强骨饮联合西药治疗肾虚血瘀型膝骨关节炎合并骨质疏松症临床疗效观察  

Clinical efficacy observation on treatment of knee osteoarthritis complicated with osteoporosis of kidney deficiency and blood stasis type by Qianggu Decoction combined with western medicine

作　　者：崔龙慷 李学飞 沈高波 曾晗冰 吴连国 CUI Long-kang;LI Xue-fei;SHEN Gao-bo;ZENG Han-bing;WU Lian-guo(The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China;Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学附属第二医院,杭州310005 [2]浙江中医药大学,杭州310053 [3]浙江中医药大学附属第二医院骨伤二科,310005

出　　处：《中华中医药杂志》2022年第9期5512-5516,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药优秀青年人才基金项目(No.2021Z Q046);浙江省中医药现代化专项(No.2021ZX009);浙江省中医药科技计划重点研究项目(No.2019ZZ012);国家中医临床研究基地支撑学科建设计划(No.2020-JDXK-ZC01);浙江省“十三五”中医药重点专科建设项目(外科-运动创伤科)(No.浙卫办中医[2019]1号)。

摘　　要：目的:探讨强骨饮联合西药治疗肾虚血瘀型膝骨关节炎(KOA)合并骨质疏松症(OP)的临床疗效。方法:将80例肾虚血瘀型KOA合并OP患者随机分为对照组和研究组,每组40例。对照组予以口服塞来昔布胶囊2周、盐酸氨基葡萄糖片12周及阿仑膦酸钠12周治疗,研究组在对照组基础上口服强骨饮12周。治疗12周后观察两组临床疗效、WOMAC、VAS评分及SF-36评分,并采用ELISA法检测血清β-CTX、PINP、IL-1β、IL-6、TNF-α及NF-κB水平。结果:研究组治疗后总有效率为87.5%(35/40),显著高于对照组[67.5%(27/40)](P<0.05)。治疗后两组WOMAC评分、VAS评分均显著降低(P<0.01),且研究组显著低于对照组(P<0.05);治疗后两组SF-36评分均显著增高(P<0.01),且研究组显著高于对照组(P<0.05);治疗后两组血清β-CTX、PINP、IL-1β、IL-6、TNF-α、NF-κB水平均显著降低(P<0.01),且研究组PINP、IL-1β、IL-6、TNF-α、NF-κB水平显著低于对照组(P<0.05);两组患者均未出现不良反应。结论:强骨饮联合西药能够有效缓解肾虚血瘀型KOA合并OP患者临床症状,并改善相关血清指标。Objective: To investigate the clinical efficacy of Qianggu Decoction on patients with knee osteoarthritis(KOA) complicated with osteoporosis(OP) of kidney deficiency and blood stasis type. Methods: Patients with KOA complicated with OP were randomly divided into control group(Celebrex for 2 weeks and Glucosamine Hydrochloride Tablets for 12 weeks and Alendronate sodium for 12 weeks) and observation group(Celebrex for 2 weeks and Glucosamine Hydrochloride Tablets for 12 weeks and Alendronate sodium for 12 weeks, combined with Qianggu Decoction), 40 cases in each group. After 12 weeks of treatment, the clinical efficacy, the Western Ontario and McMaster University Osteoarthritis Index(WOMAC), the visual analog pain score(VAS) and the MOS item short form health survey(SF-36) were observed. The serum levels of β-CTX, PINP, IL-1β,IL-6, TNF-α and NF-κB were detected by ELISA. Results: The total effective rate of the observation group was 87.5%(35/40),which was significantly higher than that of the control group [67.5%(27/40)](P<0.05). After treatment, the WOMAC score and VAS score in both groups decreased significantly(P<0.01), and the observation group was lower than the control group(P<0.05).After treatment, the SF-36 score in both groups increased significantly(P<0.01), and the observation group was higher than the control group(P<0.05). After treatment, the serum levels of β-CTX, PINP, IL-1β, IL-6, TNF-α and NF-κB in both groups were decreased significantly(P<0.01), and the serum levels of PINP, IL-1β, IL-6, TNF-α and NF-κB in the observation group were lower than those in the control group(P<0.05). There were no adverse reactions in the two groups during and after treatment.Conclusion: Qianggu Decoction combined with western medicine can effectively improve the clinical symptoms and relevant serum indicators of patients with KOA complicated with OP of kidney deficiency and blood stasis type.

关 键 词：强骨饮 膝骨关节炎 骨质疏松症 肾虚血瘀证 临床研究 

分 类 号：R684.3[医药卫生—骨科学] R580[医药卫生—外科学]