人工虎骨粉与玻璃酸钠联合治疗肝肾亏虚型膝骨关节炎的效果分析  

Artificial tiger bone powder enhances efficacy in TCM liver-kidney deficiency patients with knee osteoarthritis treated with intraarticular injection of sodium hyaluronate

作　　者：蒋建新[1] 郑宪友[1] 王骁[2] 陈元元 李莉[3] 虞申[1] 葛京化[4] 赵佳宁 JIANG Jianxin;ZHENG Xianyou;WANG Xiao;CHEN Yuanyuan;LI Li;YU Shen;GE Jinghua;ZHAO Jianing(Department of Orthopedics,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China;Department of Rheumatology,Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Clinical Laboratory,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China;Department of Orthopedics,Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海交通大学医学院附属第六人民医院骨科,上海200233 [2]上海中医药大学附属龙华医院风湿科,上海200032 [3]上海交通大学医学院附属第六人民医院医学检验科,上海200233 [4]上海中医药大学附属龙华医院骨伤科,上海200032

出　　处：《同济大学学报（医学版）》2024年第4期536-542,共7页Journal of Tongji University(Medical Science)

基　　金：海南省东方市医疗健康集团科研项目(YLJTZ002);中央高校专项经费-培育基金(22120180337)。

摘　　要：目的观察人工虎骨粉与玻璃酸钠联合治疗肝肾亏虚型膝骨关节炎的临床疗效。方法按随机数字表法将120例肝肾亏虚型膝骨关节炎患者分为对照组和治疗组,每组60例。对照组患者每周进行一次玻璃酸钠关节腔内注射治疗,治疗组患者在对照组基础上给予人工虎骨粉口服治疗。持续治疗5周后,比较两组治疗前后Lequesne评分、WOMAC评分、膝关节Lysholm评分、膝骨性关节炎症状分级量化表、中医证候评分,采用ELISA法检测两组治疗前后关节液中MMP-3、TIMP-1、IL-1β及TGF-β1水平。结果治疗组总有效率为86.67%,总满意度91.67%,高于对照组(P<0.05)。治疗后,两组Lequesne评分、WOMAC评分、膝骨性关节炎症状分级量化表评分、中医证候评分及MMP-3、IL-1β表达水平显著降低(P<0.05),且治疗组降低程度低于对照组(P<0.05);治疗后,两组膝关节Lysholm评分,关节液TIMP-1、TGF-β1水平较治疗前升高(P<0.05),且治疗组升高水平明显高于对照组(P<0.05)。结论人工虎骨粉与玻璃酸钠治疗肝肾亏虚型膝骨关节炎可明显改善膝关节活动功能,缓解膝骨关节炎的症状,其机制可能与降低关节液中MMP-3、IL-1β水平,升高TIMP-1、TGF-β1的水平相关。Objective To investigate the efficacy of artificial tiger bone powder in TCM liver-kidney deficiency patients with knee osteoarthritis treated with intraarticular injection of sodium hyaluronate.Methods One hundred and twenty TCM liver-kidney deficiency patients with knee osteoarthritis were randomly divided into two groups with 60 cases in each group.Both groups received intraarticular injection of sodium hyaluronate once a week,while the study group was given with additional oral artificial tiger bone powder.After 5 weeks of continuous treatment,Lequesne score,WOMAC score,knee Lysholm score,symptom grading scale of knee osteoarthritis,and TCM symptom score were compared between the two groups before and after treatment,and MMP-3,TIMP-1,IL-1βand TGF-β1 levels in joint fluid of the two groups before and after treatment were detected by ELISA.Results The total effective rate of the study group was 86.67%,the total satisfaction rate was 91.67%,which was higher than those of the control group(P<0.05).After treatment,Lequesne score,WOMAC score,symptom grading scale of knee osteoarthritis,TCM symptom score and expression levels of MMP-3 and IL-1βin two groups were significantly decreased(P<0.05),and the reduction degree in the study group was lower than that in the control group(P<0.05).After treatment,the knee Lysholm score,joint fluid TIMP-1 and TGF-β1 levels in both groups were increased compared with those before treatment(P<0.05),and the increased levels in the study group were significantly higher than those in the control group(P<0.05).Conclusion Artificial tiger bone powder can enhance efficacy of intraarticular injection of sodium hyaluronate in the treatment of liver and kidney deficiency type knee osteoarthritis,with significantly improving knee activity and alleviating symptoms,which may be related to reducing the levels of MMP-3 and IL-1βand increasing the levels of TIMP-1 and TGF-β1 in joint fluid.

关 键 词：人工虎骨粉 玻璃酸钠 肝肾亏虚型膝骨关节炎 

分 类 号：R684[医药卫生—骨科学]