双活舒筋止痛方内服联合药泥温灸治疗膝骨关节炎气虚湿阻型临床观察  

Clinical observation of Shuanghuo Shujin Zhitong Recipe combined with medicinal mud warm moxibustion on knee osteoarthritis with Qi-deficiency and damp-stagnation syndrome

作　　者：郑玉琳 李佩鲜 朱建华 ZHENG Yulin;LI Peixian;ZHU Jianhua(Department of Rehabilitation,Hai'an Hospital of Traditional Chinese Medicine,Hai'an,Jiangsu 226600;Department of Acupuncture and Moxibustion,Hai'an Hospital of Traditional Chinese Medicine,Hai'an,Jiangsu 226600)

机构地区：[1]江苏省海安市中医院康复科,江苏海安226600 [2]江苏省海安市中医院针灸科,江苏海安226600

出　　处：《河北中医》2023年第9期1502-1506,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的 观察双活舒筋止痛方内服联合药泥温灸治疗膝骨关节炎(KOA)气虚湿阻型的临床疗效。方法 将108例KOA气虚湿阻型患者按照随机数字表法分为2组,对照组54例予塞来昔布胶囊治疗,治疗组54例在对照组治疗基础上加双活舒筋止痛方内服联合药泥温灸治疗。2组均治疗4周。比较2组疗效;比较2组治疗前后中医证候评分、关节滑液中相关因子、血清疼痛相关因子、疼痛视觉模拟评分(VAS)、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分及关节活动度变化;观察2组治疗安全性。结果 治疗组总有效率92.59%(50/54),对照组总有效率77.78%(42/54),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),治疗后治疗组中医证候各项评分及总评分均低于对照组(P<0.05)。2组治疗后肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、丙二醇(MDA)、爱帕琳肽(Apelin)均较本组治疗前降低(P<0.05),超氧化物歧化酶(SOD)较本组治疗前升高(P<0.05);治疗后治疗组TNF-α、IL-1β、MDA、Apelin均低于对照组(P<0.05),SOD高于对照组(P<0.05)。2组治疗后血清P物质(SP)、5-羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))均较本组治疗前降低(P<0.05),治疗后治疗组血清SP、5-HT、PGE_(2)均低于对照组(P<0.05)。2组治疗后疼痛VAS、WOMAC评分均较本组治疗前降低(P<0.05),关节活动度较本组治疗前升高(P<0.05);治疗后治疗组疼痛VAS、WOMAC评分均低于对照组(P<0.05),关节活动度高于对照组(P<0.05)。2组患者均未见胃肠道反应、皮疹、恶心等不良反应。结论 双活舒筋止痛方内服联合药泥温灸治疗KOA气虚湿阻型,可减轻患者疼痛程度,改善关节活动度,提高疗效,可能与调节疼痛相关因子及TNF-α、Apelin等因子表达有关。Objective To observe the effect of oral administration of Shuanghuo Shujin Zhitong Recipe combined with medicinal mud warm moxibustion in the treatment of knee osteoarthritis(KOA)with Qi-deficiency and dampness-stagnation syndrome.Methods A total of 108 KOA patients with Qi-deficiency and dampness-stagnation syndrome were randomly assigned at 1∶1 ratio to two groups.On the basis of celecoxib capsules(the control group),the treatment group were treated with Shuanghuo Shujin Zhitong Recipe combined with medicinal mud warm moxibustion.The efficacy was compared after 4 weeks of treatment,the traditional Chinese medicine(TCM)syndrome score,related pain-factors in synovial fluid and serum,visual analog scale(VAS),the Western Ontario and McMaster Universities(WOMAC)score,joint range of motion,as well as treatment safety were included as comparisons.Results After treatment,the total effective rate in the treatment group was better than that in the control group(92.59%[50/54]vs 77.78%[42/54],P<0.05).The scores and total scores of TCM syndromes in the two groups were lower(P<0.05),which were lower in the treatment group than in the control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),propylene glycol(MDA)and Apelin in the two groups decreased(P<0.05),and superoxide dismutase(SOD)increased(P<0.05),improvement of the above parameters in treatment group were significantly better(all P<0.05).The levels of serum substance P(SP),5-hydroxytryptamine(5-HT)and prostaglandin E 2(PGE 2)in groups decreased(P<0.05),which were decreased in the treatment group than in the control group(P<0.05).The scores of VAS and WOMAC in groups were lower(P<0.05),and the joint range of motion was higher(P<0.05).improvement of the above parameters in treatment group were significantly better compared with the control group(all P<0.05).No adverse reactions(gastrointestinal reaction,rash and nausea)were found in the two groups.Conclusion For KOA patients with Qi-deficiency and damp-stagnation syndrome,Oral admini

关 键 词：骨关节炎 膝 辨证 中医疗法 

分 类 号：R684.3[医药卫生—骨科学] R241[医药卫生—外科学] R247[医药卫生—临床医学]