益肾壮骨汤内服外敷对膝骨关节炎患者疼痛程度及关节功能的影响  

Effects of oral and external application of Yishen Zhuanggu Decoction on pain severity and joint function in patients with knee osteoarthritis

作　　者：苗青 安海库 康思思 张晓南 刘苗苗 MIAO Qing;AN Haiku;KANG Sisi;ZHANG Xiaonan;LIU Miaomiao(Department of Traditional Chinese Medicine,Zhangjiakou Second Hospital,Zhangjiakou,Hebei 075000;Department of Orthopedics of Traditional Chinese Medicine,Zhangjiakou Second Hospital,Zhangjiakou,Hebei 075000;Patient Return Visit Center,Zhangjiakou Second Hospital,Zhangjiakou,Hebei 075000;Department of Medical,Zhangjiakou Second Hospital,Zhangjiakou,Hebei 075000)

机构地区：[1]河北省张家口市第二医院中医科,河北张家口075000 [2]河北省张家口市第二医院中医骨伤科,河北张家口075000 [3]河北省张家口市第二医院患者回访中心,河北张家口075000 [4]河北省张家口市第二医院医务科,河北张家口075000

出　　处：《河北中医》2024年第6期893-896,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2022年度中医药类科研计划项目(编号:2022529)。

摘　　要：目的观察益肾壮骨汤内服外敷对膝骨关节炎(KOA)患者疼痛程度及关节功能的影响。方法将88例KOA患者按照随机数字表法分为2组,对照组44例予益肾壮骨汤内服,治疗组44例予益肾壮骨汤内服外敷。2组均10天为1个疗程,治疗2个疗程。比较2组疗效;比较2组治疗前后疼痛视觉模拟评分(VAS)、美国膝关节外科学会膝关节功能评分(KSS)及日常生活活动能力量表(ADL)评分变化;比较2组治疗前后血清白细胞介素1β(IL-1β)、基质金属蛋白酶-3(MMP-3)、MMP-13水平变化;比较2组不良反应发生情况。结果治疗组总有效率90.91%(40/44),对照组总有效率72.73%(32/44),治疗组疗效优于对照组(P<0.05)。2组治疗后疼痛VAS较本组治疗前降低(P<0.05),KSS及ADL评分均较本组治疗前升高(P<0.05);治疗后治疗组疼痛VAS低于对照组(P<0.05),KSS及ADL评分均高于对照组(P<0.05)。2组治疗后IL-1β、MMP-3及MMP-13水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组不良反应总发生率2.27%(1/44),对照组不良反应总发生率6.82%(3/44),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论益肾壮骨汤内服外敷治疗KOA,能有效缓解患者膝关节疼痛,促进关节功能恢复。Objective To observe the effects of oral and external application of Yishen Zhuanggu Decoction on pain severity and joint function in patients with knee osteoarthritis(KOA).Methods A total of 88 KOA patients were randomly assigned to receive either oral Yishen Zhuanggu Decoction(control group,n=44)or oral and external application of Yishen Zhuanggu Decoction(treatment group,n=44).The treatment continued for 2 courses(1 course for 10 days),the aim was to compare visual analogue scale(VAS)for pain,the American Knee Society Score(KSS),activities of daily living(ADL)scale,Interleukin 1β(IL-1β),matrix metalloproteinase-3(MMP-3),MMP-13.The curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(90.91%[40/44]vs 72.73%[32/44],[P<0.05],respectively).After treatment,the VAS scores were significantly lower in both groups than that before treatment(P<0.05),the scores of KSS and ADL were significantly higher in both groups than those before treatment(P<0.05),the levels of IL-1β,MMP-3 and MMP-13 in both groups were significantly decreased than those before treatment(P<0.05),and the improvements were more pronounced in the treatment group than those of the control group(all P<0.05).The difference was not statistically significant in the total incidence of adverse reactions between the treatment group and the control group(2.27%[1/44]vs 6.82%[3/44],[P>0.05],respectively).Conclusion For KOA patients,oral and external application of Yishen Zhuanggu Decoction can effectively relieve knee joint pain and promote recovery of joint function.

关 键 词：膝关节炎 益肾壮骨汤 外敷疗法 电磁波理疗 

分 类 号：R684.3[医药卫生—骨科学] R289.6[医药卫生—外科学] R244[医药卫生—临床医学]