独活寄生汤加味联合膝四针治疗风寒湿痹型膝骨关节炎临床研究  

Clinical Study on Modified Duhuo Jisheng Tang Combined with Knee Four Needles for Knee Osteoarthritis of Wind-Cold and Fixed Impediment Type

作　　者：闫恩利 唐春阳[2] 梅胜利[1] YAN Enli;TANG Chunyang;MEI Shengli

机构地区：[1]郑州大学第二附属医院,河南郑州450000 [2]郑州市骨科医院,河南郑州450000

出　　处：《新中医》2022年第19期29-33,共5页New Chinese Medicine

摘　　要：目的:观察独活寄生汤联合膝四针治疗风寒湿痹型膝骨关节炎的临床疗效。方法:将90例风寒湿痹型膝骨关节炎患者按随机数字表法分为观察组与对照组各45例,对照组口服硫酸氨基葡萄糖胶囊治疗,观察组口服独活寄生汤联合膝四针治疗。比较2组临床疗效,比较2组治疗前后视觉模拟评分法(VAS)评分、压痛值、西安大略和麦克马斯特大学骨关节炎指数评分(WOMAC)、中医证候积分、血清疼痛介质5-羟色胺(5-HT)、前列腺素E2 (PGE2)、多巴胺(DA)、P物质(SP)及炎症介质肿瘤坏死因子-α (TNF-α)、白细胞介素-1 (IL-1)、白细胞介素-6 (IL-6)水平。结果:观察组总有效率88.89%,高于对照组77.78%(P<0.05)。与同组治疗前比较,治疗后2组VAS评分、WOMAC各项评分、各项中医证候积分及PGE2、SP、DA、5-HT、IL-1、IL-6、TNF-α水平均降低(P<0.05),压痛值均升高(P<0.05);与对照组治疗后比较,观察组治疗后VAS评分、WOMAC各项评分、各项中医证候积分及PGE2、SP、DA、5-HT、IL-1、IL-6、TNF-α水平均较低(P<0.05),压痛值较高(P<0.05)。结论:独活寄生汤联合膝四针治疗风寒湿痹型膝骨关节炎临床疗效较好,可有效缓解患者疼痛,其作用机制可能与降低血清疼痛介质及炎症介质有关。Objective: To observe the clinical effect of the therapy of Duhuo Jisheng tang combined with knee four needles for knee osteoarthritis of wind-cold and fixed impediment type. Methods:A total of90 patients with knee osteoarthritis of wind-cold and fixed impediment type were divided into the observation group and the control group according to the random number table method,with 45 cases in each group. The control group was treated with glucosamine sulfate capsules orally,and the observation group was treated with Duhuo Jisheng tang orally combined with knee four needles. The clinical effects were compared between the two groups. Before and after treatment,the scores of Visual Analogue Scale(VAS), tenderness values, scores of Western Ontario and McMaster Universities Arthritis Index(WOMAC),Chinese medicine syndrome scores and levels of pain mediators,including 5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),dopamine(DA),substance P(SP),and inflammatory mediators,including tumor necrosis factor-α(TNF-α),interleukin-1(IL-1) and interleukin-6(IL-6),were compared between the two groups. Results:The total effective rate was 88.89% in the observation group,higher than that of77.78% in the control group(P<0.05). After treatment,the scores of VAS,WOMAC and Chinese medicine syndromes and the levels of PGE2,SP,DA,5-HT,IL-1,IL-6 and TNF-α in the two groups were decreased when compared with those before treatment(P<0.05), and the tenderness values were increased(P<0.05);the scores of VAS, WOMAC and Chinese medicine syndromes and the levels of PGE2,SP,DA,5-HT,IL-1,IL-6 and TNF-α in the observation group were lower than those in the control group(P<0.05), and the tenderness value in the observation group was higher(P<0.05).Conclusion:The therapy of Duhuo Jisheng tang combined with knee osteoarthritis of wind-cold and fixed impediment type has a good clinical effect, which can effectively alleviate the pain of patients, and its mechanism may be related to reducing the serum pain mediators and inflammatory mediators.

关 键 词：膝骨关节炎 独活寄生汤 膝四针 风寒湿痹型 疼痛介质 炎症介质 

分 类 号：R274.9[医药卫生—中西医结合]