化瘀通痹方对膝骨关节炎患者骨代谢指标、滑膜液中炎性介质及生活质量的影响  

Effect of Huayu Tongbi Prescription on Bone Metabolism Indexes,Inflammatory Mediators in Synovial Fluid and Quality of Life in Patients with Knee Osteoarthritis

作　　者：刘严 LIU Yan

机构地区：[1]商丘市第四人民医院骨科,河南商丘476000

出　　处：《新中医》2022年第15期108-112,共5页New Chinese Medicine

摘　　要：目的:观察化瘀通痹方对膝骨关节炎(KOA)患者骨代谢指标、滑膜液中炎性介质及生活质量的影响。方法:选取150例KOA患者,根据随机数字表法分为对照组与观察组各75例。对照组采用常规治疗,观察组在对照组基础上采用化瘀通痹方治疗。比较2组骨代谢指标、滑膜液中炎性介质及生活质量。结果:观察组总恢复率94.67%,高于对照组82.67%(P<0.05)。与同组治疗前比较,治疗后2组关节疼痛肿胀、关节功能障碍、活动摩擦音、腰膝酸痛等中医证候积分,视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分,Ⅱ型胶原交联C末端肽(CTX-Ⅱ)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)、白细胞介素-1β (IL-1β)水平,生活质量测量表2-短卷(AIMS2-SF)躯体功能、疼痛症状、情绪影响、社会、工作等评分均降低(P<0.05),美国膝关节协会(AKS)评分,血清骨钙素(BGP)、血清骨特异性碱性磷酸酶(BALP)水平均升高(P<0.05);治疗后,与对照组比较,观察组关节疼痛肿胀、关节功能障碍、活动摩擦音、腰膝酸痛等中医证候积分,VAS、WOMAC骨关节炎指数评分,CTX-Ⅱ、TNF-α、IL-6、IL-1β水平,AIMS2-SF躯体功能、疼痛症状、情绪影响、社会、工作等评分均较低(P<0.05),AKS评分,血清BGP、BALP水平均较高(P<0.05)。结论:化瘀通痹方可有效提高KOA患者恢复率,改善骨代谢指标,降低滑膜液中炎性因子水平,提高生活质量。Objective:To observe the effect of Huayu Tongbi prescription on bone metabolism indexes,inflammatory mediators in synovial fluid and quality of life in patients with knee osteoarthritis(KOA).Methods:A total of 150 cases of KOA patients were selected and divided into the control group and the observation group according to the random number table method,with 75 cases in each group.The control group was given routine treatment,and the observation group was treated with Huayu Tongbi prescription based on the treatment of the control group.The bone metabolism indexes,inflammatory mediators in synovial fluid and quality of life in the two groups were compared.Results:The total recovery rate was 94.67%in the observation group,higher than that of 82.67%in the control group(P<0.05).After treatment,the scores of Chinese medicine syndromes including pain and swelling of joint,joint dysfunction,active friction sound and soreness and weakness of waist and knees,Visual Analogue Scale(VAS)and Western Ontario and Mcmaster Universities Osteoarthritis Index(WOMAC),the levels of C-terminal cross-linked telopeptides of type II collagen(CTX-II),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β),as well as the scores of physical function,pain symptoms,emotional impact,society and work in short form of the Arthritis Impact Measurement Scales 2(AIMS2-SF)in the two groups were decreased when compared with those in the same group before treatment(P<0.05),and the scores of American Knee Society(AKS)and the levels of bone Gla protein(BGP)and bone alkaline phosphatase(BALP)in serum were increased(P<0.05).After treatment,the scores of Chinese medicine syndromes including pain and swelling of joint,joint dysfunction,active friction sound and soreness and weakness of waist and knees,VAS and WOMAC,the levels of CTX-II,TNF-α,IL-6 and IL-1β,as well as the scores of physical function,pain symptoms,emotional impact,society and work in AIMS2-SF in the observation group were lower than those in the control group(P<0.05)

关 键 词：膝骨关节炎 化瘀通痹方 骨代谢指标 炎性介质 生活质量 

分 类 号：R274.9[医药卫生—中西医结合]