活血化瘀方对创伤性踝关节炎患者关节功能及炎症反应的影响  

Effects of Huoxue Huayu Decoction on joint function and inflammatory response in patients with traumatic ankle arthritis

作　　者：穆岭 郭跃生 赵大伟 姚太顺 孟宪杰 MU Ling;GUO Yue-sheng;ZHAO Da-wei;YAO Tai-shun;MENG Xian-jie(Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471002,Henan,CHINA;Famous TCM MENG Xianjie's Inheritance Studio,Luoyang 471002,Henan,CHINA)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院),河南洛阳471002 [2]名老中医孟宪杰传承工作室,河南洛阳471002

出　　处：《海南医学》2024年第5期658-662,共5页Hainan Medical Journal

基　　金：河南省中医药科学研究专项课题(编号:20—21ZY2249)。

摘　　要：目的 探讨活血化瘀方对创伤性踝关节炎患者关节功能及炎症反应的影响。方法 选取2019年2月至2022年5月于河南省洛阳正骨医院(河南省骨科医院)接受治疗的50例创伤性踝关节炎患者作为研究对象,按随机数表法分为观察组和对照组,每组25例。对照组接受常规治疗,观察组在对照组治疗的基础上予以活血化瘀方治疗,疗程5周。比较两组患者的治疗效果,以及治疗前后的中医症候积分、关节受损情况[Baird-Jackson评分、踝-后足评分(AOFAS)]、炎症因子[血清白细胞介素-6 (IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平、疼痛情况[疼痛视觉模拟评分(VAS)评分]。同时比较两组患者的不良反应发生率。结果 治疗后,观察组患者总有效率为100.00%,明显高于对照组的84.00%,差异有统计学意义(P<0.05);治疗后,观察组患者的疼痛、肿胀、僵硬及功能受限等中医症候积分分别为(0.39±0.14)分、(0.40±0.02)分、(1.13±0.15)分及(0.40±0.09)分,明显低于对照组的(1.01±0.18)分、(1.17±0.12)分、(1.59±0.17)分及(1.31±0.15)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的Baird-Jackson评分和AOFAS评分分别为(89.32±4.25)分、(82.66±5.23)分,明显高于对照组的(82.77±5.34)分、(71.34±3.95)分,差异均具有统计学意义(P<0.05);治疗后,观察组患者的血清IL-6、hs-CRP、TNF-α水平分别为(111.43±36.51) ng/L、(5.10±1.49) mg/L及(87.15±26.51) ng/L,明显低于对照组的(133.59±38.36) ng/L、(6.23±1.52) mg/L及(103.14±29.17) ng/L,差异均有统计学意义(P<0.05);治疗2周和4周后,观察组患者的VAS评分分别为(3.03±0.66)分、(1.72±0.18)分,明显低于对照组的(3.41±0.71)分、(2.24±0.62)分,差异均有统计学意义(P<0.05);两组患者治疗期间不良反应发生率均为4.0%,差异无统计学意义(P>0.05)。结论 活血化瘀方用于创伤性踝关节炎能够显著提高患者的治疗效果,改善临床症状,�Objective To explore the effects of Huoxue Huayu Decoction on joint function and inflammatory response in patients with traumatic ankle arthritis.Methods A total of 50 patients with traumatic ankle arthritis treated in Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital) were enrolled as the research objects between February 2019 and May 2022.According to random number table method,they were divided into a control group(routine treatment) and an observation group(Huoxue Huayu Decoction on basis of control group),with 25 cases in each group.All patients were treated for 5 weeks.The curative effect,scores of TCM syndromes,joint injury [Baird-Jackson,American Orthopedic Foot and Ankle Society(AOFAS)],inflammatory factors[serum interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],pain [Visual Analogue Scale(VAS)] before and after treatment,and incidence of adverse reactions were compared between the two groups.Results After treatment,total response rate of the observation group was significantly higher than that of control group(100.00% vs 84.00%,P<0.05).After treatment,scores of TCM symptoms(pain,swelling,stiffness,functional limitation) in the observation group were(0.39±0.14) points,(0.40±0.02) points,(1.13±0.15) points,and(0.40±0.09) points,significantly lower than(1.01±0.18) points,(1.17±0.12) points,(1.59±0.17) points,(1.31±0.15) points in the control group(P<0.05).After treatment,scores of Baird-Jackson and AOFAS in the observation group were(89.32±4.25) points and(82.66±5.23) points,significantly higher than(82.77±5.34) points,(71.34±3.95) points in the control group(P<0.05).After treatment,levels of serum IL-6,hs-CRP,and TNF-α in the observation group were(111.43±36.51) ng/L,(5.10±1.49) mg/L,and(87.15±26.51) ng/L,significantly lower than(133.59±38.36) ng/L,(6.23±1.52) mg/L,(103.14±29.17) ng/L in the control group(P<0.05).After 2 and 4 weeks of treatment,VAS scores in the observation group were(3.03±0

关 键 词：活血化瘀方 创伤性踝关节炎 中医症候积分 关节功能 炎症反应 

分 类 号：R684.3[医药卫生—骨科学]