富血小板血浆联合补肾活络方治疗膝骨关节炎的临床观察  

Clinical Observation of Platelet-Rich Plasma Combined with Bushen Huoluo Decoction on the Treatment of Knee Osteoarthritis

作　　者：夏同林 张明焕 刘雷 张磊[2] 祁福 毛文 XIA Tonglin;ZHANG Minghuan;LIU Lei;ZHANG Lei;QI Fu;MAO Wen(Wuhan Third Hospital,Wuhan 430070,China;Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,China)

机构地区：[1]武汉市第三医院,武汉430070 [2]武汉市中医医院

出　　处：《中国中医骨伤科杂志》2024年第12期53-57,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:研究富血小板血浆联合中药补肾活络方治疗膝骨关节炎的临床效果。方法:筛查西医诊断为膝骨关节炎且中医辨证为肝肾亏虚证患者120例,分为对照组和观察组(各60例),随机观察。对照组在膝关节腔内单纯使用肌骨超声辅助注射富血小板血浆,观察组则在服用中药补肾活络方汤剂的同时以肌骨超声辅助关节腔注射富血小板血浆治疗,进行5周的联合治疗。对患者临床疗效进行中医病证辨证评估,同时记录治疗前后VAS、WOMAC、SF-36评分的变化。测定关节液中IL-1β水平、IL-6水平、TNF-α水平,对治疗效果进行评估。结果:治疗后VAS、WOMAC和SF-36评分,在两个组别中都有明显的改善,观察组的评分也明显好于对照组。经治疗后,两组患者IL-1β、IL-6、TNF-α水平明显下降,观察组炎症因子水平比对照组明显降低,且与对照组相比疗效更好,差异有统计学意义(P<0.05)。结论:肌骨超声引导下富血小板血浆注射联合补肾活络方能减少炎症因子的表达,改善中医症候,从而改善膝骨关节炎的临床症状,增强治疗效果,对提高患者的生存质量有一定的帮助。Objective:To observe the clinical efficacy of platelet-rich plasma combined with traditional Chinese medicine(TCM)Bushen Huoluo decoction on the treatment of knee osteoarthritis.Methods:A total of 120 patients with knee osteoarthritis diagnosed by Western medicine and liver and kidney deficiency syndrome in TCM were screened and divided into control group and observation group,with 60 cases in each group.The control group was treated with intramuscular bone ultrasound-assisted injection of platelet-rich plasma in the knee joint cavity,and the observation group was treated with intramuscular bone ultrasound-assisted injection of platelet-rich plasma in the knee joint cavity at the same time of taking TCM Bushen Huoluo decoction for 5 weeks.The clinical efficacy of the patients was evaluated by TCM syndrome dialectical evaluation,and the scores of VAS,WOMAC and SF-36 before and after treatment were recorded.The levels of IL-1β,IL-6 and TNF-αin synovial fluid were measured,and the therapeutic effect was evaluated.Results:After treatment,the scores of VAS,WOMAC and SF-36 in the two groups were significantly improved,and the scores of the observation group were significantly better than those of the control group.After treatment,the levels of IL-1β,IL-6 and TNF-αin the two groups were significantly decreased,and the levels of inflammatory factors in the observation group were significantly lower than those in the control group,and the curative effect was better than that in the control group.Conclusion:Platelet-rich plasma injection combined with Bushen Huoluo decoction can reduce the expression of inflammatory factors and improve the TCM symptoms,so as to improve the clinical symptoms of knee osteoarthritis,enhance the therapeutic efficacy,and improve the quality of life of patients.

关 键 词：补肾活络方 富血小板血浆 肌骨超声 膝骨关节炎 

分 类 号：R684.3[医药卫生—骨科学]