消瘀散精简方贴膏治疗膝骨关节炎临床研究  

Clinical Study on the Treatment of Knee Osteoarthritis with Xiaoyusan Simplified Plaster

作　　者：马碧涛[1] 柏萍[1] 滕蔚然[1] 金立伦[1] MA Bitao;BAI Ping;TENG Weiran;JIN Lilun(Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院,上海200092

出　　处：《中国中医药信息杂志》2024年第12期156-162,共7页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家重点专科建设项目(ZJ0901EK013);上海科委项目(19401932000);上海卫健委骨关节病专科联盟[ZY(2021-2023)-03-02-25]。

摘　　要：目的观察探讨消瘀散精简方贴膏治疗膝骨关节炎的临床疗效及对软骨代谢干预的意义。方法采用随机数字表法将105例膝骨关节炎病例随机分为消瘀散精简方组、消瘀散组和双氯芬酸二乙胺组各35例。消瘀散精简方组在肿胀疼痛部位贴敷消瘀散精简方,消瘀散组在肿胀疼痛部位贴敷消瘀散方,以覆盖整个病变部位为宜,24 h换药1次;双氯芬酸二乙胺组在肿胀疼痛部位均匀涂抹双氯芬酸二乙胺乳胶剂,每日3次;3组均2周为1个疗程,连续治疗2个疗程。观察3组临床疗效,比较3组治疗前后视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、膝关节活动度及软骨代谢指标血清透明质酸(HA)、Ⅱ型胶原、血清人软骨寡聚基质蛋白(COMP)、尿Ⅱ型胶原C端肽(CTX-Ⅱ)的含量改变。监测3组安全性指标。结果消瘀散精简方组、消瘀散组总有效率均为97.1%(33/34),优于双氯芬酸二乙胺组的81.8%(27/33),3组比较差异有统计学意义(P<0.05)。消瘀散精简方组和消瘀散组患者治疗后VAS评分、WOMAC评分、坐-立5次时间明显低于双氯芬酸二乙胺组(P<0.05);消瘀散精简方组和消瘀散组在延缓HA含量降低程度及COMP含量升高程度上优于双氯芬酸二乙胺组(P<0.05);消瘀散精简方组和消瘀散组治疗4周VAS评分、WOMAC评分、膝关节活动度及骨代谢指标含量差异无统计学意义(P>0.05)。3组治疗前后血尿常规、肝肾功能及心电图检查无异常。结论消瘀散精简方与消瘀散功效相当,能减少膝骨关节炎患者疼痛,增加患者膝关节活动度及日常生活能力,延缓软骨组织的损伤代谢。Objective To observe the clinical efficacy of Xiaoyusan simplified plaster in the treatment of knee osteoarthritis and the significance of intervention in cartilage metabolism.Methods Totally 105 patients with knee osteoarthritis were divided into Xiaoyusan simplified prescription group,Xiaoyusan group and diclofenac diethylamine group according to random number table method.Xiaoyusan simplified prescription group:Apply it to the swollen and painful area,covering the entire lesion area,and change the dressing every 24 hours;Xiaoyusan group:Apply it to the swollen and painful area,covering the entire lesion area,and change the dressing every 24 hours;diclofenac diethylamine group:Apply evenly to the swollen and painful area,3 times a day;all the groups were treated for 2 courses(4 weeks).The changes of VAS score,WOMAC score,knee joint activity and the content of cartilage metabolism index HA,typeⅡcollagen,COMP and CTX-Ⅱbefore and after treatment were compared.Safety indicators of the three groups were monitored.Results The total effective rates of Xiaoyusan simplified plaster group and Xiaoyusan group were all over 97.1%(33/34),better than the diclofenac diethylamine group(81.8%,27/33),with statistical significance in the three groups (P<0.05). Xiaoyusan simplified plaster group and Xiaoyusan groupwere superior to diclofenac diethylamine group in VAS score, WOMAC score, sitting-standing 5 times time (P<0.05);Xiaoyusan simplified plaster group and Xiaoyusan group were superior to diclofenac diethylamine group in delayingthe decrease of HA content and the increase of COMP content, with statistical significance (P<0.05). After treatment,there was no significant difference in VAS score, WOMAC score, knee joint activity and bone metabolism indexcontent between Xiaoyusan simplified plaster group and Xiaoyusan group (P>0.05). The blood routine, urine routine,liver function, kidney function and electrocardiogram examinations before and after treatment in the three groupswere all normal. Conclusion Xiaoyusan simplified

关 键 词：膝骨关节炎 软骨代谢 消瘀散精简方 

分 类 号：R274.94[医药卫生—中西医结合]