筋骨止痛膏联合化瘀通络灸治疗气滞血瘀型膝原发性骨关节炎的临床观察  

Clinical Observation on the Treatment of Primary Knee Osteoarthritis(Qi Stagnation and Blood Stasis Type)with Jingu Zhitong Plaster and Moxibustion for Removing Blood Stasis and Removing Collaterals

作　　者：吴灵芝 姜天鑫 李飞[1] 翟静静[1] 张闻东[2] WU Lingzhi;JIANG Tianxin;LI Lei;ZHAI Jingjing;ZHANG Wendong(Anhui University of Traditional Chinese Medicine Second Affiliated Hospital,Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院中医科,合肥230061 [2]安徽中医药大学第二附属医院脑病五科,合肥230061

出　　处：《实用医学杂志》2023年第14期1842-1847,共6页The Journal of Practical Medicine

基　　金：2021年安徽省财政中医领军后备人才培养项目(编号:中发展(2022)4号);2021年度安徽中医药大学临床科研项目(编号:2021EFYLC09)。

摘　　要：目的探讨自拟筋骨止痛膏联合化瘀通络灸治疗膝原发性骨关节炎(气滞血瘀型)的临床疗效。方法将68例符合纳入标准的膝原发性骨关节患者按照随机数字法分为观察组和西药组,各34例。西药组给予药物消炎止痛联合玻璃酸钠注射液关节腔注射,观察组采用自拟筋骨止痛膏联合化瘀通络灸疗法,每周治疗6次,连续2周。分别在治疗前、治疗后当天以及疗程结束后1个月随访观察两组患者的WOMAC骨关节量表、步行测试以及炎性指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和不良反应发生率。结果观察组总有效率96.7%,优于西药组总有效率的86.7%(P<0.05);与治疗前比较,两组患者在治疗后及随访时的膝关节疼痛评分、TNF-α及IL-6炎性指标较前均有所改善(P<0.05,P<0.01);与西药组比较:观察组治疗后及治疗后1个月随访时的WOMAC骨关节量表评分、相关炎性指标均较前显著改善(P<0.01);观察组的不良反应发生率(5.88%)与西药组不良反应发生率(14.70%)相比,差异无统计学意义(P>0.05)。结论筋骨止痛膏联合化瘀通络灸能有效减少气滞血瘀型膝原发性骨关节炎患者关节腔积液及炎性指标含量,改善膝关节活动度、减轻疼痛,治疗安全有效,疗效优于单纯使用西药治疗。Objective To explore the clinical effect of the treatment of primary knee osteoarthritis(Qi stagnation and blood stasis type)with self-made Jingu Zhitong Plaster and Huayu Tongluo Moxibustion.Methods 68 patients with primary knee osteoarthritis who met the inclusion criteria were randomly divided into treatment group and western medicine group,with 34 cases each.The western medicine group was treated with anti-inflammatory and analgesic drugs combined with sodium hyaluronate injection into the joint cavity,while the treatment group was treated with self-made Jinggu Zhitong ointment combined with blood-stasis and collateral-removing moxibustion,6 times a week for 2 weeks.The WOMAC bone joint scale,walking test and inflammatory index(tumor necrosis factor(TNFα),Interleukin-6(IL-6))and the incidence of adverse reactions.Results The total effective rate of the treatment group was 96.7%,which was better than that of the western medicine group(86.7%,P<0.05);Compared with before treatment,the knee pain score and TNFαof the two groups of patients after treatment and the inflammatory indexes of IL-6 were improved(P<0.05,P<0.01);Compared with the western medicine group,the score of WOMAC bone joint scale and related inflammatory indexes in the treatment group were significantly improved after treatment and at the follow-up of one month after treatment(P<0.01);There was no significant difference in the incidence of adverse reactions between the treatment group(5.88%)and the western medicine group(14.70%)(P>0.05).Conclusion Jingu Zhitong Ointment combined with Huayu Tongluo Moxibustion can effectively reduce the joint cavity effusion and inflammatory index content in patients with primary osteoarthritis of the knee of qi stagnation and blood stasis type,improve the knee joint range of motion,relieve pain,and treat safely and effectively.The curative effect is better than that of using western medicine alone.

关 键 词：膝原发性关节炎 气滞血瘀型 筋骨止痛膏 化瘀通络灸 

分 类 号：R246.9[医药卫生—针灸推拿学]