基于“辨位归经”理论针刀循经论治联合独活寄生汤治疗膝骨关节炎的临床观察  

Clinical Observation on the Treatment of Knee Osteoarthritis Based on the Theory of“Differentiation of Position and Return to Meridians”with Acupuncture and Meridian Treatment Combined with Duhuo Jisheng Decoction(独活寄生汤)

作　　者：姚飞 田向东 YAO Fei;TIAN Xiangdong(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029

出　　处：《辽宁中医药大学学报》2023年第8期145-149,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：北京中医药大学中央高校基本科研项目(2020-JYB-ZDGG-142-5)。

摘　　要：目的探讨针刀循经论治联合独活寄生汤治疗膝骨性关节炎临床观察。方法选择于医院就诊的膝骨性关节炎患者118例,根据随机数字表方法随机分为对照组与治疗组各59例,对照组59例患者给予西医常规治疗及独活寄生汤治疗,治疗组59例患者对照组基础上给予针刀治疗。观察两组患者治疗前后中医证候评分,血液流变学指标[血浆黏度(plasma viscosity,PV)、低切全血黏度(whole Blood low shear rate,LS)、中切全血黏度(whole blood middle shear rate,MS)、高切全血黏度(whole blood high shear rate,HS)],关节液炎症因子指标[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],膝关节功能评价[Lysholm评分、WOMAC评分量表评分、Lequesne指数评分、滑膜厚度、关节积液深度],骨代谢指标[骨钙素(bone gla-protein,BGP)、软骨寡聚基质蛋白(cartilage oligomeric matrix protein,COMP)、骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BALP)]。结果治疗后两组膝关节隐痛、腰膝无力、屈伸不利、头晕耳鸣评分,关节液炎症因子IL-1β、IL-6、TNF-α水平较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后两组PV、LS、MS、HS、COMP指标均较治疗前降低,且治疗组低于对照组(P<0.05)。两组BGP、BALP指标均较治疗前升高,且治疗组高于对照组(P<0.05)。疗后两组WOMAC评分量表、Lequesne指数评分、滑膜厚度、关节积液深度均较治疗前降低,Lysholm评分较治疗前上升,且治疗组优于对照组。结论针刀循经论治联合独活寄生汤可显著改善KOA患者临床症状,改善膝关节功能。Objective To explore the clinical observation of the treatment of knee osteoarthritis(KOA)with needle knife combined with Duhuo Jisheng Decoction(独活寄生汤).Methods A total of 118 patients with knee osteoarthritis who were treated in our hospital were selected and randomly divided into the control group and the treatment group,59 cases in each group,according to the random number table method.The control group of 59 patients received routine Western medicine treatment and Duhuo Jisheng Decoction treatment,while the treatment group of 59 patients received needle knife treatment on the basis of the control group.To observe the TCM syndrome scores,hemorheology indexes[plasma viscosity(PV),whole blood low shear rate(LS),whole blood middle viscosity(MS),whole blood high shear rate(HS)],synovial fluid inflammatory factors indicators[interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],knee joint function evaluation(Lysholm score,WOMAC score scale score,Lequesne index score,synovial thickness,joint effusion depth),bone metabolism index[bone glaprotein(BGP),cartilage oligomeric matrix protein(COMP),bone-specific alkaline phosphatase(BALP)].Results After treatment,the two groups had lower knee joint pain,waist and knee weakness,unfavorable flexion and extension,dizziness and tinnitus scores,and the levels of synovial fluid inflammatory factors IL-1β,IL-6 and TNF-αwere lower than those before treatment,and the treatment group was lower than the control group(P<0.05).After treatment,the indexes of PV,LS,MS,HS and COMP in the two groups were all lower than those before treatment,and the treatment group was lower than the control group(P<0.05).The BGP and BALP indexes of both groups were higher than those before treatment,and the treatment group was higher than the control group(P<0.05).After treatment,the WOMA score scale,Lequesne index score,synovial thickness and joint effusion depth in the two groups were decreased compared with those before treatment,and the Lysholm score was increased co

关 键 词：辨位归经 针刀 循经论治 独活寄生汤 膝骨性关节炎 临床观察 

分 类 号：R274.9[医药卫生—中西医结合]