平乐正骨外洗方熏洗联合舒筋活血汤内服治疗踝关节创伤性关节炎的临床研究  

Clinical study of Pingle Zhenggu external washing formula combined with Shujin Huoxue decoction in the treatment of traumatic arthritis of ankle joint

作　　者：巩浩然 曹梅娜 胡业华 王佳 王振龙 吕杭州 GONG Haoran;CAO Meina;HU Yehua;WANG Jia;WANG Zhenlong;LYU Hangzhou(Department of Rehabilitation Medicine,Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei 054000,China;The Third Department of Internal Medicine,Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei 054000,China)

机构地区：[1]华北医疗健康集团邢台总医院康复医学科,河北邢台054000 [2]华北医疗健康集团邢台总医院内三科,河北邢台054000

出　　处：《安徽医药》2023年第12期2520-2524,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨平乐正骨外洗方熏洗联合舒筋活血汤内服对踝关节创伤性关节炎的治疗效果。方法选取2020年12月至2022年1月华北医疗健康集团邢台总医院收治的168例踝关节创伤性关节炎病人,按随机数字表法分为甲、乙、丙、丁四组,各42例。四组均进行踝关节功能训练,甲组给予玻璃酸钠注射液治疗,乙、丙、丁组分别在甲组治疗基础上给予平乐正骨外洗方熏洗、舒筋活血汤内服、平乐正骨外洗方熏洗联合舒筋活血汤内服治疗,四组均治疗3周。对比四组治疗前后中医症状积分、踝关节功能,临床疗效,治疗前后血清炎性因子水平及治疗期间的不良反应。结果甲、乙、丙、丁四组病人治疗后中医症状积分分别为(13.79±2.35)分、(12.60±2.23)分、(11.75±2.31)分、(10.43±2.18)分,差异有统计学意义(P<0.05),乙、丙、丁组均低于甲组(P<0.05),丁组低于乙、丙组(P<0.05);甲、乙、丙、丁四组病人治疗后美国足踝协会(AOFAS)评分分别为(76.01±3.36)分、(80.35±4.02)分、(81.88±4.43)分、(90.27±5.04)分,差异有统计学意义(P<0.05),乙、丙、丁组均高于甲组(P<0.05),丁组高于乙、丙组(P<0.05);四组临床疗效分布均差异有统计学意义(P<0.05);丁组总有效率为95.24%高于甲组的73.81%(P<0.05);四组病人治疗后白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平均差异有统计学意义(P<0.05),且乙、丙、丁组以上三个指标均低于甲组(P<0.05),丁组IL-1、TNF-α水平低于乙、丙组(P<0.001);四组不良反应发生率差异无统计学意义(P>0.05)。结论对踝关节创伤性关节炎病人给予平乐正骨外洗方熏洗联合舒筋活血汤内服治疗可改善临床症状,促进踝关节功能恢复,提高疗效,减轻关节炎症反应,且安全性良好。Objective To explore the therapeutic effect of Pingle Zhenggu external washing formula combined with Shujin Huoxue decoction on traumatic arthritis of ankle joint.Methods Totally 168 cases of traumatic arthritis of ankle treated in Xingtai General Hospital of North China Medical Health Group from December 2020 to January 2022 were randomly assigned into groups A,B,C and D according to the random number table method,with 42 cases in each group.All four groups received ankle function training,and group A was treated with sodium hyaluronate injection,while groups B,C and D were treated with additional Pingle Zhenggu external washing formula,Shujin Huoxue decoction,Pingle Zhenggu external washing formula combined with Shujin Huoxue decoction,and all four groups were treated for 3 weeks.The traditional Chinese medical symptom scores,ankle function,clinical efficacy,and serum inflammatory factor levels before and after treatment as well as adverse reactions during treatment were compared among the four groups.Results The TCM symptom scores of patients in four groups were(13.79±2.35),(12.60±2.23),(11.75±2.31)and(10.43±2.18)respectively.There was significant difference among the four groups after treatment(P<0.05),and the scores in groups B,C and D were lower than that in group A(P<0.05),and the score was lower in group D than in groups B and C(P<0.05).The American Foot and Ankle Association(AOFAS)scores of the four groups were(76.01±3.36),(80.35±4.02),(81.88±4.43)and(90.27±5.04),respectively.There was significant difference among the four groups after treatment(P<0.05),and the scores of groups B,C and D were higher than that of group A(P<0.05),and the score was higher in group D than in groups B and C(P<0.05).There was significant difference in the distribution of clinical efficacy among the four groups(P<0.05).The total effective rate of group D was higher than that of the group A(95.24%vs.73.81%,P<0.05).There were significant differences in the levels of interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and

关 键 词：关节炎 创伤和损伤 平乐正骨外洗方 舒筋活血汤 踝关节 创伤性关节炎 

分 类 号：R274.9[医药卫生—中西医结合]