加味补肾活血汤治疗肾虚血瘀型膝骨关节炎临床疗效观察  

Clinical Observation of Modified Bushen Huoxue Decoction in Treating Knee Osteoarthritis of Kidney Deficiency and Blood Stasis Type

作　　者：苑成发 韩松 俞鹏飞[2] 陈国锋[1] 王少甫[1] 王琦[3] YUAN Chengfa;HAN Song;YU Pengfei;CHEN Guofeng;WANG Shaofu;WANG Qi(Suqian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suqian 223800,Jiangsu China;Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China;Nanjing University of Chinese Medicine,Nanjing 210046,China)

机构地区：[1]南京中医药大学附属宿迁市中医院,江苏宿迁223800 [2]南京中医药大学附属苏州市中医医院 [3]南京中医药大学

出　　处：《中国中医骨伤科杂志》2022年第9期36-42,共7页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：宿迁市科技计划项目(S202011)。

摘　　要：目的:研究加味补肾活血汤治疗肾虚血瘀型膝骨关节炎的临床疗效。方法:选取肾虚血瘀型膝骨关节炎患者120例,采用随机数字表法分为治疗组和对照组(各60例)。治疗组口服加味补肾活血汤,对照组口服硫酸氨基葡萄糖治疗。比较两组不同治疗时期血清肿瘤坏死因子(Tumor Necrosis Factor,TNF)及骨形态发生蛋白(Bone Morphogenetic Proteins,BMPs)指标变化;比较两组治疗前后组内及组间中医证候评分、总有效率、Lysholm膝关节功能评分、WOMAC评分变化差异。结果:两组BMP-2比较,两组患者时间因素和分组因素存在交互效应(P<0.001),两组患者总体BMP-2值比较存在分组效应(P<0.001),治疗后4周和治疗后8周的血清BMP-2值,治疗组均高于对照组(P<0.001)。两组患者治疗前后不同时间节点BMP-2值比较存在时间效应(P<0.001)。两组不同时间节点BMP-2值均呈上升趋势,差异有统计学意义(P<0.001)。两组TNF-α比较,两组患者时间因素和分组因素存在交互效应(P<0.001),两组患者总体TNF-α值比较存在分组效应(P<0.001),治疗后4周和治疗后8周的血清TNF-α值治疗组均高于对照组(P<0.001);两组患者治疗前后不同时间节点TNF-α值比较存在时间效应(P<0.001)。两组不同时间节点TNF-α值均呈下降趋势,差异有统计学意义(P<0.001)。两组Lysholm评分比较,两组患者时间因素和分组因素存在交互效应(P=0.004);治疗后4周和治疗后8周治疗组的评分明显高于对照组(P<0.001);两组患者总体评分比较差异有统计学意义(治疗组高于对照组),即存在分组效应(P<0.001);两组患者治疗前后不同时间节点评分比较存在时间效应(P<0.001)。两组不同时间节点Lysholm值均呈上升趋势,差异有统计学意义(P<0.001)。两组WOMAC评分比较,两组患者时间因素和分组因素无交互效应(P=0.091);治疗后4周和治疗后8周治疗组的评分明显低于对照组(P<0.001);两组患者总体评分比较差�Objective:To study the clinical efficacy of modified Bushen Huoxue decoction on the treatment of osteoarthritis of kidney deficiency and blood stasis type.Methods:120 cases of knee osteoarthritis of kidney deficiency and blood stasis type were randomly divided into treatment group(60 cases)and control group(60 cases).The treatment group was treated with modified Bushen Huoxue decoction and the control group was treated with glucosamine sulfate.The changes of serum tumor necrosis factor(TNF)and bone morphogenetic proteins(BMPs)were compared between the two groups at different treatment points,and the differences of TCM scores,total effective rate,Lysholm knee function scores and WOMAC scores before and after treatment were compared between the two groups.Results:Compared with BMP-2,there was an interaction effect between time factors and grouping factors in the two groups(P<0.001),and a grouping effect in the comparison of overall BMP-2 values between the two groups(P<0.001).The serum BMP-2 values at 4 weeks and 8 weeks after treatment in the treatment group were higher than that in the control group(P<0.001).There was a time effect in the comparison of BMP-2 values at different time points before and after treatment between the two groups(P<0.001).BMP-2 increased at different time points in the two groups,and the difference had statistical significance(P<0.001).The comparison of TNF-αbetween the two groups showed that there was an interaction effect between time factors and grouping factors in the two groups(P<0.001).There was a grouping effect in the comparison of overall TNF-αvalues between the two groups(P<0.001),and the serum TNF-αvalues at 4 weeks after treatment and 8 weeks after treatment in the treatment group were higher than that in the control group(P<0.001).There was a time effect in the comparison of TNF-αvalues at different time points before and after treatment between the two groups(P<0.001).TNF-αshowed a downward trend at different time points in the two groups,and the difference had statist

关 键 词：膝骨关节炎 肿瘤坏死因子 骨形态发生蛋白 肾虚血瘀 加味补肾活血汤 

分 类 号：R684.3[医药卫生—骨科学]