补肾散寒止痛汤联合温针灸治疗膝骨关节炎临床研究  

Clinical Study on Bushen Sanhan Zhitong Decoction Combined with Warm Needling Therapy for Knee Osteoarthritis

作　　者：陆春梅 朱晓华 汤李洁 吴山永 LU Chunmei;ZHU Xiaohua;TANG Lijie;WU Shanyong(Department of Chinese Medicine Acupuncture and Moxibustion,Healthcare Group of Haiyan County Hospital of Chinese Medicine,Haiyan Zhejiang 314303,China;Department of Chinese Medicine,The Second Hospital of Jiaxing,Jiaxing Zhejiang 314000,China)

机构地区：[1]海盐县中医院医疗卫生集团中医针灸科,浙江海盐314303 [2]嘉兴市第二医院中医科,浙江嘉兴314000

出　　处：《新中医》2024年第23期64-68,共5页New Chinese Medicine

摘　　要：目的:观察补肾散寒止痛汤联合温针灸治疗膝骨关节炎的疗效。方法:选取78例风寒湿痹型膝骨关节炎患者,按随机数字表法分为观察组及对照组各39例。对照组采用常规西药治疗,观察组采用补肾散寒止痛汤联合温针灸治疗。2组均治疗2个月。比较2组临床疗效及不良反应发生情况、治疗前后中医证候积分、疼痛视觉模拟评分法(VAS)、奎森功能演算指数(Lequesne)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及白细胞介素-1β(IL-1β)水平的变化。结果:观察组临床疗效总有效率为92.31%,对照组为74.36%,2组疗效比较,差异有统计学意义(P<0.05)。治疗后,2组畏寒肢冷、关节僵硬、酸痛沉重、腰膝酸软中医证候积分均较治疗前下降(P<0.05),观察组上述4项中医证候积分均低于对照组(P<0.05)。治疗后,2组VAS评分、WOMAC评分均较治疗前下降(P<0.05),Lequesne评分均较治疗前升高(P<0.05);观察组VAS评分、WOMAC评分均低于对照组(P<0.05),Lequesne评分高于对照组(P<0.05)。治疗后,2组血清TNF-α、IL-6、IL-1β水平均较治疗前下降(P<0.05),观察组上述3项水平均低于对照组(P<0.05)。治疗期间,观察组不良反应发生率为12.82%,对照组为17.95%,2组比较,差异无统计学意义(P>0.05)。结论:补肾散寒止痛汤联合温针灸治疗膝骨关节炎疗效较好,能有效缓解临床症状,改善疼痛和膝关节功能,安全性高。Objective:To observe the curative effect of the combination use of Bushen Sanhan Zhitong Decoction and warm needling therapy on knee osteoarthritis.Methods:A total of 78 patients with knee osteoarthritis of wind-cold-damp blockage type were selected and divided into the observation group and the control group according to the random number table method,with 39 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Bushen Sanhan Zhitong Decoction combined with warm needling therapy based on the treatment of the control group.Both groups were treated for two months.The clinical effects and incidence of adverse reactions,and the changes of traditional Chinese medicine syndrome scores,scores of Visual Analogue Scale(VAS)of pain,Lequesne Index(Lequesne)and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)for joint function,and levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)before and after treatment were compared between the two groups.Results:The total clinical effective rate was 92.31%in the observation group and 74.36%in the control group,the difference being significant(P<0.05).After treatment,the traditional Chinese medicine syndrome scores of fear of cold and cold limbs,stiffness of joint,soreness and sense of heaviness and weakness in the waist and knees in the two groups were reduced when compared with those before treatment(P<0.05),and the above four scores in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of VAS and WOMAC in the two groups were down-regulated when compared with those before treatment,and the Lequesne scores were elevated when compared with those before treatment;the scores of VAS and WOMAC in the observation group were lower than those in the control group,and the Lequesne score was higher than that in the control group(P<0.05).After treatment,the levels of serum TNF-α,IL-6 and IL-1βin the t

关 键 词：膝骨关节炎 风寒湿痹型 补肾散寒止痛汤 温针灸 中医证候积分 

分 类 号：R684.3[医药卫生—骨科学]