关节腔注射自体富血小板血浆结合通痹散熏洗治疗早期膝骨关节炎的临床研究  

Clinical study of intra-articular injection of autologous PRP combined with Tongbi San fumigation in the treatment of early knee osteoarthritis

作　　者：孙磊 郭永园[2] 赵心[3] Sun Lei;Guo Yongyuan;Zhao Xin(Department of Orthopedics,Tai'an Second Hospital of Traditional Chinese Medicine,Tai'an 271000,China;Department of Orthopedics,Qilu Hospital,Shandong University,Jinan 250012,China;College of Resources,Shandong University of Science and Technology,Tai'an 271000,China)

机构地区：[1]泰安市中医二院骨科,泰安271000 [2]山东大学齐鲁医院骨科,济南250012 [3]山东科技大学资源学院,泰安271000

出　　处：《国际中医中药杂志》2023年第8期963-967,共5页International Journal of Traditional Chinese Medicine

基　　金：2021年度泰安市科技创新发展项目(2021NS173)。

摘　　要：目的评价关节腔注射自体富血小板血浆(PRP)结合通痹散熏洗治疗早期膝骨关节炎(KOA)的疗效。方法随机对照试验研究。选取2021年3月-2022年3月泰安市中医二院KOA患者160例作为观察对象,采用随机数字表法分为2组,每组80例。对照组予以西医常规疗法治疗,观察组予以关节腔注射自体PRP+通痹散熏洗治疗。2组均治疗3周。采用西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评估膝关节功能,Lysholm膝关节评分量表(LKS)评估日常生活能力,VAS量表评估疼痛程度;采用ELISA法检测IL-1β、TNF-α水平;记录治疗期间的不良反应,评价临床疗效。结果观察组总有效率为95.0%(76/80)、对照组为77.5%(62/80),2组比较差异有统计学意义(χ^(2)=10.33,P<0.01)。治疗后1、3、6个月,观察组WOMAC评分低于对照组(F=15.63,P<0.01),LKS评分高于对照组(F=55.23,P<0.01),VAS评分低于对照组(F=11.93,P<0.01)。观察组治疗后IL-1β[(51.75±2.74)μg/L比(63.38±3.31)μg/L,t=24.21]、TNF-α[(10.58±1.25)μg/L比(11.62±1.84)μg/L,t=4.18]水平低于对照组(P<0.01)。观察组不良反应发生率为10.0%(8/80)、对照组为7.5%(6/80),2组比较差异无统计学意义(χ^(2)=0.31,P=0.576)。结论关节腔注射自体PRP结合通痹散熏洗可有效改善早期KOA患者膝关节功能和日常生活能力,缓解疼痛症状,降低炎症反应,提高临床疗效。Objective To evaluate the efficacy of intra-articular injection of autologous platelet-rich plasma(PRP)combined with Tongbi Powder fumigation in the treatment of early knee osteoarthritis(KOA).Methods Randomized controlled trial.Totally 160 patients with KOA in Tai'an Second Hospital of Traditional Chinese Medicine were enrolled between March 2021 and March 2022.According to random number table method,they were divided into two groups,with 80 cases in each group.The control group was given routine treatment,while observation group was given intra-articular injection of autologous PRP combined with Tongbi Powder fumigation.All were treated for 3 weeks.The knee function was evaluated by Western Ontario and McMaster University(WOMAC)osteoarthritis index.The activities of daily living were evaluated by Lysholm knee scale(LKS).The pain degree was evaluated by VAS.The levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)were detected by ELISA.The adverse reactions during treatment were observed and recorded.The clinical efficacy was evaluated.Results The total effective rate of the observation group was 95.0%(76/80),and that of the control group was 77.5%(62/80),with statistical significance(χ^(2)=10.33,P<0.01).At 1,3 and 6 months after treatment,the WOMAC score of the observation group was lower than that of the control group(F=15.63,P<0.01),the LKS score was higher than that of the control group(F=55.23,P<0.01),and the VAS score was lower than that of the control group(F=11.93,P<0.01).After treatment,the observation group IL-1β[(51.75±2.74)μg/L vs.(63.38±3.31)μg/L,t=24.21],TNF-α[(10.58±1.25)μg/L vs.(11.62±1.84)μg/L,t=4.18]were lower than those in the control group(P<0.01).The incidence of adverse reactions was 10.0%(8/80)in the observation group and 7.5%(6/80)in the control group,without statistical significance(χ^(2)=0.31,P=0.576).Conclusion Intra-articular injection of autologous PRP combined with Tongbi San fumigation can effectively improve knee function and activities of living abilit

关 键 词：骨关节炎 膝 自体富血小板血浆 通痹散 注射 关节内 熏洗疗法 

分 类 号：R684.3[医药卫生—骨科学]