白虎加桂枝汤加味治疗膝骨关节炎(湿热痹阻证)的临床观察  

Clinical Study on Modified Baihu plus Guizhi Decoction in the Treatment of Knee Osteoarthritis with Syndrome of Damp-heat Stagnation

作　　者：张壮 周朝清 于丽丽[1] Zhang Zhuang;Zhou Chaoqing;Yu Lili(Macao University of Science and Technology,Macao 999078,China)

机构地区：[1]澳门科技大学,中国澳门999078 [2]广东省珠海市中西医结合医院,广东珠海519000

出　　处：《中国中医急症》2024年第6期1073-1076,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20202172)。

摘　　要：目的观察白虎加桂枝汤加味治疗膝骨关节炎(KOA)(湿热痹阻证)的临床效果。方法选择膝骨关节炎患者100例,参考随机数字表法分为治疗组与对照组各50例。对照组予西医常规治疗;治疗组在对照组基础上予白虎加桂枝汤加味治疗。两组均治疗2周。比较两组临床疗效、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数和疼痛视觉模拟量表(VAS)评分以及血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶(MMP)-13水平。结果治疗后,治疗组总有效率为96.00%,显著高于对照组的80.00%(P<0.05);治疗1周和2周后,两组WOMAC评分显著降低,治疗组降低更显著(P<0.05);治疗后,两组活动和静息时VAS评分均显著降低,治疗组降低更显著(P<0.05);治疗后,两组血清IL-1β、TNF-α、MMP-13水平显著降低,治疗组降低更显著(P<0.05)。结论白虎加桂枝汤加味治疗湿热痹阻证之KOA的临床效果明显,能改善患者的症状体征,减轻疼痛,下调血清IL-1β、TNF-α、MMP-13水平。Objective:To investigate the efficacy of Modified Baihu plus Guizhi Decoction in the treatment of knee osteoarthritis(KOA)with syndrome of damp-heat stagnation.Methods:A total of 100 KOA patients with syndrome of damp-heat stagnation were divided into treatment group and control group by random number table method(50 cases in each).The control group was given conventional western medicine;patients in the treatment group were added with Modified Baihu plus Guizhi Decoction.Both groups were treated for 2 weeks.The treatment effects,scores of Western Ontario and McMaster University(WOMAC)osteoarthritis index and visual analogue scale(VAS),and serum levels of interleukin(IL)-1β,tumor necrosis factor(TNF)-α,matrix metalloproteinase(MMP)-13 were compared between the two groups.Results:After treatment,the total effective rate of the treatment group(96.00%)was significantly higher than that of the control group(80.00%)(P<0.05).After 1 and 2 weeks of treatment,WOMAC scores in two groups were significantly decreased,and those in the treatment group were more significantly decreased(P<0.05).After treatment,the VAS scores at activity and rest were significantly decreased in both groups,and more significantly in the treatment group(P<0.05).After treatment,serum levels of IL-1β,TNF-αand MMP-13 were significantly decreased in two groups,and more significantly in treatment group(P<0.05).Conclusion:Modified Baihu plus Guizhi Decoctionin the treatment of KOA with syndrome of dampheat stagnation is evident,which can improve the symptoms and signs,reduce pain,and down-regulate serum levels of IL-1β,TNF-α,and MMP-13.

关 键 词：膝骨关节炎 白虎加桂枝汤 白细胞介素-1Β 肿瘤坏死因子-α 基质金属蛋白酶-13 湿热痹阻证 

分 类 号：R684[医药卫生—骨科学]