清利活血解毒汤治疗膝骨关节炎的疗效及对膝关节功能与血清CRP、MMP-1、SOD的影响  

Clinical Effects of Qingli Huoxue Jiedu Tang in Treating Knee Osteoarthritis and Its Influence on Knee Joint Function,Serum CRP,MMP-1 and SOD

作　　者：王文哲 瞿龙 张桂香 WANG Wenzhe;QU Long;ZHANG Guixiang(Tangshan City Second Hospital,Tangshan 063000,China)

机构地区：[1]唐山市第二医院,河北唐山063000

出　　处：《西部中医药》2022年第9期107-110,共4页Western Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2019045)。

摘　　要：目的:探讨清利活血解毒汤治疗膝骨关节炎(knee osteoarthritis,KOA)的疗效及对膝关节功能、血清C反应蛋白(C-reaction protein,CRP)、基质金属蛋白酶1(matrix metalloproteinase 1,MMP-1)、超氧化物歧化酶(superoxide dismutase,SOD)水平的影响。方法:将KOA患者108例随机分为对照组、观察组各54例。对照组予美洛昔康片及硫酸氨基葡萄糖片治疗,观察组在对照组治疗的基础上予清利活血解毒汤,治疗4周后观察两组临床疗效、中医症状评分、美国特种外科医院(HSS)评分、视觉模拟疼痛评分(visual analog scale,VAS)及CRP、MMP-1、SOD与不良反应发生情况。结果:总有效率观察组为90.74%(49/54),高于对照组的74.07%(40/54),差异有统计学意义(P<0.05)。治疗后两组患者中医症状评分及总分均降低,观察组低于对照组(P<0.05)。治疗后两组患者HSS评分升高,观察组高于对照组(P<0.05);VAS评分降低,观察组低于对照组(P<0.05)。治疗后两组患者血清CRP、MMP-1水平降低,SOD水平升高,观察组CRP、MMP-1水平低于对照组(P<0.05),SOD水平高于对照组(P<0.05)。观察组不良反应发生率为5.56%,低于对照组的18.52%(P<0.05)。结论:清利活血解毒汤联合美洛昔康片及硫酸氨基葡萄糖片能够降低KOA患者中医症状评分,改善膝关节功能,减轻炎症反应,调节SOD水平,疗效优于单用美洛昔康片及硫酸氨基葡萄糖片治疗,且安全性较好。Objective:To explore curative effects of Qingli Huoxue Jiedu Tang in the treatment of knee osteoarthritis(KOA)and its influence on knee joint function,the levels of serum CRP,MMP-1 and SOD.Methods:All 108 KOA patients were randomized into the control group and the observation group,with 54 cases in each group.The control group was treated by meloxicam tablets and glucosamine sulfate tablets,and the observation group took Qingli Huoxue Jiedu Tang on the foundation of Western medicine therapy,after four weeks of treatment,to observe clinical effects,TCM symptom scores,HSS scores,VAS,the levels of CRP,MMP-1 and SOD,as well as the incidence of adverse reaction between both groups.Results:Total effective rate of the observation group was 90.74%(49/54),higher than 74.07%(40/54)of the control group,and the difference had statistical meaning(P<0.05).After the treatment,TCM symptom scores and total scores of both groups were lowered,the observation group was lower than the control group(P<0.05).After the treatment,HSS scores of both groups were raised,the observation group was higher than the control group(P<0.05);VAS scores reduced,the observation group was lower than the control group(P<0.05).After the treatment,the levels of CRP and MMP-1were lowered,while the level of SOD was increased in both groups,the level of of CRP and MMP-1 of the observation group was lower than that of the control group(P<0.05),the level of SOD was higher than that of the control group(P<0.05).The incidence of adverse reaction of the observation group was 5.56%,lower than 18.52%of the control group(P<0.05).Conclusion:Qingli Huoxue Jiedu Tang could reduce TCM symptom scores in KOA patients,improve knee joint function,relieve inflammatory reaction,adjust SOD level,and its effects are superior to these of meloxicam tablets and glucosamine sulfate tablets,meanwhile it shows better safety.

关 键 词：膝骨关节炎 膝关节功能 C反应蛋白 基质金属蛋白酶1 超氧化物歧化酶 清利活血解毒汤 

分 类 号：R274.9[医药卫生—中西医结合]