消痹汤结合中药外敷治疗湿热阻络型成人髋关节滑膜炎的临床疗效观察  

Clinical Observation of Xiaobi Decoction(消痹汤) Combined with External Application of Traditional Chinese Medicine in Treatment of Adult Hip Synovitis of Damp-heat and Collateral Obstruction Type

作　　者：周子康 郭天贵 曹玉净[2] ZHOU Zikang;GUO Tiangui;CAO Yujing(Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]河南省中医院,河南郑州450000

出　　处：《中华中医药学刊》2022年第10期194-197,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项(2019ZYBJ15)。

摘　　要：目的 观察消痹汤结合中药外敷治疗湿热阻络型成人髋关节滑膜炎的临床疗效。方法 随机将2019年1月—2020年10月就诊于河南省中医院的86例髋关节滑膜炎住院患者,随机分为两组,每组43例,对照组给予塞来昔布胶囊,在对照组的基础上,观察组给予消痹汤结合中药外敷治疗,两组持续治疗3周。分别于治疗前后比较两组患者的临床疗效、中医证候积分、髋关节活动情况、VAS评分、Barthel指数评分、红细胞沉降率(ESR)、C反应蛋白(CRP)、血清白介素-1β(IL-1β)、白介素-6(IL-6)水平。结果 观察组总有效率为95.4%(41/43),对照组总有效率为83.7%(36/43),两组比较有统计学意义(P<0.05)。观察组患者的疼痛缓解时间及关节活动障碍解除时间明显低于对照组(P<0.05);观察组患者的髋关节腔积液、股骨颈前间隙显著降低(P<0.05),并且均较对照组的各指标低(P<0.05)。两组治疗后湿热阻络证各评分、Harris评分、VAS及Barthel指数评分均显著降低(P<0.05),并且改善程度优于对照组(P<0.05)。治疗后观察组患者IL-1β、IL-6、ESR及CRP水平显著降低(P<0.05),并且IL-1β、IL-6、ESR及CRP水平均低于对照组(P<0.05)。结论 消痹汤结合中药外敷治疗湿热阻络型成人髋关节滑膜炎可有效改善临床症状,还可以降低部分炎症指标水平,促进水肿吸收,使患者髋关节活动度得到明显改善。Objective To observe the clinical efficacy of Xiaobi Decoction(消痹汤)combined with external application of traditional Chinese medicine in the treatment of adult hip synovitis of damp-heat and collateral obstruction type.Methods A total of 86 hospitalized patients with hip synovitis who came to the hospital from January 2019 to October 2020 were randomly divided into two groups,each with 43 cases.The control group was given celecoxib capsules.On the basis,the observation group was given Xiaobi Decoction combined with external application of traditional Chinese medicine,and the two groups continued treatment for 3 weeks.The clinical efficacy,TCM syndrome scores,hip joint activity,VAS score,Barthel index score,erythrocyte sedimentation rate(ESR),levels of C-reactive protein(CRP)and serum interleukin-1β(IL-1β),interleukin-6(IL-6)were observed.Results The total effective rate of the observation group was 95.4%(41/43),and that of the control group was 83.7%(36/43).The comparison between the two groups was statistically significant(P<0.05).The pain relief time and joint dysfunction release time of the observation group were significantly lower than those of the control group(P<0.05).The hip joint cavity effusion and the anterior femoral neck space of the observation group were significantly reduced(P<0.05),and all were lowered compared with those of the control group(P<0.05).After treatment,the scores of damp-heat and collateral obstruction syndrome,Harris score,VAS and Barthel index scores were significantly reduced in the two groups(P<0.05),and the degree of improvement in the observation group was better than that in the control group(P<0.05).After treatment,the levels of IL-1β,IL-6,ESR and CRP in the observation group were significantly reduced(P<0.05),and the levels of IL-1β,IL-6,ESR and CRP were lower than those in the control group(P<0.05).Conclusion Xiaobi Decoction combined with external application of traditional Chinese medicine can effectively improve the clinical symptoms of adult hip synovitis of

关 键 词：髋关节滑膜炎 湿热阻络证 HARRIS评分 IL-1Β 

分 类 号：R269.867[医药卫生—中西医结合]