补肾活血方联合双氯芬酸钠治疗膝骨关节炎伴关节积液临床研究  

Clinical Study of Bushen Huoxue Prescription Combined with Diclofenac Sodium for Knee Osteoarthritis Complicated with Joint Effusion

作　　者：陈宇 黄亚丽 金雪芬 CHEN Yu;HUANG Yali;JIN Xuefen

机构地区：[1]玉环市人民医院骨科,浙江玉环317600 [2]玉环市人民医院中医科,浙江玉环317600 [3]玉环市人民医院康复科,浙江玉环317600

出　　处：《新中医》2022年第12期127-131,共5页New Chinese Medicine

摘　　要：目的:观察补肾活血方联合双氯芬酸钠治疗膝骨关节炎(KOA)伴关节积液的临床疗效。方法:选取84例KOA伴关节积液患者,按照随机数字表法分为观察组和对照组各42例。对照组给予双氯芬酸钠治疗,观察组在对照组基础上给予补肾活血方治疗,2组均治疗6周。比较2组临床疗效及治疗前后中医证候积分、疼痛程度、膝关节功能,以及关节液白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平和血清骨保护素(OPG)、血管内皮细胞生长因子(VEGF)、基质金属蛋白酶-3(MMP-3)水平,记录不良反应。结果:观察组总有效率92.86%,高于对照组73.81%(P<0.05)。治疗后,2组中医证候积分、视觉模拟评分法(VAS)评分及关节液IL-6、TNF-α、IL-1β水平均较治疗前降低(P<0.05),观察组中医证候积分、VAS评分及关节液IL-6、TNF-α、IL-1β水平均低于对照组(P<0.05);2组日本骨科协会评估治疗分数(JOA评分)均较治疗前升高(P<0.05),观察组JOA评分高于对照组(P<0.05)。治疗后,2组血清OPG水平均较治疗前升高(P<0.05),血清VEGF、MMP-3水平均较治疗前降低(P<0.05);观察组血清OPG水平高于对照组(P<0.05),血清VEGF、MMP-3水平均低于对照组(P<0.05)。2组均未出现严重不良反应。结论:补肾活血方联合双氯芬酸钠治疗KOA伴关节积液,可缓解临床症状,降低关节液炎症因子水平,调节血清OPG、VEGF、MMP-3表达,促进关节功能恢复,安全性高。Objective:To observe the clinical effect of the therapy of Bushen Huoxue prescription combined with diclofenac sodium on knee osteoarthritis(KOA)complicated with joint effusion.Methods:A total of 84 patients with KOA complicated with joint effusion were selected and divided into the observation group and the control group according to the random number table method,with 42 cases in each group.The control group was treated with diclofenac sodium,and the observation group was additionally treated with Bushen Huoxue prescription based on the treatment of the control group.Both groups were treated for six weeks.The clinical effects,Chinese medicine syndrome scores,pain,knee function as well as levels of interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in synovial fluid and levels of serum osteoprotegerin(OPG),vascular endothelial growth factor(VEGF)and matrix metalloproteinase-3(MMP-3)before and after treatment were compared between the two groups,and the adverse reactions were recorded.Results:The total effective rate was 92.86%in the observation group,higher than that of 73.81%in the control group(P<0.05).After treatment,the scores of Chinese medicine syndrome and Visual Analogue Scale(VAS)as well as the levels of IL-6,TNF-αand IL-1βin synovial fluid in the two groups were decreased when compared with those before treatment(P<0.05),and the above two scores as well as the levels of IL-6,TNF-αand IL-1βin synovial fluid in the observation group were lower than those in the control group(P<0.05);the scores of Japanese Orthopaedic Association(JOA)in the two groups were increased when compared with those before treatment(P<0.05),and the JOA score in the observation group was higher than that in the control group(P<0.05).After treatment,the serum OPG levels in the two groups were increased when compared with those before treatment(P<0.05),and the levels of serum VEGF and MMP-3 were decreased(P<0.05);the serum OPG level in the observation group was higher than that in the control group(P<0

关 键 词：膝骨关节炎 关节积液 补肾活血方 双氯芬酸钠 炎症因子 骨保护素 血管内皮细胞生长因子 基质金属蛋白酶-3 

分 类 号：R684.3[医药卫生—骨科学]