不同温度清凉活化散外敷对膝骨关节炎患者膝关节功能及炎症指标的影响  

Effect of External Application of Qingliang Huohua Powder at Different Temperatures on Knee Joint Function and Inflammatory Indexes in Patients with Knee Osteoarthritis

作　　者：舒琼燕 陈丹[1] 陈艳[1] 王翠娟[1] 赵万军[1] 贾高永 SHU Qiongyan;CHEN Dan;CHEN Yan;WANG Cuijuan;ZHAO Wanjun;JIA Gaoyong(Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou Zhejiang 310007,China)

机构地区：[1]杭州市中医院,浙江杭州310007

出　　处：《新中医》2024年第15期162-166,共5页New Chinese Medicine

基　　金：浙江省中医药科技计划项目(2023ZL531,2023ZL528)。

摘　　要：目的:观察不同温度清凉活化散外敷对膝骨关节炎患者膝关节功能及炎症指标的影响。方法:选取102例膝骨关节炎患者,按随机数字表法分为低温组、常温组及加热组各34例。比较3组临床疗效及不良反应发生情况,比较3组治疗前后中医证候积分、炎症指标值[血清C-反应蛋白(CRP)、白细胞介素-1 (IL-1)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)、红细胞沉降率(ESR)]、疼痛视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、Lyshom评分的变化。结果:治疗后,加热组临床疗效总有效率为97.06%,高于低温组、常温组,差异有统计学意义(P<0.05)。治疗后,3组关节疼痛、关节畏寒、关节发热、关节肿胀、腰膝酸软、倦怠乏力中医证候积分均较治疗前下降(P<0.05),加热组上述6项中医证候积分均低于低温组、常温组(P<0.05)。治疗后,3组血清CRP、IL-1、IL-6、TNF-α、ESR指标值均较治疗前下降(P<0.05),加热组上述5项指标值均低于低温组、常温组(P<0.05)。治疗后,3组VAS评分、WOMAC评分均较治疗前下降(P<0.05),Lysholm膝关节功能评分均较治疗前提升(P<0.05);加热组VAS评分、WOMAC评分均低于低温组、常温组(P<0.05),Lysholm膝关节功能评分高于低温组、常温组(P<0.05)。结论:加热下的清凉活化散(37~45℃)外敷应用于膝骨关节炎治疗中能改善其临床症状,降低炎症反应,缓解疼痛感以及病情程度,提高膝关节功能。Objective:To observe the effect of external application of Qingliang Huohua Powder at different temperatures on knee joint function and inflammatory indexes in patients with knee osteoarthritis.Methods:A total of 102 cases of patients with knee osteoarthritis were selected and divided into the lowtemperature group,the normal temperature group and the heated group according to random number table method,with 34 cases in each group.The clinical effects and adverse reactions were compared among the three groups.The change in traditional Chinese medicine(TCM)syndrome scores,values of inflammatory indexes[serum C-reactive protein(CRP),interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),erythrocyte settlement rate(ESR)],Visual Analogue Scale(VAS)of pain,arthritis indexes of Western Ontario and McMaster University Arthritis Index (WOMAC) and Lyshom scores beforeand after treatment were compared among the three groups. Results:After treatment,the total effectiverate was 97.06% in the heated group, higher than those in the low-temperature group and the normaltemperature group,the difference being significant (P<0.05). After treatment,the TCM syndrome scoresof joint pain,joint chills,joint fever,joint swelling,soreness and weakness of waist and knees,fatigueand lack of strength in the three groups were decreased when compared with those before treatment (P<0.05), and the above six TCM syndrome scores in the heated group were lower than those in the lowtemperaturegroup and the normal temperature group (P<0.05). After treatment,the values of CRP,IL-1,IL-6, TNF- α and ESR in serum in the three groups were decreased when compared with those beforetreatment (P<0.05), and the above five indexes in the heated group were lower than those in the lowtemperaturegroup and the normal temperature group (P<0.05). After treatment,VAS scores and WOMACscores in the three groups were decreased when compared with those before treatment (P<0.05), andLysholm scores of knee joint function were increased when compared with t

关 键 词：膝骨关节炎 清凉活化散 外敷 温度 膝关节功能 炎症指标 

分 类 号：R274.9[医药卫生—中西医结合] R684.3[医药卫生—中医骨伤科学]