理筋手法联合消瘀膏治疗膝骨关节炎的疗效观察  

Curative Effect of Tendon-regulating Manipulation Combined with Xiaoyu Ointment for Knee Osteoarthritis

作　　者：公维志[1] 戴缙[1] 史文强[1] 王浩 吴建丽[2] GONG Weizhi;DAI Jin;SHI Wenqiang;WANG Hao;WU Jianli(Department of Massage,Second Affiliated Hospital of Heilongjiang University of Chinese medicine,Harbin 150001,China;Acupuncture Research Institute,Heilongjiang University of Chinese medicine,Harbin 150004,China)

机构地区：[1]黑龙江中医药大学附属二院推拿科,哈尔滨150001 [2]黑龙江中医药大学针灸研究所,哈尔滨150040

出　　处：《世界中医药》2022年第15期2199-2202,共4页World Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(82105030);中国民族医药学会科研项目(2021Z1068-470301)。

摘　　要：目的:探究理筋手法联合消瘀膏辅助治疗膝骨关节炎的临床疗效。方法:选取2019年7月至2021年2月间在黑龙江中医药大学附属二院推拿科治疗的膝骨关节炎患者70例作为研究对象,按照数字表法分为观察组和对照组,每组35例,对照组患者实施临床常规西医治疗,观察组患者在西医治疗基础上增加中医理筋手法联合消瘀膏治疗。对比分析2组患者临床疗效、膝关节功能和炎症水平、软骨代谢水平情况。结果:观察组疗效显著优于对照组(P<0.05)。治疗前,2组西安大略和麦克马斯特大学骨关节炎指数量表(WOMAC)各维度评分、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)水平比较差异均无统计学意义(P>0.05),治疗后,2组患者WOMAC各项评分、TNF-α、IL-1水平均下降,且观察组显著低于对照组(P<0.05)。治疗前,2组患者血清软骨寡聚基质蛋白(COMP)、Ⅱ型胶原羧基端端肽(CTX-Ⅱ)、硫酸角质素(KS)水平比较差异均无统计学意义(P>0.05),治疗后,2组患者COMP、CTX-Ⅱ、KS水平均下降,且观察组显著低于对照组(P<0.05)。结论:理筋手法联合消瘀膏治疗能显著提升膝骨关节炎患者临床疗效,改善膝关节功能,下调炎症反应,改善软骨代谢异常。Objective:To explore the clinical effect of tendon-regulating manipulation combined with Xiaoyu ointment on the treatment of knee osteoarthritis.Methods:Seventy patients with knee osteoarthritis who were treated in the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese medicine from July 2019 to February 2021 were selected,and randomly separated into two groups according to the random number table method,with 35 cases in each group.Patients in the control group were treated with conventional western medicine,and patients in the study group were treated with traditional Chinese medicine(TCM)tendon-regulating manipulation combined with Xiaoyu ointment based on western medicine.The clinical effect,knee joint functions,inflammation level,and cartilage metabolism level were compared and analyzed between the two groups.Results:The curative effect of the study group was better than that of the control group(P<0.05).Before treatment,there was no statistical difference between the two groups in the all-dimension Western Ontario and McMaster University Osteoarthritis Index(WOMAC)scores,serum tumor necrosis factor-α(TNF-α),and interleukin-1(IL-1)levels(P>0.05).After treatment,the all-dimension WOMAC scores,TNF-α,and IL-1 levels of the two groups decreased,and the study group was significantly lower than the control group(P<0.05).Before treatment,there was no significant difference in the levels of serum cartilage oligomeric matrix protein(COMP),C telopeptide of typeⅡcollagen(CTX-Ⅱ),and keratan sulfate(KS)between the two groups(P>0.05).After treatment,the levels of COMP,CTX-Ⅱ,and KS of the two groups decreased,and the study group was significantly lower than the control group(P<0.05).Conclusion:Tendon-regulating manipulation combined with Xiaoyu ointment can significantly improve the clinical effect of patients with knee osteoarthritis,improve knee joint functions,down-regulate inflammatory response,and improve cartilage metabolism abnormalities.

关 键 词：膝骨关节炎 理筋手法 消瘀膏 膝关节功能 软骨代谢 软骨寡聚基质蛋白 疗效 联合治疗 

分 类 号：R289.5[医药卫生—方剂学] R684.3[医药卫生—中药学]