右归丸联合中药熏蒸治疗肾阳虚型老年膝骨关节炎及其对关节液中OPN、S100A12及MMP-3的影响研究  

Yougui Pill(右归丸)Combined with Traditional Chinese Medicine Fumigation in Treatment of Elderly Knee Osteoarthritis with Kidney Yang Deficiency and Its Effect on OPN,S100A12 and MMP-3 in Joint Fluid

作　　者：孙思东 黄群[2] SUN Sidong;HHUANG Qun(The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 100034,Liaoning,China;Affiliated Hospitol of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学附属第二医院,辽宁沈阳110034 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医杂志》2023年第11期113-116,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：中国博士后科学基金特别资助项目(2017T100827);辽宁中医药大学中医脏象理论及应用国家教育部重点实验室开放基金项目(zyzx1710)。

摘　　要：目的探讨右归丸联合中药熏蒸治疗肾阳虚型老年膝骨关节炎及其对关节液中骨桥蛋白(OPN)、钙结合蛋白(S100A12)及基质金属蛋白酶-3(MMP-3)的影响。方法选用2018年1月—2020年5月老年肾阳虚型膝骨关节炎患者89例,将其作为观察对象。随机编号的方法分为对照组42例和联合组47例,全部完成治疗和随访。联合组选用右归丸联合中药熏蒸治疗;对照组选用常规疗法,持续治疗4周。比较两组患者的临床疗效,治疗前后分别记录骨关节炎调查量表(WOMAC)、视觉模拟量表评分(VAS)、生存质量测定量表(QOL-BREF)和关节液中OPN、S100A12、MMP-3的水平。结果与对照组比,联合组治疗2周、治疗4周WOMAC评分、VAS评分和QOL-BREF评分较低,差异有统计学意义(P<0.05);与对照组比较,联合组治疗2周、治疗4周关节液中OPN、S100A12和MMP-3水平较低,差异有统计学意义(P<0.05)。联合组的总有效率95.74%(45/42)高于对照组80.95%(34/42),差异有统计学意义(P<0.05)。联合组的恶心呕吐、腹泻、皮疹、肝肾功降低发生率与对照组比较,差异无统计学意义(P>0.05)。结论右归丸联合中药熏蒸治疗肾阳虚型老年膝骨关节炎的疗效确切,可以降低关节液中OPN、S100A12、MMP-3水平,从而提高生活质量,值得大力推广。Objective To investigate the effect of Yougui Pill(右归丸)combined with traditional Chinese medicine fumigation on elderly knee osteoarthritis with kidney yang deficiency and its effect on osteopontin(OPN),calcium binding protein(S100A12)and matrix metalloproteinase-3(MMP-3)in joint fluid.Methods Eighty-nine elderly patients with kidney Yang deficiency type of knee osteoarthritis from January 2018 to may 2020 were selected as the observation objects.The patients were randomly di-vided into 42 cases in the control group and 47 cases in the combined group.The combined group was treated with Yougui Pill combined with traditional Chinese medicine fumigation.The control group was treated with conventional therapy for 4 weeks.The clinical effects of the two groups were compared.The levels of osteoarthritis investigation scale(WOMAC),visual analogue scale score(VAS),quality of life scale(QOL-BREF)and the levels of OPN,S100A12 and MMP-3 in joint fluid were recorded be-fore and after treatment.Results Compared with those of the control group,the WOMAC score,VAS score and QOL-BREF score of the observation group were lower after 2 and 4 weeks of treatment(P<0.05).Compared with those of the control group,the levels of OPN,S100A12 and MMP-3 in joint fluid of the observation group were lower after 2 and 4 weeks of treatment(P<0.05).The total effective rate of the combined group was 95.74%(45/47),which was significantly higher than that of the control group(80.95%,34/42)(P<0.05).The incidence of nausea,vomiting,diarrhea,rash and decreased liver and kidney function in the combined group was not statistically significant compared with that of the control group(P>0.05).Conclusion Yougui Pill combined with traditional Chinese medicine fumigation is effective in the treatment of elderly knee osteoarthritis with kidney Yang deficiency.It can reduce the levels of OPN,S100A12 and MMP-3 in joint fluid,so as to improve the quality of life,which is wor-thy of vigorous promotion.

关 键 词：右归丸 中药熏蒸 肾阳虚型老年膝骨关节炎 OPN S100A12 MMP-3 

分 类 号：R255.6[医药卫生—中医内科学]