of Postmenopausal Knee Osteoarthritis Based on Tiankui Theory

作　　者：陶帅[1] 姜宏 戴瑜[1] 王铠[1] 印红兵[1] 龚华惠[1] TAO Shuai;JIANG Hong;DAI Yu;WANG Kai;YIN Hongbing;GONG Huahui(Taizhou Hospital of TCM Affiliated to Nanjing University of Traditional Chinese Medicine,Taizhou 225300,Jiangsu China;Suzhou Hospital of TCM Affiliated to Nanjing University of Traditional Chinese Medicine,Suzhou 215000,Jiangsu China.)

机构地区：[1]南京中医药大学泰州附属医院,江苏泰州225300 [2]南京中医药大学苏州附属医院

出　　处：《中国中医骨伤科杂志》2021年第10期22-27,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：江苏省泰州市科技支撑计划(社会发展项目)(TS201909)。

摘　　要：目的:基于天癸理论观察补肾活血方治疗绝经后膝骨关节炎的临床疗效。方法:选取绝经后膝骨关节炎患者70例,采用随机数字表法分为治疗组和对照组,最终纳入67例完成研究,其中治疗组33例给予补肾活血方治疗,对照组34例给予西乐葆治疗,观察两组患者治疗前后血清学E2、TNF-α及WOMAC评分、骨关节炎中医证候分级量化评分的变化,并进行中医临床疗效评定。结果:补肾活血方可提高患者血清中E2表达,抑制TNF-α的表达,显著降低WOMAC评分,差异有统计学意义(P<0.01),尤其对中医证候关节酸软乏力、关节冷痛喜暖恶寒、头晕耳鸣等症状改善优势明显,同时其可明显降低改良Kupperman指数评分,差异有统计学意义(P<0.05)。结论:补肾活血方治疗绝经后膝骨关节炎有临床优势,尤其对绝经后女性伴有全身不适症状者疗效更佳,可能存在对下丘脑-垂体轴的良性调节作用。Objective:To observe the clinical efficacy and advantages of Bushen Huoxue decoction on the treatment of postmenopausal knee osteoarthritis based on Tiankui theory. Methods:70 patients with postmenopausal knee osteoarthritis were selected and divided into treatment group and control group by random number table method. 67 patients were finally included to complete the study, among which 33 patients in the treatment group were given Bushen Huoxue decoction, and 34 patients in the control group were given Celebrex. The changes of serum E2, TNF-α, WOMAC scores and quantitative scores of TCM syndrome grading of osteoarthritis in two groups were observed before and after treatment, and the clinical efficacy of TCM was evaluated. Results:Bushen Huoxue decoction improved the patient’s E2 expression in serum, inhibited the expression of TNF-α, and significantly reduced the WOMAC score(P<0.01). In particular, it had obvious advantage for improving Chinese medicine syndromes such as joint weakness and fatigue, cold and pain in joints like warmth and aversion to cold, dizziness, tinnitus. At the same time, Bushen Huoxue decoction obviously reduced the modified Kupperman index score, and the difference was statistically significant(P<0.05). Conclusion:Bushen Huoxue decoction has clinical advantages on the treatment of postmenopausal knee osteoarthritis, especially for postmenopausal women with general discomfort symptoms. It may play a role in regulating the hypothalamic-pituitary axis.

关 键 词：天癸 补肾活血方 绝经 膝骨关节炎 疗效 

分 类 号：R681.5[医药卫生—骨科学]